Rebound weight gain in children with obesity linked to disconnect between brain and gut

Obese children who have recently lost weight are more likely to show hunger-related activity in the brain after eating, according to a study presented today at the 60th European Congress of Pediatric Endocrinology.

This brain activity reflects that they were dissatisfied with their diet and, as expected, occurs despite changes in gut hormone levels to reduce hunger and indicate satiety. This disconnect between food satisfaction in the digestive system may underlie why many people regain weight, especially after a strict diet. Understanding this persistence of brain activity that drives hunger and addressing it 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 managed through family-based behavioral therapy that includes regular outpatient sessions that focus on diet and physical activity education.

In the United States, the gold standard for such programs is a minimum of 26 hours of contact over a 6-month period, and many children regain weight quickly after completing the program. The reason for the low success rate is not well understood. Appetite and metabolism, or weight gain, are regulated by the activity of 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 revert weight gain.

In this study, Professor Ross and colleagues at Seattle Children’s Hospital in the United States compared brain appetite-regulatory activity and gut hormonal responses in obese children before and after a 24-week weight loss program. They used functional MRI to assess activation patterns in brain regions that control appetite in response to postprandial high- and low-calorie imaging.

Gastrointestinal hormone levels were also assessed pre- and postprandially at the beginning and end of the program. Even at the end of the program, the children showed high levels of activation in appetite-related brain regions in response to food images after eating, indicating that they were hungry. Levels of regulating gut hormones were indicative of satiety and satiety. Surprisingly, the children who lost the most weight showed the strongest activation in their brains for food cues after the meal at the end of the program.

“Their results suggest that during weight-loss interventions, the body acts to conserve fat by maintaining a hunger response in the brain, which probably needs to be addressed through drug therapy,” said Ross. Obesity.”

“Because these findings are from a small group of children tested only at the beginning and end of the intervention programme,” said Prof. Ross, “there is no need to examine this central effect at a larger scale.” Detailed studies will be needed to guide intervention plans. The disconnect between central and local appetite control persists long after weight loss is maintained.”

“To be more successful in treating childhood obesity, interventions that lead to rapid weight loss should be avoided, and instead adopted a more gradual and consistent lifestyle over years rather than months,” said Professor Ross. It suggests that change should be aimed at: weight loss and long-term improvement in health.”

Courtesy of the European Pediatric Endocrinology Society