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Obesity, is a chronic, biological, preventable, and treatable disease. The accumulation of fat mass causes physical changes (adiposity), metabolic and hormonal changes due to adipose tissue dysfunction (adiposopathy), and psychological changes. Bariatric endocrinology was conceived from the need to address the neuro-endocrinological derangements that are associated with adiposopathy, and from the need to broaden the scope of the management of its complications. In addition to the well-established metabolic complications of overweight and obesity, adiposopathy leads to hyperinsulinemia, hyperleptinemia, hypoadiponectinemia, dysregulation of gut peptides including GLP-1 and ghrelin, the development of an inflammatory milieu, and the strong risk of vascular disease. Therapy for adiposopathy hinges on effectively lowering the ratio of orexigenic to anorexigenic signals reaching the the hypothalamus and other relevant brain regions, favoring a lower caloric intake. Adiposopathy, overweight and obesity should be treated indefinitely with the specific aims to reduce fat mass for the adiposity complications, and to normalize adipose tissue function for the adiposopathic complications. This paper defines the principles of medical practice in bariatric endocrinology—the treatment of overweight and obesity as means to treat adiposopathy and its accompanying metabolic and hormonal derangements.

This qualitative research through phenomenological approach in which it is made to gather important data and information based on the participant’s experiences of the Tax Reform for Acceleration and Inclusion (TRAIN) Act. The interview collected data using in-depth interview where the questions were semi-structured for deeper clarification and further discussions. After the data was being collected, there were three themes formulated as the effects after the implementation of TRAIN law on poor income class families. According to the findings, the impact of TRAIN law to the poor are mostly the basic need such as food in which it is needed to reduce their budget for them to survive since there are other things that needed to be paid such like utility bills and debts. Furthermore, it also affects the mental and well-being of a person such as anxiety, stress, and depression due to financial problems. It is therefore concluded that after the implementation of TRAIN the poor income class families becomes poorer.

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