Energy balance, the relationship between energy intake and expenditure, is regulated by a complex interplay of hormones, brain circuits and peripheral tissues. Leptin is an adipocyte-derived cytokine that suppresses appetite and increases energy expenditure. Ironically, obese individuals have high levels of plasma leptin and are resistant to leptin treatment. Neurotrophic factors, particularly ciliary neurotrophic factor (CNTF) and brain-derived neurotrophic factor (BDNF), are also important for the control of body weight. CNTF can overcome leptin resistance to reduce body weight, although CNTF and leptin activate similar signalling cascades. Mutations in the gene for BDNF lead to insatiable appetite and severe obesity.