Table 2 Key differences between the EBM and the CIM of obesity
From: On the pathogenesis of obesity: causal models and missing pieces of the puzzle
EBM | CIM | |
|---|---|---|
Causal direction | Positive energy balance results in net fat deposition | Altered fuel partitioning results in net fat deposition and, subsequently, positive energy balance |
Primary dietary driver | Increased availability and marketing of a wide variety of inexpensive, convenient, energy-dense ultraprocessed foods that are high in portion size, fat, salt and sugar and low in protein and fibre | Carbohydrate-rich foods with high glycaemic index and fructose-rich beverages |
Point of entry into the regulatory system | Brain | Periphery |
Brain’s response to signals of energy and nutrient availability or needs | Overwhelmed or impaired | Intact |
Predicted change in energy expenditure | Increased at the whole-body level; unaltered if adjusted for changes in body composition | Decreased if food intake does not increase; unchanged or even increased if food intake increases |
