Abstract
Recent advances in knowledge about the control of appetite and energy expenditure have revolutionised our understanding of obesity as a disease. Far from being simply the result of poor individual self-control, obesity has its roots in a natural selection process, operating over millennia, that has favoured a predisposition to store excess dietary energy when food supply is unreliable. Only since industrialization has made inexpensive, highly palatable, energy-dense foods available to a sizeable proportion of the global population has this genetic inheritance turned into a liability. This review describes the role of hormones, and their interactions with the central nervous system, in regulating appetite and energy expenditure, and builds on this to examine current and possible future obesity therapies. © 2013 Elsevier Ltd. All rights reserved.