Obesity 2021: Rejecting Old Misconceptions and Embracing a New Paradigm to Improve Outcomes

Caren Mangarelli*

*Corresponding author for this work

Research output: Contribution to journalComment/debatepeer-review


Despite the best efforts of many health care workers and increasing knowledge about the human energy regulatory system and dietary and exercise science, rates of obesity continue to rise. In the past 40 years, not a single country in the world has experienced a reduction in the prevalence of obesity. Over these same 40 years, treatment options such as medications, as well as bariatric and other surgical procedures, have continued to expand. Why then, are we not seeing more improvement in obesity outcomes? This commentary hypothesizes that it is due to a combination of factors. These factors include an individual's genetic predisposition combined with the modern obesogenic environment, an energy regulatory system that defends fat mass and fights loss, obesity not being seen as a disease state, and individual and societal weight bias. (Clin Ther. 2021;43:XXX–XXX)

Original languageEnglish (US)
Pages (from-to)1147-1153
Number of pages7
JournalClinical Therapeutics
Issue number7
StatePublished - Jul 2021


  • Energy regulatory system
  • Obesity
  • Obesogenic environment
  • Outcomes
  • Weight bias

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)


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