The hypothalamic path to obesity

Obesity is a growing public health concern, affecting an estimated 11% of children in Western society. The impact of obesity-related morbidity and mortality on society is significant, with both genetic and environmental factors contributing to its development. In most individuals, food intake and energy expenditure are tightly regulated by a feedback system comprising a number of hormonal and central nervous system pathways. Leptin released from adipocytes acts on hypothalamic neurons to release proopiomelanocortin (POMC), leading to a cascade of neuronal and hormonal events that inhibit feeding behavior. Specific gene mutations in the leptin/POMC pathways account for only 5% of all cases of obesity, and most cases of familial or idiopathic obesity are polygenic in origin. Although further research to identify specific genetic causes of obesity may lead to more tailored therapies, significant changes in societal and individual behavior are needed to stop the obesity epidemic from progressing.