{"id":"https://openalex.org/W2139752380","doi":"https://doi.org/10.1146/annurev.med.59.103106.105628","title":"Childhood Obesity: Adrift in the \u201cLimbic Triangle\u201d","display_name":"Childhood Obesity: Adrift in the \u201cLimbic Triangle\u201d","publication_year":2007,"publication_date":"2007-09-11","ids":{"openalex":"https://openalex.org/W2139752380","doi":"https://doi.org/10.1146/annurev.med.59.103106.105628","mag":"2139752380","pmid":"https://pubmed.ncbi.nlm.nih.gov/17845135"},"language":"en","primary_location":{"id":"doi:10.1146/annurev.med.59.103106.105628","doi":"https://doi.org/10.1146/annurev.med.59.103106.105628","is_oa":true,"landing_page_url":"https://doi.org/10.1146/annurev.med.59.103106.105628","pdf_url":"https://www.annualreviews.org/doi/pdf/10.1146/annurev.med.59.103106.105628","source":{"id":"https://openalex.org/S16909082","display_name":"Annual Review of Medicine","issn_l":"0066-4219","issn":["0066-4219","1545-326X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-b","doyens","jufo-2","medline","norway-1","poland-200","russia-white-list-1"],"host_organization":"https://openalex.org/P4310320373","host_organization_name":"Annual Reviews","host_organization_lineage":["https://openalex.org/P4310320373"],"host_organization_lineage_names":["Annual Reviews"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Annual Review of Medicine","raw_type":"journal-article"},"volume":null,"type":"review","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"bronze","oa_url":"https://www.annualreviews.org/doi/pdf/10.1146/annurev.med.59.103106.105628","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5030646475","display_name":"Michele Mietus\u2010Snyder","orcid":"https://orcid.org/0000-0003-2791-9896","observed_orcids":["https://orcid.org/0000-0003-2791-9896"]},"institutions":[{"id":"https://openalex.org/I180670191","display_name":"University of California, San Francisco","ror":"https://ror.org/043mz5j54","country_code":"US","type":"education","lineage":["https://openalex.org/I180670191"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Michele L. Mietus-Snyder","raw_affiliation_strings":["Department of Pediatrics, University of California, San Francisco, California 94143;","Department of Pediatrics, University of California, San Francisco, California 94143, USA. mietussnyderm@peds.ucsf.edu"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Pediatrics, University of California, San Francisco, California 94143;","institution_ids":["https://openalex.org/I180670191"]},{"raw_affiliation_string":"Department of Pediatrics, University of California, San Francisco, California 94143, USA. mietussnyderm@peds.ucsf.edu","institution_ids":["https://openalex.org/I180670191"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5003686041","display_name":"Robert H. Lustig","orcid":"https://orcid.org/0000-0001-6983-2639","observed_orcids":["https://orcid.org/0000-0001-6983-2639"]},"institutions":[{"id":"https://openalex.org/I180670191","display_name":"University of California, San Francisco","ror":"https://ror.org/043mz5j54","country_code":"US","type":"education","lineage":["https://openalex.org/I180670191"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Robert H. Lustig","raw_affiliation_strings":["Department of Pediatrics, University of California, San Francisco, California 94143;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Pediatrics, University of California, San Francisco, California 94143;","institution_ids":["https://openalex.org/I180670191"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":["https://openalex.org/I180670191"],"apc_list":null,"apc_paid":null,"fwci":0.7417,"has_fulltext":true,"cited_by_count":58,"citation_normalized_percentile":{"value":0.5752809,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":88,"max":99},"biblio":{"volume":"59","issue":"1","first_page":"147","last_page":"162"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10010","display_name":"Obesity, Physical Activity, Diet","score":0.8833000063896179,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10010","display_name":"Obesity, Physical