Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Denver, Aurora, CO 80045, USA.
Physiol Behav. 2011 Sep 26;104(4):608-12. doi: 10.1016/j.physbeh.2011.04.003. Epub 2011 Apr 9.
Obesity is a serious and growing public health problem in the United States and the world. While weight loss is associated with significant benefits in obesity-related co-morbidities, successful long-term weight loss maintenance is extremely difficult. This limited success is primarily due to biologic mechanisms that clearly favor weight regain. The weight-reduced state is associated with not only reductions in energy expenditure and changes in substrate metabolism but also in increased energy intake. Measures of appetite (increased hunger, reduced satiety) clearly change with weight loss. These changes in appetite may be mediated by alterations of peripheral appetite-related signals, such as leptin and meal-related gut peptides, promoting energy intake. Furthermore, significant changes in the neuronal response to food-related cues in the weight-reduced state have also been shown, stressing the importance of the interactions between homeostatic and non-homeostatic regulation of energy intake. In summary, the weight-reduced state is clearly associated with a dysregulation of energy balance regulation, resulting in a milieu promoting weight regain, and thus being one of the major obstacles of "treating" obesity and reducing its comorbidities. This paper will review the adaptations in the central regulation of energy intake that occur after weight-loss or in the weight-reduce state in humans, including changes in peripheral appetite-related signals and neuroimaging studies examining the brain's response to weight loss.
肥胖是美国和全球严重且日益严重的公共卫生问题。虽然体重减轻与肥胖相关合并症的显著益处相关，但成功的长期体重维持非常困难。这种有限的成功主要是由于生物学机制明显有利于体重恢复。体重减轻状态不仅与能量消耗减少和底物代谢变化有关，而且与能量摄入增加有关。食欲的衡量标准（饥饿感增加，饱腹感降低）显然会随着体重减轻而变化。这些食欲变化可能是通过改变外周食欲相关信号（如瘦素和与膳食相关的肠道肽）介导的，从而促进能量摄入。此外，还显示体重减轻状态下对与食物相关的线索的神经元反应也发生了显著变化，强调了体内平衡和非体内平衡调节能量摄入之间相互作用的重要性。总之，体重减轻状态与能量平衡调节的失调明显相关，导致促进体重恢复的环境，因此成为“治疗”肥胖症和减少其合并症的主要障碍之一。本文将综述人类在体重减轻或体重减轻状态下，中枢能量摄入调节的适应性改变，包括外周食欲相关信号的改变和神经影像学研究检查大脑对体重减轻的反应。
