"Once you reach a certain age, almost everybody is leptin resistant," he says. "Nature stops protecting you once you pass the reproductive years," requiring all of us to watch our diets and do exercise.

Unger's perspective comes from the research he does at UT Southwestern's Touchstone Center for Diabetes Research and a thorough understanding of the scientific literature, but it also stems from his own memories in childhood when one only saw fat ladies at the circus. "That's how unusual it was," he says. "The younger you are, the more skewed your perception is of an epidemic that surrounds you."

Unger concludes his review article this way: "Based on evidence reviewed here, it seems that prevalent forms of metabolic syndrome and T2DM [type 2 diabetes mellitus] result from unremitting caloric surplus complicated by failure of adipocytes to maintain protection against lipotoxicity. If one imagines the USA population to be unwitting volunteers in the largest (300 million subjects) and longest (50 years) clinical research project in history, the specific aim of which was to determine if the deleterious effects of sustained caloric surplus in rodents also can occur in humans, the outcome of the project becomes clear-after 50 years of exposure to an inexpensive calorie-dense diet high in fat and carbohydrates, 200 million subjects are overweight and >50 million have metabolic syndrome. The failure of healthcare providers and pharmaceutical industries to contain the pandemic suggests that elimination of 'bargain basement' calories will be required to 'price obesity out of the market.' Unfortunately, this would have profound socioeconomic implications: How do we tax excessive calories while at the same time guaranteeing sufficient access to high-quality foods for the underprivileged?"

Scherer et al.: "Gluttony, sloth and the metabolic syndrome: a roadmap to lipotoxicity.'"

Source: Cell Press