Activity, Diet","score":0.8833000063896179,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10489","display_name":"Regulation of Appetite and Obesity","score":0.10189999639987946,"subfield":{"id":"https://openalex.org/subfields/2807","display_name":"Endocrine and Autonomic Systems"},"field":{"id":"https://openalex.org/fields/28","display_name":"Neuroscience"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},{"id":"https://openalex.org/T10263","display_name":"Eating Disorders and Behaviors","score":0.006599999964237213,"subfield":{"id":"https://openalex.org/subfields/3203","display_name":"Clinical Psychology"},"field":{"id":"https://openalex.org/fields/32","display_name":"Psychology"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/childhood-obesity","display_name":"childhood obesity","score":1.0},{"id":"https://openalex.org/keywords/ventromedial-hypothalamic-nucleus","display_name":"ventromedial hypothalamus","score":0.8939999938011169},{"id":"https://openalex.org/keywords/ventral-tegmental-area","display_name":"ventral tegmental area","score":0.9679999947547913},{"id":"https://openalex.org/keywords/nucleus-accumbens","display_name":"nucleus accumbens","score":0.9990000128746033},{"id":"https://openalex.org/keywords/amygdala","display_name":"amygdala","score":0.9990000128746033},{"id":"https://openalex.org/keywords/food-reward","display_name":"food reward","score":0.6990000009536743},{"id":"https://openalex.org/keywords/stress","display_name":"stress","score":0.3970000147819519},{"id":"https://openalex.org/keywords/energy-balance","display_name":"energy balance","score":0.5339999794960022},{"id":"https://openalex.org/keywords/insulin-resistance","display_name":"insulin resistance","score":0.9340000152587891},{"id":"https://openalex.org/keywords/palatable-food","display_name":"palatable food","score":0.7580000162124634},{"id":"https://openalex.org/keywords/built-environment","display_name":"built environment","score":0.8069999814033508},{"id":"https://openalex.org/keywords/obesity-prevention","display_name":"obesity prevention","score":0.5879999995231628},{"id":"https://openalex.org/keywords/family-based-education","display_name":"family-based education","score":0.6690000295639038},{"id":"https://openalex.org/keywords/community-based-education","display_name":"community-based education","score":0.6110000014305115}],"concepts":[{"id":"https://openalex.org/C2776552330","wikidata":"https://www.wikidata.org/wiki/Q1476178","display_name":"Nucleus accumbens","level":3,"score":0.7339038848876953},{"id":"https://openalex.org/C511355011","wikidata":"https://www.wikidata.org/wiki/Q12174","display_name":"Obesity","level":2,"score":0.5767685174942017},{"id":"https://openalex.org/C2779144063","wikidata":"https://www.wikidata.org/wiki/Q338924","display_name":"Amygdala","level":2,"score":0.5584577322006226},{"id":"https://openalex.org/C541082541","wikidata":"https://www.wikidata.org/wiki/Q192560","display_name":"Limbic system","level":3,"score":0.5531168580055237},{"id":"https://openalex.org/C169760540","wikidata":"https://www.wikidata.org/wiki/Q207011","display_name":"Neuroscience","level":1,"score":0.4793884754180908},{"id":"https://openalex.org/C2779422640","wikidata":"https://www.wikidata.org/wiki/Q3241451","display_name":"Childhood obesity","level":4,"score":0.4722394645214081},{"id":"https://openalex.org/C15744967","wikidata":"https://www.wikidata.org/wiki/Q9418","display_name":"Psychology","level":0,"score":0.4482212960720062},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.4290018081665039},{"id":"https://openalex.org/C2777003273","wikidata":"https://www.wikidata.org/wiki/Q164386","display_name":"Hypothalamus","level":2,"score":0.42255860567092896},{"id":"https://openalex.org/C2780948874","wikidata":"https://www.wikidata.org/wiki/Q640562","display_name":"Ventral tegmental area","level":4,"score":0.41710522770881653},{"id":"https://openalex.org/C134018914","wikidata":"https://www.wikidata.org/wiki/Q162606","display_name":"Endocrinology","level":1,"score":0.2822715640068054},{"id":"https://openalex.org/C2780586474","wikidata":"https://www.wikidata.org/wiki/Q332428","display_name":"Overweight","level":3,"score":0.19589269161224365},{"id":"https://openalex.org/C529278444","wikidata":"https://www.wikidata.org/wiki/Q47273","display_name":"Central