Obesity

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sychological Status
Dysphoric mood state and weight status are frequently related (31). The data analysis from the National Health Epidemiological follow-up study to the first National Health and Nutrition Survey revealed that depression played a substantial role in the patterns of weight change in US adults (34). Persons who gain weight with one episode of depression tend to gain weight with the next, just as persons who tend to lose weight with depression have a similar response with the next occurrence of depression (35). The use of medications to modify psychiatric dysfunction with resultant weight modification is discussed above (31). Studies have indicated that brain serotonin is critically involved in controlling mood, and many patients learn they can transiently reduce depressive symptoms by eating. This is frequently seen in seasonal affective disorder, premenstrual syndrome, and nicotine withdrawal (36).

Genetics
Advancements in the field of genetics and obesity may lay the groundwork for the development of effective pharmacotherapy. Evidence for a strong genetic contribution of human obesity comes from a variety of sources. Twin and familial aggregation studies suggest that genetic factors account for 60% to 80% of the predisposition to obesity (16-19). The genetic basis of obesity has also been shown in animal studies. In general, genes that influence body weight encode the molecular components of the physiological system that regulates body weight. In animals single-gene mutations usually produce massive obesity (20). The ob gene or leptin gene codes for a protein called “leptin.” Leptin is a circulating hormone secreted by fat cells that signals the level of energy reserves to the hypothalamus. Cloning of the leptin gene was a breakthrough in understanding one form of obesity that has been identified in humans (21,22). Nearly all individuals with obesity exhibit an excess of circulating leptin in direct proportio...