Obesity is a significant global health concern, affecting an estimated 124 million children globally. Many other health problems, like type 2 diabetes, heart disease, and cancer, are more likely to happen if you are overweight.

Family-based behavioral therapy with regular outpatient sessions that emphasize nutrition and physical activity education is frequently used to treat childhood obesity.

In the United States, the gold standard for such programs is a minimum of 26 contact hours spread over a 6-month period; however, many children regain weight soon after completing the program.

It is unclear why the success rate is so low. Activity in both the brain and the digestive system regulates appetite and metabolism, and so does weight gain.

It may be possible to better understand the mechanisms causing children to have rebound weight gain by examining how these processes are impacted by weight loss.

According to a new study presented today at the 60th Annual European Society of Paediatric Endocrinology Meeting, children with obesity who have recently lost weight are more likely to experience hunger-related activity in their brains after a meal.

This brain activity, which indicates that individuals were dissatisfied with their meal, occurs despite the fact that their gut hormone levels have changed, as expected, to lower hunger and show fullness.

This difference between how their brain and digestive system feel about food may be why many people gain the weight back, especially after going on a strict diet.

In this study, Professor Roth and associates at Seattle Children’s Hospital in the United States compared the activity of the brain regions that regulate hunger with the reactions of the gut hormones in obese children before and after a 24-week weight loss program.

They evaluated the activation patterns in brain regions that control hunger in response to high- vs. low-calorie images after a meal using functional MRI. In addition, the levels of gut hormones were measured before and after meals at the beginning and end of the program.

After a meal, children still showed significant levels of activation in brain areas related to appetite in reaction to food images, indicating that they were hungry at the end of the program. However, their levels of gut chemicals that regulate hunger showed fullness and satiety.

Surprisingly, towards the end of the program, after eating, the kids who had dropped the most weight displayed the highest brain response to food signals.

The findings “imply that during weight loss intervention,” according to Professor Roth, “your body acts to conserve fat through maintaining hunger responses in the brain, and that this needs to be addressed, perhaps through drug treatment, for successful and sustained weight loss in children with obesity.”

Although Professor Roth adds, that these findings are based on a small sample of children examined just at the beginning and conclusion of the intervention program; therefore, larger and more in-depth investigations are required to corroborate this central effect. 

To inform therapeutic strategies, according to the professor, it would be helpful to find out how long there remains a gap between central and local appetite regulation after sustained weight loss.

“For more successful treatment of obesity in children, we should avoid interventions that lead to fast body weight reductions and instead aim for more gradual and consistent lifestyle changes, over years rather than months, which will lead to sustained and long-term improvements in weight loss and health,” says Professor Roth.

Image Credit: Getty

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