Sunday, February 16, 2014

Obesity, a Complex Disorder

I am going to put forth a thought that obesity is a complex disorder where the resolution is going to involve the complex interplay of several hormonal processes. I recently read Dr. Sharma's blog where he describes persistent weight loss as trying to run down the up escalator.

This fight against our own body's processes reminds me of a battle I had with the thermostat in our old apartment. It was a fancy thing, designed to keep temperature constant between a range of high and low temperatures. It had a flaw however. If temperatures snuck above the high setting, the furnace would blow full blast until it got cooler. Think about that for a minute. Our solution? If it were a cool day, we would open every window in the house in the hopes of beating the furnace. If it was a hot day, we would have to set the thermostat above the ambient temperature. Over the next few days, I would gradually lower the higher setting on the thermostat, as the apartment cooled. It was a trick to fix a flaw.

I have also been thinking of the complex interplay of hormones that regulate hunger and weight. The miracle of insulin was solved when the discoverers realized it has a balanced relationship with glucose. Neither can be too high.
This is a two-way relationship, complex enough to figure out. But what if the relationship between hunger and weight gain were even more complex; two-way, three-way or even more?;postID=7809158473050261965
Nicholas Perony's Bats 

With a system that complex, how might we ever disentangle it? There's Cortisol, Leptin, Ghrelin, Insulin, Estrogen and Progesterone. There could be as many as forty hormones involved. It should not be surprising that so many processes are involved in eating, acquiring energy and storing it. Doing this efficiently is critical to our survival. I am reminded of Penfield's bain map.
Representation of Penfield's Brain Map
 We dedicate a good many of our resources to this interplay. It's complex, and it's central to our survival.

So again, back to the disentangling. Perhaps this could be mapped out using the new technology that allows us to build analogues of bodily systems; organs on a chip.

If we build a successful analogue that replicates the body's propensity to obesity (at least among a percentage of the population or under certain conditions), we can then more readily test adding or subtracting the various hormones/foods/interplays.

Perhaps the answer will be to add a new artificial organ/hormone, to create a "too high" setting on our thermostat. A trick to fix a flaw in our makeup.