Thursday, November 19, 2009

Etiological Assessment of Obesity

Regular readers of these pages may recall an earlier post in which I emphasized the importance of not just describing behaviours (this patient eats too much) but rather actually attempting to determine the root causes of these behaviours (why does this patient eat too much?).

I also suggested that obesity can best be conceptualized as the physical manifestation of chronic energy excess.

In fact, using the analogy of oedema, the consequence of positive fluid balance or fluid retention, I explained that obesity can be seen as the consequence of positive energy balance or calorie ‘retention’.

I further recommended that just as the assessment of oedema requires a comprehensive assessment of factors related to fluid balance, the assessment of obesity requires a systematic assessment of factors potentially affecting energy intake, metabolism and expenditure.

The full paper describing this concept has now been published as an early release on OBESITY REVIEWS.

I believe that this paper provides an aetiological framework for the systematic assessment of the socio-cultural, biomedical, psychological and iatrogenic factors that influence energy input, metabolism and expenditure.

The full paper discusses factors that affect metabolism (age, sex, genetics, neuroendocrine factors, sarcopenia, metabolically active fat, medications, prior weight loss), energy intake (socio-cultural factors, mindless eating, physical hunger, emotional eating, mental health, medications) and activity (socio-cultural factors, physical and emotional barriers, medications).

Based on my own experience of using this framework in my practice, I anticipate that clinicians will find this approach helpful in systematically assessing, identifying and thereby addressing the aetiological determinants of positive energy balance.

I very much hope that application of this framework will ultimate result in more effective obesity prevention and management.

As always, comments are most welcome.

Toronto, Ontario

VN:F [1.9.22_1171]
Rating: 10.0/10 (1 vote cast)
VN:F [1.9.22_1171]
Rating: +3 (from 3 votes)
Etiological Assessment of Obesity, 10.0 out of 10 based on 1 rating

5 Responses to “Etiological Assessment of Obesity”

  1. Anonymous says:

    I like this comprehensive approach.

    I would like to learn more details of how prior weight loss affects metabolism.

    Thank you for your work Dr Sharma.

  2. Yoni Freedhoff says:

    I’ve always loved this analogy of yours Arya.

    Great work getting it published.


  3. Mahri says:

    Chronic energy excess has no ‘failure’ in its definition. Only a sign! Brilliant. This really helps me use this term with my clients. They HATE the word Obese. Thank you for your very interesting research, education and kind heart! Mahri

  4. Mary Forhan says:

    Congratulations on a v. interesting and important paper. This article
    is effective in highlighting the complexity of obesity and the need for
    interprofessional health teams for the treatment of obesity. This is an
    article I could use with students to demonstrate the application of
    rehabilitation principles to the treatment of obesity. I was reminded
    of the conceptual model of obesity drivers out of the UK while reading
    your paper. The framework that you are proposing considers a number of
    factors driving obesity in the UK model that need to be looked at
    Well done

  5. Who Helps Canadians Manage Their Weight? | Dr. Sharma's Obesity Notes says:

    [...] Indeed, weight management plans too often follow along the lines of well-meant but often ineffective diet or exercise recommendations, that virtually always fail to address the actual root of the problem (see my post – overeating is a symptom). [...]

Leave a Comment

In The News

Diabetics in most need of bariatric surgery, university study finds

Oct. 18, 2013 – Ottawa Citizen: "Encouraging more men to consider bariatric surgery is also important, since it's the best treatment and can stop diabetic patients from needing insulin, said Dr. Arya Sharma, chair in obesity research and management at the University of Alberta." Read article

» More news articles...


  • Subscribe via Email

    Enter your email address:

    Delivered by FeedBurner

  • Arya Mitra Sharma
  • Disclaimer

    Postings on this blog represent the personal views of Dr. Arya M. Sharma. They are not representative of or endorsed by Alberta Health Services or the Weight Wise Program.
  • Archives


  • RSS Weighty Matters

  • Click for related posts

  • Disclaimer

    Medical information and privacy
    Any medical discussion on this page is intended to be of a general nature only. This page is not designed to give specific medical advice. If you have a medical problem you should consult your own physician for advice specific to your own situation.

  • Meta

  • Obesity Links

  • If you have benefitted from the information on this site, please take a minute to donate to its maintenance.

  • Home | News | KOL | Media | Publications | Trainees | About
    Copyright 2008–2015 Dr. Arya Sharma, All rights reserved.
    Blog Widget by LinkWithin