Overweight children who have recently lost weight are more likely to show hunger-related brain activity after a meal

Overweight children who have recently lost weight are more likely to show hunger-related brain activity after a meal

Children with obesity who have recently lost weight are more likely to show hunger-related activity in their brains after a meal, according to research presented today at the 60th annual meeting of the European Society for Pediatric Endocrinology. This brain activity, reflecting that they were not satisfied with their meal, occurs even though their gut hormone levels have changed as expected to reduce hunger and indicate satiety. This discrepancy between food satisfaction in their brain and digestive system could be why many people gain weight back, especially after a strict diet. Understanding and treating this persistent hunger-promoting brain activity could lead to better and more sustainable treatments for obesity in children and adults.

Obesity is a growing global health crisis, affecting an estimated 124 million children worldwide. Obesity increases the risk of many other health problems, including type 2 diabetes, heart disease and cancer. Childhood obesity is often treated through family-based behavioral therapy, which includes regular outpatient sessions that focus on nutrition and exercise education. In the United States, the gold standard for such programs is a minimum of 26 contact hours over a 6-month period, however many children regain weight soon after completing the program. Little is known why the success rate is so low. Appetite and metabolism, and therefore weight gain, are regulated by activities in both the brain and digestive system. Understanding how these processes are affected by weight loss can help us better understand the mechanisms that predispose children to weight gain.

In this study, Professor Roth and colleagues from Seattle Children's Hospital in the US compared brain appetite regulation activity with gut hormonal response in children with obesity before and after a 24-week weight loss program. Using functional MRI, they assessed activation patterns in appetite-regulating brain areas in response to high- versus low-calorie images after a meal. Gut hormone levels were also measured before and after meals, at the beginning and at the end of the program. At the end of the program, the children still showed high levels of activation in appetite-related brain areas in response to food pictures after a meal, suggesting they were hungry. However, their appetite-regulating gut hormones indicated feelings of fullness and satiety. Remarkably, at the end of the program, the children who lost the most weight showed the greatest activation in their brains from food stimuli after a meal.

Our findings imply that your body conserves fat during a weight loss intervention by maintaining hunger responses in the brain, and that this may need to be addressed through drug treatment to achieve successful and sustained weight loss in children with obesity.

Professor Roth, Children's Hospital Seattle, USA

Although Professor Roth cautions: "These results come from a small group of children tested only at the start and end of the intervention program, so larger and more detailed studies would be required to confirm this central effect. It would also be useful to examine how long the separation between central and local appetite regulation lasts after sustained weight loss, to guide intervention plans."

Professor Roth suggests: "For more successful treatment of childhood obesity, we should avoid interventions that lead to rapid reductions in body weight and instead aim for more gradual and consistent lifestyle changes, over years rather than months, leading to sustained and long-term improvements in weight loss and health."

Source:

European Society of Pediatric Endocrinology

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