Abstract

The worldwide epidemic of obesity has become an important public health issue, with serious psychological and social consequences. Obesity is a multifactorial disorder in which various elements (genetic, host, and environment), play a definite role, even if none of them satisfactorily explains its etiology. A number of neurological comorbidities, such as anxiety and depression, charges the global obesity burden, and evidence suggests the hypothesis that the brain could be the seat of the initial malfunction leading to obesity. The gut microbiome plays an important role in energy homeostasis regulating energy harvesting, fat deposition, as well as feeding behavior and appetite. Dietary patterns, like the Western diet, are known to be a major cause of the obesity epidemic, probably promoting a dysbiotic drift in the gut microbiota. Moreover, the existence of a “gut–brain axis” suggests a role for microbiome on hosts’ behavior according to different modalities, including interaction through the nervous system, and mutual crosstalk with the immune and the endocrine systems. In the perspective of obesity as a real neuropsychological disease and in light of the discussed considerations, this review focuses on the microbiome role as an emerging director in the development of obesity.

Highlights

  • Obesity is an abnormal or excessive fat mass accumulation that affects the health status.The worldwide epidemic of obesity has become an important public health issue, with serious psychological and social consequences since, worldwide, over 650 million adults and 340 million children and adolescents are obese [1]

  • In the perspective of obesity as a real neuropsychological disease and in light of the discussed considerations, this review focuses on the microbiome role as an emerging director in the development of obesity

  • All these data suggest the presence of a deep link between the composition of the microbiota and the development of obesity

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Summary

Introduction

Obesity is an abnormal or excessive fat mass accumulation that affects the health status. Obesity is a multifactorial disorder which is a result of the interaction of host and environmental factors and its prevalence in high income and upper middle-income countries is more than double that of low and lower middle income countries [4] Because of that, it constitutes a social problem, especially in those upper middle-income countries, not just affecting the welfare state, and creating issues in terms of social relations and acceptance, and personal development. By considering the complex nature of the pathology (from genetic factors to behavioral and social ones) and given the poor effectiveness of many pharmacological and nutritional approaches, some researchers suggest that “behavioral dimension” should not be neglected, in order to develop new approaches, both preventive and therapeutic, that include obesity within neuropsychological syndromes [5]. We used our judgment to select articles, sum evidences, and interpret results

Why a Neuropsychological View of Obesity?
Neurobiological Aspects of Obesity’s Pathogenesis
Obesity
Mechanisms
Findings
The Microbiota–Gut–Brain Axis
Microbiome and Energy Harvest
Microbiome and the Brain
The Role of Microbiome-Driven Inflammation
Conclusions and Future Directions
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