The 4BE quinqunx: A model for obesity pathogenesis

Authors

  • Sanjay Kalra Department of Endocrinology, Bharti Hospital, Karnal, India; University Centre for Research & Development, Chandigarh University, Mohali, India
  • Madhur Verma Department of Community/Family Medicine, All India Institute of Medical Sciences, Bathinda, India
  • Nitin Kapoor Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, India; Non-communicable disease unit, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia

DOI:

https://doi.org/10.47391/JPMA.25-46

Abstract

For obesity management to be effective, one must
appreciate its causes and consequences. To do so, the
seemingly complex science of obesity must be made
simpler. A model which helps us explain its causes,
contributory factors, as well as potential corrective
measures, is needed. We share the 4BE winged quincunx
model of obesity etiopathogenesis. Four central players -
the Brain, Bowel, Beta/alpha cell and Bulk (adipose tissue)-
form a causative quadruple, with four wings-
Environmental determinants, Endocrine factors, Enteric
microbiome and Extraneous limitations. The centre of the
quincunx is occupied, in a stylish manner, by the ABC of
weight management: Attitude, Behaviour and Choices.
The 4BE concept makes it easy for health care
professionals to understand, and explain, obesity.
KEYWORDS: Biochemistry, endocrinology, obesity,
overweight, pathogenesis, person centred care,
therapeutic patient education

Published

2025-06-01

How to Cite

Sanjay Kalra, Madhur Verma, & Nitin Kapoor. (2025). The 4BE quinqunx: A model for obesity pathogenesis. Journal of the Pakistan Medical Association, 74(06), 1002–1003. https://doi.org/10.47391/JPMA.25-46

Issue

Section

BAROCRINOLOGY

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