Etiologic Factors in Obesity and Leanness
In recent years the literature placed before the pediatric audience has belabored the role of psychogenic factors in the causation of obesity. This stimulating essay shows promise that this spell is to be broken. In the past the obese person has been pictured as an individual who is the victim of a disordered personality. Insufficient attention has been given to inherent difficulties in the metabolic systems which govern exchange of energy in the body. This paper challenges the concept that obesity is generally due simply to overeating. A review is given of possible variations in efficiency of phosphorylation; aerobiosis versus anaerobiosis; variations in energy utilization and variations in lipogenesis, any of which may be attributes of the person prone to obesity or leanness. It is emphasized that the maintenance of an optimal body weight by an individual is the result of the algebraic sum of 1) hereditary traits affecting metabolic reactions and 2) the environmental and cultural influences, which may act in conjunction with the former to predispose to either obesity or leanness. One may conjecture that we shall ultimately come to view the simple restriction of intake to be as ruthless a therapy for the obese as we have discovered the simple restriction of carbohydrate to be ridiculous as a treatment for juvenile diabetes mellitus.
