Join Date: May 2002
Hormone may be key to weight loss
Here is an interesting story from MSNBC that I found this morning... Figured it would be a good read.
Story begind below... And here's a link: <A HREF="http://www.msnbc.com/news/755855.asp" TARGET=_blank>http://www.msnbc.com/news/755855.asp</A>
May 22 — A hormone thought to boost appetite rises in the bloodstream after dieters lose lots of weight, possibly explaining why it’s so hard to keep weight off long-term — and offering a new target for a diet drug, researchers say.
A SMALL STUDY of obese people found much higher levels of ghrelin, a recently discovered hormone released by the stomach and upper intestine, in the blood after the patients had lost significant weight.
The finding may be the key to helping overweight people shed extra pounds and keep them off, according to the report in this week’s New England Journal of Medicine.
In tests on 33 people, the researchers found that, in most people, the levels of ghrelin rose spiked before meals and plunged after, both before and after weight loss.
GASTRIC BYPASS EXCEPTION
But the five people who had undergone gastric bypass surgery — an operation that sews shut 95 percent of the stomach and reroutes the flow of food — turned out to be the significant exception. In those cases, ghrelin levels never rose or fell; remaining at nearly undetectable levels. On average, the bypass group had 72 percent less ghrelin than five dieters who ended up at about the same body mass index, a ratio of weight to height.
“Not only did (ghrelin levels) not go up, but in people who lost an enormous amount of weight, it went way down,” said Dr. David E. Cummings, an endocrinologist who led the researchers at the University of Washington and the Veterans Affairs Puget Sound Health Care System.
Cummings and Dr. Mitchell S. Roslin, chief of obesity surgery at Lenox Hill Hospital in New York, say the abnormally low ghrelin levels after gastric bypass could help explain why it is more successful than dieting or operations that simply reduce stomach size.
Some 75,000 to 100,000 severely obese Americans are expected to undergo some type of bariatric, or stomach-reducing, surgery this year. Gastric bypass is meant only for people at least 100 pounds overweight.
The five patients who had gastric bypass surgery dropped from an average of 435 pounds to 280 pounds, while 13 people on a supervised low-fat, liquid diet dropped from an average weight of 220 pounds to 182 pounds. Ten normal weight patients served as controls. In the diet group, ghrelin levels were consistently about 50 percent higher after weight loss.
People trying to stay on a diet had the highest ghrelin levels, which may explain why people who lose weight typically have a hard time keeping it off.
The results are “suggesting that ghrelin might contribute to the drive to eat that makes long-term success with dieting so rare,” said Drs. Jeffrey Flier of Beth Israel Deaconess Medical Center and Eleftheria Maratos-Flier of the Joslin Diabetes
Center, both in Boston, in a Journal editorial.
Ghrelin is thought to be nature’s way of making people fatten up when food is plentiful to increase survival during cycles of famine, a protective mechanism now harmful when plenty of high-calorie food is available The hormone also has a role in promoting growth, from making children taller to building bone density.
CALL FOR MORE RESEARCH
The researchers and other experts say the findings are circumstantial evidence of ghrelin’s effects, and more research is needed.
“This is a first step, and it may be an important hormone, but we don’t know that yet,” said Dr. Xavier Pi-Sunyer, former chairman of the National Heart, Lung and Blood Institute’s obesity task force and director of the Obesity Research Center at St. Luke’s/Roosevelt Hospital Center in New York. “It’s not like this is a breakthrough.”
The body has multiple backup systems for regulating body weight, probably including other hormones not yet discovered, said Dr. Stephen H. Schneider, director of diabetes services at UMDNJ-Robert Wood Johnson Medical School in New Brunswick, N.J.
“This is probably one of a number of substances which control appetite,” and it’s unclear how they interact, he said.
POSSIBLE OBESITY TREATMENT
If controlling the hormone were found to be an effective treatment for obesity, it could help fight a worrying rise in overweight people in the United States. A study published Tuesday in the Journal of the American Medical Association found that one in five Americans were overweight in 2000, up from just over one in 10 a decade earlier.
Some data indicates obesity now outranks smoking as a cause of disease and death, adding millions of dollars to the nation’s health care costs.
“If this approach works, then it might be something we could use even for people who are only modestly overweight,” said Dr. David Cummings of the University of Washington in Seattle, chief author of the new study.
But the Fliers cautioned that further studies are needed to see if treatment with a drug that blocks the effect of ghrelin is a safe and effective weight-loss treatment. Until then, stomach bypass surgery “will remain an important therapy for severe obesity,” they said.
And for people trying to put on weight, especially people suffering from cancer and other wasting disorders, it is possible that treatment with ghrelin may prevent the severe and dangerous weight loss, the Fliers said.
Several major pharmaceutical companies are trying to develop drugs to block the hormone, Cummings said.
“A true cure for obesity would be the biggest moneymaker that any drug company’s ever seen,” he said.
What do you guys think?