nervous system","level":2,"score":0.10209724307060242},{"id":"https://openalex.org/C137183658","wikidata":"https://www.wikidata.org/wiki/Q461076","display_name":"Dopaminergic","level":3,"score":0.0},{"id":"https://openalex.org/C513476851","wikidata":"https://www.wikidata.org/wiki/Q170304","display_name":"Dopamine","level":2,"score":0.0}],"mesh":[{"descriptor_ui":"D002648","descriptor_name":"Child","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008032","descriptor_name":"Limbic System","qualifier_ui":"Q000503","qualifier_name":"physiopathology","is_major_topic":true},{"descriptor_ui":"D009765","descriptor_name":"Obesity","qualifier_ui":"Q000209","qualifier_name":"etiology","is_major_topic":true},{"descriptor_ui":"D009765","descriptor_name":"Obesity","qualifier_ui":"Q000523","qualifier_name":"psychology","is_major_topic":false},{"descriptor_ui":"D009765","descriptor_name":"Obesity","qualifier_ui":"Q000628","qualifier_name":"therapy","is_major_topic":true},{"descriptor_ui":"D015430","descriptor_name":"Weight Gain","qualifier_ui":"Q000502","qualifier_name":"physiology","is_major_topic":true}],"locations_count":4,"locations":[{"id":"doi:10.1146/annurev.med.59.103106.105628","doi":"https://doi.org/10.1146/annurev.med.59.103106.105628","is_oa":true,"landing_page_url":"https://doi.org/10.1146/annurev.med.59.103106.105628","pdf_url":"https://www.annualreviews.org/doi/pdf/10.1146/annurev.med.59.103106.105628","source":{"id":"https://openalex.org/S16909082","display_name":"Annual Review of Medicine","issn_l":"0066-4219","issn":["0066-4219","1545-326X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-b","doyens","jufo-2","medline","norway-1","poland-200","russia-white-list-1"],"host_organization":"https://openalex.org/P4310320373","host_organization_name":"Annual Reviews","host_organization_lineage":["https://openalex.org/P4310320373"],"host_organization_lineage_names":["Annual Reviews"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Annual Review of Medicine","raw_type":"journal-article"},{"id":"pmid:17845135","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/17845135","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Annual review of medicine","raw_type":"Journal Article"},{"id":"pmh:oai:escholarship.org/ark:/13030/qt9nq1k1g5","doi":null,"is_oa":false,"landing_page_url":"https://escholarship.org/uc/item/9nq1k1g5","pdf_url":null,"source":{"id":"https://openalex.org/S4306400115","display_name":"eScholarship (California Digital Library)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I2801248553","host_organization_name":"California Digital Library","host_organization_lineage":["https://openalex.org/I2801248553"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Annual Review of Medicine, vol 59","raw_type":"article"},{"id":"pmh:qt9nq1k1g5","doi":null,"is_oa":false,"landing_page_url":"http://www.escholarship.org/uc/item/9nq1k1g5","pdf_url":null,"source":{"id":"https://openalex.org/S4306400115","display_name":"eScholarship (California Digital Library)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I2801248553","host_organization_name":"California Digital Library","host_organization_lineage":["https://openalex.org/I2801248553"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Mietus-Snyder, Michele L.; & Lustig, Robert H.(2008). Childhood obesity: Adrift in the \"Limbic Triangle\". Annual Review of Medicine, 59, 147 - 162. UC San Francisco: Retrieved from: http://www.escholarship.org/uc/item/9nq1k1g5","raw_type":"article"}],"best_oa_location":{"id":"doi:10.1146/annurev.med.59.103106.105628","doi":"https://doi.org/10.1146/annurev.med.59.103106.105628","is_oa":true,"landing_page_url":"https://doi.org/10.1146/annurev.med.59.103106.105628","pdf_url":"https://www.annualreviews.org/doi/pdf/10.1146/annurev.med.59.103106.105628","source":{"id":"https://openalex.org/S16909082","display_name":"Annual Review of