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

Obese children who have recently lost weight are more likely to show hunger-related activity in their brains after eating a meal, according to research presented today at Sixty.The tenth Annual meeting of the European Society of Pediatric Endocrinology. This brain activity, which reflects their dissatisfaction with their meal, occurs even though their gut hormone levels change, as expected, to reduce hunger and signal satiety. This disconnect between food satisfaction in their brains versus their digestive system may be why so many people regain weight, especially after following a strict diet. Understanding and treating persistent hunger-enhancing brain activity could lead to better and more sustainable treatments for obesity in children and adults.

Obesity is a growing health crisis worldwide with an estimated 124 million children affected globally. Obesity increases the risk of many other health problems including type 2 diabetes, heart disease, and cancer. Childhood obesity is often managed with family behavioral therapy that includes regular outpatient sessions focused on nutritional education and physical activity. In the United States, the gold standard for such programs is a minimum of 26 contact hours over 6 months, however, many children regain weight soon after the program ends. It is not understood why the success rate is low. Appetite and metabolism, and thus weight gain, are regulated by activity in both the brain and the digestive system. Understanding how these processes are affected by weight loss may help us better understand the mechanisms that predispose children to regain weight gain.

In this study, Professor Roth and colleagues at Seattle Children’s Hospital, USA, compared the brain’s appetite-regulating activity with the responses of gut hormones in obese children before and after a 24-week weight-loss program. Using functional magnetic resonance imaging, they assessed activation patterns in areas of the brain that regulate appetite in response to high versus low-calorie images, after a meal. Gut hormone levels were also assessed before and after meals, at the beginning and end of the program. At the end of the program, the children were still showing high levels of activity in areas of the brain related to appetite, after eating, in response to pictures of food, indicating that they were hungry. However, levels of gut hormones that regulate appetite indicate satiety and satiety. Remarkably, the children who had lost the most weight showed the strongest activity in their brains for food cues after the meal, at the end of the program.

Our results suggest that during the weight loss intervention, your body works to conserve fat by maintaining hunger responses in the brain, and that this needs to be addressed, possibly through drug therapy, for successful and sustained weight loss in obese children.

Professor Roth, Children’s Hospital Seattle, USA

Although Professor Roth cautions, “These results are from a small group of children tested only at the beginning and end of the intervention programme, so larger and more detailed studies will be needed to confirm this central effect. It would also be useful to investigate how for a long time, The disconnect between central and local appetite regulation after weight loss was maintained, continued to guide intervention plans.”

Professor Roth suggests, “For a 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 steady pattern changes, over years rather than months, which will result in persistent and prolonged Duration Term improvements in weight loss and health.