Ten putative contributors to the obesity epidemic

Area of Science:

• Obesity research
• Epidemiology
• Public health

Background:

• The global obesity epidemic persists with unclear causes.
• Current focus on diet and physical activity lacks definitive causal evidence.
• Existing public health efforts may overlook other significant contributors.

Purpose of the Study:

• To review alternative and emerging etiological factors in obesity.
• To challenge the dominance of traditional factors in research funding and public health initiatives.
• To advocate for broader consideration of obesity's complex causes.

Main Methods:

• Systematic review of scientific literature.
• Analysis of evidence for various putative obesity contributors.
• Synthesis of findings on emerging and under-recognized factors.

Main Results:

• Evidence reviewed for microorganisms, epigenetics, maternal age, fecundity, assortative mating, sleep debt, endocrine disruptors, pharmaceutical iatrogenesis, temperature variability, and intrauterine/intergenerational effects.
• Strong evidence exists for pharmaceutical-induced weight gain.
• Emerging evidence supports other reviewed factors as potential contributors.

Conclusions:

• Obesity's etiology is multifactorial, extending beyond diet and physical activity.
• Broader investigation of diverse factors is crucial for effective obesity prevention and treatment.
• Cause-specific strategies informed by comprehensive etiological understanding are needed.