Medicine","issn_l":"0066-4219","issn":["0066-4219","1545-326X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-b","doyens","jufo-2","medline","norway-1","poland-200","russia-white-list-1"],"host_organization":"https://openalex.org/P4310320373","host_organization_name":"Annual Reviews","host_organization_lineage":["https://openalex.org/P4310320373"],"host_organization_lineage_names":["Annual Reviews"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Annual Review of Medicine","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":0.9537000060081482,"display_name":"Good health and well-being"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W2139752380.pdf","grobid_xml":"https://content.openalex.org/works/W2139752380.grobid-xml"},"referenced_works_count":120,"referenced_works":["https://openalex.org/W90137078","https://openalex.org/W98270808","https://openalex.org/W204405190","https://openalex.org/W285502117","https://openalex.org/W1498897377","https://openalex.org/W1546792714","https://openalex.org/W1569693056","https://openalex.org/W1589150167","https://openalex.org/W1909375567","https://openalex.org/W1967053672","https://openalex.org/W1967333583","https://openalex.org/W1967444481","https://openalex.org/W1967832563","https://openalex.org/W1967843472","https://openalex.org/W1970091616","https://openalex.org/W1977899574","https://openalex.org/W1977915489","https://openalex.org/W1980287527","https://openalex.org/W1981320195","https://openalex.org/W1981487663","https://openalex.org/W1981564181","https://openalex.org/W1981858452","https://openalex.org/W1982366939","https://openalex.org/W1986020285","https://openalex.org/W1991148887","https://openalex.org/W1996635305","https://openalex.org/W1997233851","https://openalex.org/W1997757017","https://openalex.org/W2001304351","https://openalex.org/W2006949877","https://openalex.org/W2008100712","https://openalex.org/W2009049199","https://openalex.org/W2010732010","https://openalex.org/W2014991255","https://openalex.org/W2018527534","https://openalex.org/W2020604193","https://openalex.org/W2023948378","https://openalex.org/W2024409585","https://openalex.org/W2025433166","https://openalex.org/W2034640995","https://openalex.org/W2038670090","https://openalex.org/W2039163106","https://openalex.org/W2041108449","https://openalex.org/W2041265673","https://openalex.org/W2046944542","https://openalex.org/W2049578370","https://openalex.org/W2049991997","https://openalex.org/W2050252451","https://openalex.org/W2053489121","https://openalex.org/W2056460191","https://openalex.org/W2058015922","https://openalex.org/W2058326161","https://openalex.org/W2060936747","https://openalex.org/W2068564008","https://openalex.org/W2078884365","https://openalex.org/W2079055777","https://openalex.org/W2082113374","https://openalex.org/W2082487184","https://openalex.org/W2085792819","https://openalex.org/W2086188302","https://openalex.org/W2086773481","https://openalex.org/W2086950122","https://openalex.org/W2087657674","https://openalex.org/W2087694942","https://openalex.org/W2089668061","https://openalex.org/W2092509345","https://openalex.org/W2097644620","https://openalex.org/W2098842638","https://openalex.org/W2098959637","https://openalex.org/W2100183198","https://openalex.org/W2101078555","https://openalex.org/W2101348111","https://openalex.org/W2102203174","https://openalex.org/W2102712175","https://openalex.org/W2107568835","https://openalex.org/W2108492381","https://openalex.org/W2109439255","https://openalex.org/W2112364979","https://openalex.org/W2116347964","https://openalex.org/W2116784595","https://openalex.org/W2117399732","https://openalex.org/W2118192748","https://openalex.org/W2119057053","https://openalex.org/W2123022077","https://openalex.org/W2123683848","https://openalex.org/W2123840543","https://openalex.org/W2125226484","https://openalex.org/W2130059167","https://openalex.org/W2130177558","https://openalex.org/W2131572295","https://openalex.org/W2138122607","https://openalex.org/W2140917036","https://openalex.org/W2141060229","https://openalex.org/W2142013939","https://openalex.org/W2145688382","https://openalex.org/W2147276857","https://openalex.org/W2148346586","https