The prevalence and severity of childhood obesity have increased steadily over the past three decades. The human species evolved to rigorously defend its lower limit for weight and adiposity but is tolerant of the upper limit, which, until recent times, was rarely approached. Neuroendocrine mechanisms within the limbic core of the brain prevent starvation (ventromedial hypothalamus), heighten reward (ventral tegmental area and nucleus accumbens), and attenuate stress (amygdala), in order to promote food-seeking and ingestive behavior and to conserve energy output. In a stressful modern environment with ready access to calorie-dense, highly palatable foods and limited venues for activity, normal, reflexive responsiveness to these three drives makes weight gain all but inevitable. The obesity that ensues often engenders insulin resistance, which undermines the ability of normal hunger and satiety signals to accurately modulate energy intake versus expenditure. Obesity interventions that rely on cognitive information alone cannot free children from this "limbic triangle." Integrated multidisciplinary family- and community-based education, effective stress reduction, and a societal commitment to alter the food and built environments are all necessary components to battle the global obesity epidemic.

中文翻译：

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儿童肥胖：飘浮在“三角三角形”中。

在过去的三十年中，儿童肥胖的患病率和严重程度稳步上升。经过进化，人类可以严格捍卫其体重和肥胖症的下限，但可以忍受这一上限，直到最近，这种上限很少有人使用。脑边缘边缘内的神经内分泌机制可防止饥饿（下丘脑下丘脑），增强奖赏（腹侧被盖区和伏隔核）和减轻压力（杏仁核），以促进觅食和摄取行为并节省能量输出。在压力重重的现代环境中，人们容易获得卡路里密集的，可口的食物，并且活动场所有限，对这三种驱动力的正常反身反应使体重增加几乎不可避免。随之而来的肥胖通常会引起胰岛素抵抗，这破坏了正常饥饿和饱食信号准确调节能量摄入与支出的能力。仅依靠认知信息的肥胖症干预措施无法使儿童摆脱这种“边缘三角形”。综合的多学科家庭和社区教育，有效的压力减轻以及改变食物和建筑环境的社会承诺，都是与全球肥胖症流行作斗争的必要组成部分。