Ghrelin, the 'hunger hormone,' plays a key role in driving appetite and weight regain. Could tackling ghrelin be the key to tackling obesity?
Clinical Assistant Professor, Department of Medicine, Division of Endocrinology, Gerontology and Metabolism , Stanford University, Stanford, CaliforniaResident, Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, PennsylvaniaServe as a director, officer, partner, employee, advisor, consultant, or trustee for: Internal medicine resident at Allegheny General Hospital, Pennsylvaniaregain itand many end up heavier within 5 years.
Since the discovery of ghrelin, in 1999, research in mice and people has focused on its effect on regulating appetite and implications for long-term weight control. When hunger strikes, ghrelin levels surge, sending signals to the brain that ramp up the appetite. Following a meal,experienced a 46% increase in hunger and ate 28% more at their next meal than those who didn't receive a ghrelin injection.
Excess weight could increase sensitivity to ghrelin, where more receptors lead to higher hunger stimulation with less ghrelin. Beyond hunger, ghrelin can also lead us to eat for comfort, as when stressed or anxious. Ghrelin and synthetic ghrelin mimetics increase body weight and fat mass by activating receptors in the arcuate nucleus of the hypothalamus and Roux-en-Y gastric bypass , have opposite effects on ghrelin levels, reflecting their distinct mechanisms for weight loss.
Could ghrelin be the key to tackling obesity? Blocking ghrelin pharmacologically might be a strategy to keep weight off after weight loss, and it could help prevent the typical rebound effect seen with diets and withdrawal of medications. Considering the high rates of weight regain after diet-induced weight loss and withdrawal of weight loss medications, targeting ghrelin might be the missing link in long-term obesity treatment.
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