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Obesity and metabolism.

Obesity and metabolism, M. Korbonits, editor (S. Karger AG, Basel, Switzerland) 2008. 294 pages.

Price: US $ 289.00

ISBN 978-3-8055-8429-6

Obesity is the scourge of modern civilization contributing to more deaths worldwide than any other known condition. The complex aetiopathogenesis of obesity is gradually unravelling before mankind with advances in molecular biology and genetics opening up new management avenues; this forms the basis of Obesity and Metabolism. The book has been divided into 18 chapters with 35 authors contributing to the effort. The initial part deals with the genetic basis of obesity delving into monogenic causes involving leptin, POMC, MC4R, etc., as well as polygenic ones. The detailed dissection of culprit genes at times gets a bit difficult to grasp for the practitioner but is a veritable goldmine for researchers on the subject. The chapter titled "Genetic Obesity Syndromes" deals brilliantly with the genotypic and phenotypic characteristics of affected individuals with special emphasis on Prader-Willi syndrome. The book vividly describes the developmental origins of obesity right from maternal factors affecting the conceptus to the effects of infant nutrition. An outstanding chapter titled "Obesity in Old Age" outlines the basis, consequences and management of obesity in the elderly. The long appreciated association between type 2 diabetes mellitus and obesity has been exhaustively dealt with as has been the role of endocannabinoid system and lip HSD in energy regulation and obesity. The position of gut hormones and adipokines has been delineated with particular advertence to ghrelin, PYY and leptin and their prospective pharmacotherapeutic denouement. The pathophysiologic role of AMP kinase has been extensively discussed with allusion to its selective modulation which might be the Holy Grail for future drug researchers. The closing chapters move from the realm of research to clinical practice with vignettes of the association of hypothyroidism, PCOS, Cushing's syndrome and hypothalamic disorders with obesity.

The chapter on obesity treatment focusses on bariatric surgery and provides interesting insights into future molecules like recombinant variant ciliary neurotrophic factor. However, the information on Rimonabant and Sibutramine is a tad outdated following the FDA ban and SCOUT result publication respectively. About 2000 years ago, Cicero had famously remarked, "One should eat to live, not live to eat", but societal influences have resulted in just the opposite culminating in the manmade pandemic of obesity. The "Sociology of Obesity" forms the penultimate chapter of this book. The book ends in a lighter vein elucidating the reflection of the obese human anatomy in the works of artists which also sheds light on the chronological evolution of obesity.

The book makes for an intriguing read and is well balanced. The elaborate dissertation on molecular and genetic concepts might be of particular interest to researchers but clinicians will also gain from its knowledge base. In conclusion, the book sheds light on the profound complexities of obesity and has the potential to stimulate the development of more effective and innovative techniques for its management.

Subhankar Chowdhury

Department of Endocrinology & Metabolism

Institute of Postgraduate Medical

Education & Research and SSKM Hospital

244, A.J.C. Bose Road

Kolkata 700 020, India
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Author:Chowdhury, Subhankar
Publication:Indian Journal of Medical Research
Article Type:Book review
Date:Jun 1, 2011
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