Clinical Obesity in Adults and Children. Группа авторов

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OHS obesity hypoventilation syndrome OR odds ratio OSA obstructive sleep apnea PAI‐1 plasminogen activator inhibitor‐1 PCOS polycystic ovary syndrome PHT pulmonary hypertension PMF protein‐modified fast POMC pro‐opiomelanocortin PP pancreatic polypeptide PSG polysomnography PTP1B protein tyrosine phosphatase 1B PUFA polyunsaturated fatty acids PVN paraventricular nucleus PWS Prader–Willi syndrome QOL quality of life R_a rate of appearance RBP‐4 retinol binding protein‐4 REE resting energy expenditure REM rapid eye movement RMR resting metabolic rate ROS reactive oxygen species RPE rating of perceived exertion RQ respiratory quotient RR relative risk RYGB Roux‐en‐Y gastric bypass SCFAs short chain fatty acids SD standard deviations SES socio‐economic status SFA saturated fatty acids SHGB sex hormone‐binding globulin SNP single nucleotide polymorphisms SNS sympathetic nervous system SPA spontaneous physical activity T1DM type 1 diabetes mellitus T2DM type 2 diabetes mellitus TCRFTA temperature‐controlled radiofrequency ablation to the tongue base and palate TEF thermic effect of food TG triacylglycerol/triglyceride TIMP tissue inhibitor of metalloproteinase TRH thyrotropin‐releasing hormone TSH thyroid‐stimulating hormone UCP‐1 uncoupling protein 1 UPPP uvulopalatopharyngoplasty VAI visceral adiposity index VAT visceral adipose tissue VBG vertical banded gastroplasty VEGF vascular endothelial growth factor VLCD very low‐calorie diets VLDL very low‐density lipoprotein VLED very low‐energy diets VMH ventromedial hypothalamus WAT white adipose tissue WC waist circumference WHO World Health Organization WHR waist/hip ratio

1 Obesity

1 Obesity – Introduction: History and the Scale of the Problem Worldwide

       W. Philip T. James1 and Tim Gill2

      ¹ Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK

      ² Boden Initiative, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia

      Obesity is a complex condition and, although much remains to be elucidated, our understanding of the many facets of overweight and obesity has advanced greatly over the last few decades. Current research is often focussed on the genetic and molecular patho‐physiological drivers which derange energy balance and lead to excess body fat, but it is important that clinicians have an appreciation of the history and context of these findings and an awareness of the significant challenges created by the different features of obesity that continue to be revealed. Different patterns of obesity emerging across the world may also have different impacts on the public health burden and may require a different approach to the development of prevention and treatment strategies.

      The condition of obesity has been recognized for millennia, and its historical context was described in detail by George Bray [1], who

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