Resumo

LASTRA LASTRA, Guido  e  LASTRA GONZALEZ, Guido. Obesity: epidemy of new millennium. rev.fac.med. [online]. 2005, vol.53, n.3, pp.186-195. ISSN 0120-0011.

Obesity is one of the oldest diseases in the world. Nevertheless, the importance of this true epidemic and its unfortunate pathological associations have been called into attention since relatively a short time ago. Even if energy storage in early times allowed survival of mankind during starvation times, the hormonal machinery responsible for this has turned against us in modern days, due to industrialization, sedentarism and overfeeding that characterises industrialized societies. Therefore, the dream of our ancestors, food easily available with less physical work, has turned into a nightmare. More than 450 genes work together to produce a great number of hormonal factors that regulate energyhomeostasis, and their variation is the cornerstone of obesity. Hypertrophied and dysfunctional adipocytes produce adipokines that alter glucose metabolism, predispose to the diabetes mellitus type 2 and can also damage vascular endothelium, making obesity a chronic low grade proinflammatory state. Development of different strategies for treatment of this multifactorial disease necessarily implies a reduction in energy storage, and an increase in its expenditure. In the long term, definitive treatment of obesity might result from advances related to molecular biology development. Nonetheless, that horizon is very distant at the present time, and knowledge of the serious complications of obesity, educational efforts, and changes in our environment and lifestyle are critical to face the challenge of obesity.

Palavras-chave : obesity; diabetes mellitus; adipose tissue; basal metabolism; thermodynamics; hyperphagia; public health; appetite, satiation.

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