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Regulation of Appetite and Obesity · Journal article
Evolution Medicine and Public Health · September 9, 2026
Raises a question worth testing. It does not answer one.
This narrative review proposes that human gastric capacity, adaptive under ancestral scarcity, has become maladaptive in modern energy-dense food environments, contributing to obesity and metabolic disease. The framework is conceptual and mechanistic, grounded in evolutionary biology and clinical observation of bariatric surgery outcomes, but does not present new empirical data or causal proof.
Narrative review. Modern humans in obesogenic environments; ancestral human populations under scarcity conditions (comparative, not directly studied)..
Ancestral gastrointestinal anatomy evolved under food scarcity and low-caloric-density diets, where large gastric volume conferred survival advantage. Modern food environments with constant access to energy-dense foods and sedentary lifestyles have reversed selective pressures, creating evolutionary mismatch. Gastric accommodation capacity may promote excessive energy intake, delayed satiety, and metabolic dysfunction in presence of ultra-processed foods.
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
This framework may inform understanding of obesity pathogenesis but does not provide direct evidence for new clinical interventions beyond existing bariatric surgery. The hypothesis requires prospective testing to determine whether gastric capacity itself is a modifiable, targetable driver of metabolic disease independent of weight.
A narrative review synthesizing existing evidence to propose a mechanistic explanation for obesity via evolutionary mismatch; raises a conceptual framework rather than presenting new empirical results or clinical trials.
As stated by the source record.
This framework may inform understanding of obesity pathogenesis but does not provide direct evidence for new clinical interventions beyond existing bariatric surgery. The hypothesis requires prospective testing to determine whether gastric capacity itself is a modifiable, targetable driver of metabolic disease independent of weight.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
What is missing. This record has no reported figures. That is a gap in the analysis, not a judgement about the study.
Abstract Human gastrointestinal anatomy evolved under conditions of food scarcity, low–caloric-density diets, and high physical activity. In this context, a relatively gastric accommodation stomach capacity conferred a survival advantage by allowing consumption of large volumes of fibrous, low-energy foods, buffering seasonal shortages, and maximizing intake during rare periods of abundance. Modern food environments, characterized by constant access to energy-dense foods and sedentary lifestyles, have reversed these selective pressures, creating an evolutionary mismatch between ancestral digestive physiology and contemporary diets. This narrative review explores how a digestive architecture shaped by scarcity may become maladaptive in modern high-calorie conditions and examines stomach capacity as an under-recognized contributor to obesity and metabolic disease. Evidence was synthesized from evolutionary biology, anthropology, gastroenterology, and metabolic medicine using literature identified in PubMed, Scopus, and Web of Science (1990–2024). Evolutionary and anthropological evidence suggests that increased gastric volume was advantageous in both pre-agrarian and agrarian societies. In contrast, in modern environments this trait may promote excessive energy intake, delayed satiety, and metabolic dysfunction, particularly in the presence of ultra-processed foods. Clinical observations from bariatric surgery support this framework, as surgical reduction of gastric volume induces rapid metabolic improvements, often preceding significant weight loss. Gastric accommodation capacity, once adaptive, may now contribute to metabolic disease in obesogenic environments, reframing obesity as a predictable consequence of evolutionary mismatch.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.