Trevor Klee writes clearly about complicated physiology and pharma chemistry.

He's also incredibly innovative. Here he turns that skill to the baffling topic of weight gain and obesity.

Clipped for length, and worth the read on his site.

https://open.substack.com/pub/trevorklee/p/the-way-scientists-think-about-obesity

The way scientists think about obesity now is wrong.

Here's my tentative attempt at a better way of thinking about obesity.

TREVOR KLEE    |    APR 09, 2024

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We can then start talking about just being fat, or even extremely fat, not as a health condition but as a state of being that’s determined by bodily processes. While the cardiovascular system of a very fat person probably doesn’t look like the cardiovascular system of a very fat hummingbird preparing for migration, the way that they store and maintain fat does have a lot of similarities, especially with the connections to the insulin system.

This can be put in a useful contrast to the way that young individuals, both human and otherwise, find it impossible to put on weight. My brothers and I used to eat 2000+ calories at fast food restaurants just for fun in eating competitions without putting on a single pound. Why were we able to do that? I don’t know, but we won’t be able to find out with the way we’re thinking about obesity right now. 

Energy acquisition, metabolism, and storage is a fundamental biological problem. Fat storage is a crucial part of every animal’s solution to this problem. But, because we insist on thinking of being fat as a human health issue, rather than a method that basically the entire animal kingdom has adopted to solve the energy storage problem, we have failed to understand fatness in either its biological form or, ironically, even as a health issue.

Every drug developer knows the acronym ADME: absorption, deposition, metabolism, excretion. It’s the way of describing what happens to any drug that enters the body, and every drug that gets approved gets characterized in those terms. We should be able to do the same thing for food and understand the path of food in at least as much detail. But we’re not there yet.