Energy balance
Common obesity is primarily driven by increased energy intake due to a changing food environment overwhelming homeostatic feedback, rather than defective homeostatic regulation.
Focus on the environment. Since homeostatic regulation is likely intact but overwhelmed, successful weight management requires changing the food environment (e.g., reducing access to hyper-palatable foods) and managing hedonic/cognitive triggers, rather than assuming a biological defect.
These observations, along with little direct evidence of decreased physical activity from the late 1970s, suggest that increased food intake is likely to be the primary driver of obesity.
Why this rating
Based on population-level trends and lack of evidence for decreased activity, though individual variability exists.
Source
Dynamic Interplay Among Homeostatic, Hedonic, and Cognitive Feedback Circuits Regulating Body Weight
Kevin D. Hall et al. · American Journal of Public Health · 2014
DOI 10.2105/ajph.2014.301931
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