Levels of hormones regulating appetite and energy homeostasis in response to a 1.5-Year combined lifestyle intervention for obesity

Abstract

Background: Weight loss can induce changes in appetite-regulating hormone levels, possibly linked to increases in appetite and weight regain. However, hormonal changes vary across interventions. Here, we studied levels of appetite-regulating hormones during a combined lifestyle intervention (CLI: healthy diet, exercise and cognitive behavioral therapy).Methods: We measured levels of long-term adiposity-related hormones (leptin, insulin, high-molecular-weight (HMW) adiponectin) and short-term appetite hormones (PYY, cholecystokinin, gastric-inhibitory polypeptide, pancreatic polypeptide, FGF21, AgRP) in overnight-fasted serum of 39 patients with obesity. Hormone levels were compared between T0 (baseline), T1 (after 10 weeks) and T2 (end of treatment, 1.5 years). T0-T1 hormone changes were correlated with T1-T2 anthropometric changes.Results: Initial weight loss at T1 was maintained at T2 (−5.0%, p < 0.001), and accompanied by decreased leptin and insulin levels at T1 and T2 (all p < 0.05) compared to T0. Most short-term signals were not affected. Only PP levels were decreased at T2 compared to T0 (p < 0.05). Most changes in hormone levels during initial weight loss did not predict subsequent changes in anthropometrics, except for T0-T1 decreases in FGF21 levels and T0-T1 increases in HMW adiponectin levels tended to be associated with larger T1-T2 increases in BMI (p < 0.05 and p = 0.05, respectively).Conclusion: CLI-induced weight loss was associated with changes in levels of long-term adiposity-related hormones towards healthy levels, but not with orexigenic changes in most short-term appetite signals. Our data indicates that the clinical impact of alterations in appetite-regulating hormones during modest weight loss remains questionable. Future studies should investigate potential associations of weight-loss-induced changes in FGF21 and adiponectin levels with weight regain.

The effect of radiofrequency treatment on insulin resistance in obese post-menopausal women: a randomized controlled trial

“…The hormonal milieu changes of menopause, impacting sex steroid release from adipose tissue, can further dysregulate body fat deposition (Varma et al, 2023). A multifaceted obesity treatment approach features culturally appropriate lifestyle and behavioral changes, pharmacological and surgical evaluation, and aerobic plus resistance physical activity for weight reduction (Kalmykova, 2023;Kuckuck et al, 2023). Pharmacotherapy is an impactful component of holistic, maintainable weight loss by boosting behavior and diet changes, which by themselves may only partially reduce weight and can be difficult to sustain because of adaptive physiological responses (Kuckuck et al, 2023).…”

“…A multifaceted obesity treatment approach features culturally appropriate lifestyle and behavioral changes, pharmacological and surgical evaluation, and aerobic plus resistance physical activity for weight reduction (Kalmykova, 2023;Kuckuck et al, 2023). Pharmacotherapy is an impactful component of holistic, maintainable weight loss by boosting behavior and diet changes, which by themselves may only partially reduce weight and can be difficult to sustain because of adaptive physiological responses (Kuckuck et al, 2023). Medications are suggested for obesity when BMI is ≥30 or in overweight patients (BMI ≥27) with comorbidities like diabetes, hypertension, and hyperlipidemia (Cornier, 2022).…”