Revisioning Obesity

The current ANS featured article is titled “Revisioning Obesity in Health Care Practice and Research: New Perspectives on the Role of Body Temperature” authored by Mary Madeline Rogge, PhD, RN, FNP, BC; and Bibha Gautam, PhD, RN, CNE. While it is featured you can download the article at no cost! Here is some background that Dr. Rogge shared for ANS readers:

Our area of interest is obesity, especially the problem of obesity recidivism.  Intensive efforts to promote healthy eating and higher physical activity, alone or in conjunction with pharmacologic agents or surgical interventions, have failed to quell obesity prevalence. Furthermore, decades of research have shown weight loss produced by a negative energy balance, or caloric intake below energy expenditure, is attended by a reduction in the basal metabolic rate that suppresses further weight loss and promotes fat recovery.  This annoying but consistent outcome suggests to us that obesity may serve a functional, protective function.  Furthermore, if excess fat serves a functional purpose, losing weight in obesity that does not resolve the underlying environmental stimulus may exacerbate the biological drive to gain more fat.  Based on this framework, we surveyed the literature in search of antecedents or precursors of weight gain, adipogenesis, or increased fat mass that could explain intractable obesity.

Our research revealed that a major function of adipose tissue is maintenance of core body temperature, and the body’s temperature regulation is highly integrated with body mass and energy expenditure.  White adipose tissue reduces heat loss through the skin, while brown adipose tissue dissipates or disperses heat.  Increasing body temperature activates temperature-sensitive hypothalamic receptors to reduce food intake and simultaneously stimulates brown adipose tissue energy dispersal.  Hypothalamic detection of cooler body temperature stimulates food consumption and lowers energy expenditure.

Other research shows normal body temperature in Americans has declined in men and women over the past century, which could explain the concomitant rise in the population’s adiposity.  Increased exposure to air-conditioning also corresponds to the acceleration of obesity rates during the same time frame.  We also found research that demonstrates exposure to whole-body warm ambient temperature is associated with fat loss in human subjects.

We conclude declining core body temperature and lower ambient temperature may be an important contributor to intractable obesity.  Revisioning clinical obesity as a problem of adaptation to pervasive low ambient temperature offers a new perspective for obesity research and management.