From evolutionary advantage to global epidemic: the multisystemic impact of obesity on metabolic health and the potential of bergamot (Citrus bergamia)

Historically, obesity transitioned from an evolutionary survival advantage in hunter-gatherer societies, where fat storage was crucial for periods of scarcity, to a global epidemic. This shift culminated in a dramatic rise in obesity rates, recognized as a global public health problem by the WHO in 1997. Currently, obesity affects billions worldwide, imposing significant health and economic burdens, and is strongly linked to metabolic dysregulation and chronic diseases. Obesity causes adipose tissue dysfunction, marked by impaired adipogenesis, adipocyte hypertrophy, altered adipokine secretion, and chronic low-grade inflammation. This dysfunction promotes lipotoxicity, oxidative stress, and systemic inflammation. This review aimed to report bergamot (Citrus bergamia) as a potential adjuvant to conventional therapies in the treatment of obesity and its associated metabolic complications. A systematic search was conducted in the PubMed and Google Scholar databases, with no restrictions on publication date. Keywords included “obesity,” “adipose tissue dysfunction,” “heart, muscle, kidney, and liver in obesity”, “therapeutic strategies”, “bioactive compounds,” and “Citrus bergamia”. Inclusion criteria focused on original preclinical studies examining physiopathological mechanisms and the effects of CB bioactive compounds on target organs. The findings indicate that CB bioactive compounds have promising integrative potential through antioxidant, anti-inflammatory, and metabolic-modulating effects, suggesting improved treatment outcomes by addressing underlying inflammatory and oxidative processes and enhancing insulin sensitivity across target organs.