Handbook of Eating Disorders: Physiology, Psychology, and Treatment of Obesity, Anorexia, and Bulimia

By Kelly D. Brownell; John P. Foreyt | Go to book overview

3
A Set-point Theory
of Obesity

Richard E. Keesey

Obesity is regarded by many as a behavioral problem, stemming principally from disordered eating habits. Behavioral therapy, with the goal of modifying maladaptive eating patterns, thus constitutes the most common form of treatment. But the resistance of obesity to such treatment raises concern that its origins may not be behavioral.

This chapter explicates a "set-point" model of energy regulation in contrast to the more traditional behavioral perspective. Body weight (BW) is treated as a physiological variable regulated at a specified level, or "set point." The adjustments in energy flux stabilizing weight at this level, the physiological mechanisms determining set point, and possible ways of changing the set point value are discussed. The proposal that obesity represents a condition of regulation at an elevated set point is then considered. Three animal forms of obesity are examined, and each is evaluated with respect to whether it is physiologically regulated or the product of regulatory failure. This line of inquiry is extended to obese humans where proposals are made both for diagnosing the etiology of each patient's obesity and for selecting appropriate treatment.

____________________
This research was supported in part by National Institutes of Health grant AM 19944. The author gratefully acknowledges the many helpful suggestions and criticisms of this manuscript contributed by Dr. S. W. Corbett and Dr. T. R. Vilberg.

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