Interpreting physiology to prevent pathologies associated with obesity and diabetes

Abstract

Katarina T. Borer

The approach by medicine and associated sciences dealing with the pathologies produced by obesity and Type 2 diabetes (T2D) has predominantly focused on the treatment rather than the prevention of the two health conditions. Both pharmacological and surgical approaches have been used in the treatment of both obesity and T2D. None is completely successful without incurring substantial side-effects including the option of permanent changes to the gastro-intestinal anatomy and physiology. This review puts forward for consideration two ideas: (1) That some of the failures in addressing prevention of obesity and T2D are the result of incorrect characterization of the neuroendocrine control of feeding and regulation of body weight, and (2) that there is a knowledge gap in how the capacity of the pancreas and adipose tissue, key organs in the pathologies of obesity and T2D, may be modified during two important periods of tissue proliferation, the second trimester of fetal development, the pre-pubertal growth spurt, and also possibly during recovery from substantial weight loss.