://openalex.org/W2148878444","https://openalex.org/W2149097469","https://openalex.org/W2149271886","https://openalex.org/W2150138040","https://openalex.org/W2151254286","https://openalex.org/W2154042628","https://openalex.org/W2156061175","https://openalex.org/W2156316935","https://openalex.org/W2161715455","https://openalex.org/W2162627097","https://openalex.org/W2167650996","https://openalex.org/W2169787997","https://openalex.org/W2171172629","https://openalex.org/W2172157844","https://openalex.org/W2264924707","https://openalex.org/W2316534927","https://openalex.org/W2318482745","https://openalex.org/W2322634847","https://openalex.org/W2556121154","https://openalex.org/W2745476543","https://openalex.org/W2996482718","https://openalex.org/W3138780921","https://openalex.org/W4248289319"],"related_works":["https://openalex.org/W2114384496","https://openalex.org/W2160636863","https://openalex.org/W4402691826","https://openalex.org/W2031904223","https://openalex.org/W2095499148","https://openalex.org/W2020695426","https://openalex.org/W2610477874","https://openalex.org/W2314568963","https://openalex.org/W2910380781","https://openalex.org/W2162064411"],"abstract_inverted_index":{"The":[0,15,112],"prevalence":[1],"and":[2,27,61,64,73,76,94,127,155,161,169],"severity":[3],"of":[4,32,49,124],"childhood":[5],"obesity":[6,113,180],"have":[7],"increased":[8],"steadily":[9],"over":[10],"the":[11,33,46,50,122,167,178],"past":[12],"three":[13,104],"decades.":[14],"human":[16],"species":[17],"evolved":[18],"to":[19,70,77,89,102,130,165,176],"rigorously":[20],"defend":[21],"its":[22],"lower":[23],"limit":[24],"for":[25,97],"weight":[26,107],"adiposity":[28],"but":[29,110],"is":[30],"tolerant":[31],"upper":[34],"limit,":[35],"which,":[36],"until":[37],"recent":[38],"times,":[39],"was":[40],"rarely":[41],"approached.":[42],"Neuroendocrine":[43],"mechanisms":[44],"within":[45],"limbic":[47],"core":[48],"brain":[51],"prevent":[52],"starvation":[53],"(ventromedial":[54],"hypothalamus),":[55],"heighten":[56],"reward":[57],"(ventral":[58],"tegmental":[59],"area":[60],"nucleus":[62],"accumbens),":[63],"attenuate":[65],"stress":[66,159],"(amygdala),":[67],"in":[68],"order":[69],"promote":[71],"food-seeking":[72],"ingestive":[74],"behavior":[75],"conserve":[78],"energy":[79,133],"output.":[80],"In":[81],"a":[82,162],"stressful":[83],"modern":[84],"environment":[85],"with":[86],"ready":[87],"access":[88],"calorie-dense,":[90],"highly":[91],"palatable":[92],"foods":[93],"limited":[95],"venues":[96],"activity,":[98],"normal,":[99],"reflexive":[100],"responsiveness":[101],"these":[103],"drives":[105],"makes":[106],"gain":[108],"all":[109,173],"inevitable.":[111],"that":[114,139],"ensues":[115],"often":[116],"engenders":[117],"insulin":[118],"resistance,":[119],"which":[120],"undermines":[121],"ability":[123],"normal":[125],"hunger":[126],"satiety":[128],"signals":[129],"accurately":[131],"modulate":[132],"intake":[134],"versus":[135],"expenditure.":[136],"Obesity":[137],"interventions":[138],"rely":[140],"on":[141],"cognitive":[142],"information":[143],"alone":[144],"cannot":[145],"free":[146],"children":[147],"from":[148],"this":[149],"\"limbic":[150],"triangle.\"":[151],"Integrated":[152],"multidisciplinary":[153],"family-":[154],"community-based":[156],"education,":[157],"effective":[158],"reduction,":[160],"societal":[163],"commitment":[164],"alter":[166],"food":[168],"built":[170],"environments":[171],"are":[172],"necessary":[174],"components":[175],"battle":[177],"global":[179],"epidemic.":[181]},"counts_by_year":[{"year":2026,"cited_by_count":1},{"year":2025,"cited_by_count":3},{"year":2024,"cited_by_count":1},{"year":2023,"cited_by_count":1},{"year":2022,"cited_by_count":2},{"year":2021,"cited_by_count":3},{"year":2020,"cited_by_count":1},{"year":2019,"cited_by_count":2},{"year":2018,"cited_by_count":2},{"year":2017,"cited_by_count":2},{"year":2016,"cited_by_count":1},{"year":2015,"cited_by_count":6},{"year":2014,"cited_by_count":4},{"year":2013,"cited_by_count":1},{"year":2012,"cited_by_count":3}],"updated_date":"2026-10-31T12:09:11.096373","created_date":"2016-06-24T00:00:00"}