Appetite Control Mechanisms and Obesity

Abstract

Dysregulated energy homeostasis leads to obesity. The brain, particularly hypothalamus and brain stem, plays a key role in the control of food intake and homeostatic regulation of energy metabolism. Food reward-related hedonic controls integrate with homeostatic controls to regulate body weight. The brain determines energy status by receiving peripheral signals, such as nutrients, gut-derived satiety signals, and adiposity-related hormones, via the circulation or through afferent fibers of the vagus nerve. Significant advances in understanding of the molecular mechanisms of appetite control and energy metabolism drove the pursuit of anti-obesity drugs in recent years. The development of incretins as drugs for type 2 diabetes provided unprecedented results in body weight loss. Recently, clinical study results with incretin-based poly-agonists reported mean weight loss greater than 10%, inspiring confidence in development of anti-obesity medications. Here, I briefly review how brain and peripheral signals integrate and interact to regulate homeostatic and hedonic eating behavior and discuss the mechanism of action of recently developed anti-obesity drugs.