The etiopathogenesis and management of obesity: The quintessential quincunx

Authors

  • Sanjay Kalra Department of Endocrinology, Bharti Hospital, Karnal, India; University Center for Research & Development, Chandigarh University, Mohali, India.
  • Jubbin Jacob Department of Endocrinology, Christian Medical College, Ludhiana, Punjab, India.
  • Saurabh Arora Department of Endocrinology, Dayanand Medical College, Ludhiana, Punjab, India.
  • Nitin Kapoor Department of Endocrinology, Diabetes and Metabolism Christian Medical College & Hospital, Vellore, Tamil Nadu, India, Non communicable disease unit, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia

DOI:

https://doi.org/10.47391/JPMA.23-36

Keywords:

Anti-obesity medication, bariatric medicine, bariatric surgery, barocrinology, obesity, person-centred care, semaglutide, tirzepatide

Abstract

This communication uses the quincunx, i.e, a quadruple  surrounding a central point, to create a model that describes the etiopathogenesis, as well as informs the management strategy of obesity.

With the energy fulcrum (mismatch between energy intake and expenditure) at its centre, the model lists two external influencers-the physical environment and psychosocial environment, and two internal influencers- the hypothalamo-bariatric axis and the endocrine system, to explain the etiopathogenesis of obesity. Genetics factors are included with the hypothalamo-bariatric axis. The same model can be used to explain the five pillars of management: lifestyle and nutritional modification at the centre, along with environmental optimization, behavioural therapy, baro-thalamic modulation, and endocrine optimization

Keywords: Anti-obesity medication, bariatric medicine, bariatric surgery, barocrinology, obesity, person-centred care, semaglutide, tirzepatide

Published

2023-04-15

How to Cite

Sanjay Kalra, Jubbin Jacob, Saurabh Arora, & Nitin Kapoor. (2023). The etiopathogenesis and management of obesity: The quintessential quincunx. Journal of the Pakistan Medical Association, 73(05), 1134–1136. https://doi.org/10.47391/JPMA.23-36

Issue

Section

BAROCRINOLOGY

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