Gut mechanism responsible for rebound weight gain in children with obesity uncovered

As childhood obesity rates continue to skyrocket, scientists are trying to tackle the root from all angles. New research shows that children with obesity who’ve experienced recent weight loss are more likely to display hunger-related brain activity post-meal.

This type of activity represents dissatisfaction with their meal, and this happens despite positive changes in their gut hormone levels that are meant to promote a feeling of fullness. Researchers believe this may be why most people who lose weight by restriction end up gaining it all back after a short period.

Generally for children, obesity is managed through behavioral therapy involving the family in that process. They will attend regular outpatient check-ins with a dietitian or weight management educator to help guide them through their journey. In the United States, this patient population generally receives a minimum of 26 hours over a 6 month timespan.

Soon after they finish is when things begin to unravel, and weight creeps back up. It’s now a matter of asking why these programs rarely succeed long-term, and how brain and gut mechanisms play a role in regaining weight.

To delve deeper, Seattle Children’s Hospital researchers compared brain appetite regulation activity with gut hormone responses in obese children before and after participation in a 24-week weight loss program. They were able to assess brain activation trends in areas that regulate appetite using functional MRI in appetite-regulating brain. They monitored changes in response to participants viewing high and low-calorie food photos after eating. To monitor gut hormone levels, they assessed values before and after meals and at the beginning and end of the program.

By program end, the children showed gut hormone levels indicative of fullness, yet their brains showed a different story. They still had high activity in appetite-regulating areas of the brain after meals and seeing pictures of food, which means they were still hungry. Children who dropped the most weight over the 24-weeks actually had the highest amounts of brain activity, suggesting they are probably going to be the first to regain.

 “Our results imply that during weight loss intervention, 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,” says Christian Roth, lead author of the study, in a statement.

While these results are promising for figuring out how to sustain weight loss in kids with obesity, Roth also warns that this work was conducted with a smaller sample than required in order to reach solid conclusions in the future.

For now, Roth and team agree that it’s safe to say that restrictive diets likely won’t lead to a lifetime of health habits. “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,” he suggests.

This study was presented as part of the European Society for Paediatric Endocrinology

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