Review Article OBESITY: DEVELOPMENT, EPIDEMIOLOGY, FACTORS AFFECTING, QUANTITY, HEALTH HAZARDS, MANAGEMENT AND NATURAL TREATMENT-A REVIEW MANI KUMAR BOLLAPRAGADA 1 , MANJULA SHANTARAM 1 , SUNIL KUMAR R. 2 1 Department of Studies in Biochemistry, Mangalore University, Post Graduate Centre, Chikka Aluvara, Kodagu, Karnataka, 571232 India, 2 Department of Biotechnology, College of Agriculture, University of Agriculture Science, Bangalore, Hassan, Karnataka, 573225 India Email: manjula59@gmail.com Received: 04 Sep 2016 Revised and Accepted: 05 Jan 2017 ABSTRACT Due to the advancement in science, enhanced knowledge on the physiological aspects of almost all the tissues and the organs of the human body is gained. One of the most important prevalent topics needed for discussion is obesity and its effect on the metabolic changes leading to disorders in the human body such as diabetes, hypertension, cardiovascular diseases in addition to chronic diseases such as stroke, osteoarthritis, sleep apnea, some cancers, and inflammation-based pathologies. In recent years, obesity is a serious socioeconomic issue, which has become one of the major health problems all over the world, affecting people of all ages, sex, ethnicities and races. Obesity is a complex and multifactorial disease caused by the interaction of a myriad genetics, dietary, lifestyle and environmental factors and it is characterised by an excessive weight for height due to an enlarged fat deposition in the adipose tissue, which is due to a higher calorie intake than the energy expenditure. The pharmaceutical drugs are currently available to treat obesity but generally they have unpleasant side effects. Recent researches demonstrated the potential of natural products to counteract on obesity. Now the novel promising approach is the usage of dietary supplements and plant products and their bioactive compounds that could interfere on pancreatic lipase activity, food intake, lipid metabolism and adipocyte differentiation. In a similar way, hundreds of extracts are currently being isolated from plants, fungi, algae or bacteria and are screened for their potential inhibitions of activity against obesity. Natural products may have a synergistic activity that increases their bioavailability and action on multiple molecular targets. Keywords: Obesity, Anti-obesity, Lipase inhibitors, Pancreatic lipase, Adipocyte, Appetite suppressant © 2016 The Authors. Published by Innovare Academic Sciences Pvt Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4. 0/) DOI: http://dx.doi.org/10.22159/ijpps.2017v9i2.15049 INTRODUCTION Obesity has become a major health problem worldwide, affecting people across all ages, sex, ethnicities, and races. Obesity incidence is increased at an alarming rate and is becoming a major public health concern. Indeed, obesity facilitates the development of metabolic disorders and cardiovascular diseases in addition to chronic diseases [1, 2]. Body mass index (BMI), defined as the weight in kilogrammes divided by the height in meters squared (kg/m 2 ), is the most widely used measure of obesity due to its low cost and simplicity. The World Health Organization (WHO) and the National Institutes of health (NIH), have defined overweight as having a BMI between 25.0 and 29.9 kg/m 2 and obesity as having a BMI greater than 30.0 kg/m 2 [3]. Some recent WHO global estimates in 2014, more than 1.9 billion adults aged 18 y and older were overweight. Of these, over 600 million adults were obese. In 2014, an estimated 41 million children under the age of 5 y were overweight or obese. Once considered a high-income country problem, overweight and obesity are now on the rise in low and middle-income countries, particularly in urban settings. In Africa, the number of children who are overweight or obese has nearly doubled from 5.4 million in 1990 to 10.6 million in 2014. Nearly half of the children under 5 y who were overweight or obese in 2014 lived in Asia. Obesity is linked to more deaths worldwide than underweight. Globally there are more people who are obese than underweight. This occurs in every region except parts of sub-Saharan Africa and Asia [4]. According to research in different countries an obese individual incurs health care expenditures at least 25% higher than a healthy person [5]. The progress of obesity is characterised by a chronic imbalance of energy intake and energy expenditure [6, 7]. In addition, decreased energy expenditure is often associated with an inherited low basal metabolic rate and low energy cost of physical activity and low capacity for fat oxidation [8]. To reduce body weight and adiposity, a change in lifestyle habits is still the crucial keystone [9]. Physical activity might be the key step in the prevention of obesity by increasing average daily metabolic rate and increased energy expenditure [6]. Unfortunately, this clinical approach is not long lasting and weight regain often seen. Drugs that prevent weight regain appear necessary in obesity treatment [9]. Thus, the development of natural products to treat obesity is a challenging task, which can be launched faster and cheaper than conventional single-entity pharmaceuticals [10]. Many medicinal plants may offer safe, natural, and cost-effective alternatives to synthetic drugs [11- 17]. Currently, one of the most significant strategies in the treatment of obesity comprises the development of natural inhibitors for nutrient digestion, absorption and its sequential metabolic reaction pathways [18]. For example, some recent studies are: Ginsenoside F2 and Rh1 from Panax ginseng Meyer plant possesses anti-obesity activity via binding with peroxisome proliferator activated receptor- γ (PPARγ) and inhibiting adipocyte differentiation in the 3T3-L1 cell line [19, 20]. Raspberry ketone, a naturally occurring phenolic compound inhibits adipogenic and lipogenic gene expression in 3T3- L1 adipocytes [21]. Aqueous tuber extract of Cyperus rotundus L., corn silk extracts show a significant decrease in obesity [22, 23]. In this context, dietary lipids represent the major source of unwanted calories, the attenuation of this fat digestion is an interesting approach for reducing fat absorption [24, 25]. Orlistat is the only authorised anti-obesity drug approved from food and drug administration (FDA). It has been shown to act through inhibition of pancreatic lipase (PL), which is a key enzyme for the digestion of dietary triglycerides [26]. Orlistat is a saturated derivative of lipastatin, an inhibitor of PL isolated from the bacterium Streptomyces toxytricini [27]. This molecule exerts a modest weight lowering effect while accompanying a suitable dietary advice. Thus, in a recent meta-analysis [28], the mean BMI change with Orlistat (120 mg three times daily) was a reduction of 0.83 kg/m 2 compared with a placebo. Accompanying this anti-obesity action, Orlistat is also able to modestly reduce blood pressure, improve oral glucose tolerance and prevent the onset of type 2 diabetes [29, 30]. Now, extracts from hundreds of species of medicinal plants, vegetables and fruits [31] as well as products from microorganisms [11], fungi [32], and marine algae [33] are being screened for potential lipase inhibitory activity. Ideally, these treatments will act as adjuncts to behavioural and lifestyle changes, aimed at maintenance of weight International Journal of Pharmacy and Pharmaceutical Sciences ISSN- 0975-1491 Vol 9, Issue 2, 2017