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Schultes, B.* ; Ernst, B.* ; Hallschmid, M. ; Bueter, M.* ; Meyhöfer, S.M.*

The ‘Behavioral Balance Model’: A new perspective on the aetiology and therapy of obesity.

Diabetes Obes. Metab. 25, 3444-3452 (2023)
DOI PMC
Open Access Green as soon as Postprint is submitted to ZB.
Obesity is a debilitating disease of global proportions that necessitates refined, concept-driven therapeutic approaches. Policy makers, the public and even health care professionals, but also individuals with obesity harbour many misconceptions regarding this disease, which leads to prejudice, negative attitudes, stigmatization, discrimination, self-blame, and failure to provide and finance adequate medical care. Decades of intensive, successful scientific research on obesity have only had a very limited effect on this predicament. We propose a science-based, easy-to-understand conceptual model that synthesizes the complex pathogenesis of obesity including biological, psychological, social, economic and environmental aspects with the aim to explain and communicate better the nature of obesity and currently available therapeutic modalities. According to our integrative ‘Behavioral Balance Model’, ‘top-down cognitive control’ strategies are implemented (often with limited success) to counterbalance the increased ‘bottom-up drive’ to gain weight, which is triggered by biological, psycho-social and environmental mechanisms in people with obesity. Besides offering a deeper understanding of obesity, the model also highlights why there is a strong need for multimodal therapeutic approaches that may not only increase top-down control but also reduce a pathologically increased bottom-up drive.
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Publication type Article: Journal article
Document type Review
Corresponding Author
Keywords Antidiabetic Drug ; Appetite Control ; Bariatric Surgery ; Glp-1 Analogue ; Obesity Therapy ; Weight Control; Eating Behavior; Weight-loss; Food-intake; Brain; Consequences; Disorders; Outcomes; Health; Stigma; Reward
ISSN (print) / ISBN 1462-8902
e-ISSN 1463-1326
Journal Diabetes, Obesity and Metabolism
Quellenangaben Volume: 25, Issue: 12, Pages: 3444-3452 Article Number: , Supplement: ,
Publisher Wiley
Publishing Place 111 River St, Hoboken 07030-5774, Nj Usa
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Diabetes Research and Metabolic Diseases (IDM)
Grants German Federal Ministry of Education and Research (BMBF)
Eli Lilly
Novo Nordisk
Swiss National Science Foundation (SNF)
German Research Foundation (DFG)