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Interesting new Time magazine article by same title as this post, addressing the "symphony of hormonal changes sends the body relentless signals to slow metabolism and increase the urge to eat, for at least a year after weight loss."

Given that more than a few participants here at PH are admirably well informed and speak up regularly on topics related to hunger, leptin, hormone signaling/cascading, and the whole "starvation response" as a supposed evolutionary strategy:

Do you agree with the conclusions presented in the story? Especially this:

"What is clear, however, is that obesity is not merely a problem of failed willpower or an unhealthy food environment. Solving it will require far better treatments than we've got now, perhaps including drugs that can balance dieters' hormones and restore normal appetite. 'A combination of medications will probably be required,' the authors write, although no such drug has been approved by the Food and Drug Administration."

Among the questions not addressed: Will such drugs be of the appetite-suppression-upper kind? Or rather drugs aimed to promote specific hormonal changes? System-wide ramifications either way; duh.

Hack Time's perspective, if you please.

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8 Answers

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I can't believe they didn't use a control group...

Anyway, fat loss should result in a reduction in circulating leptin levels for any person, simply because that's its purpose. Had they used a control group, I think they would have found that never-obese people at the same weight produce more leptin the previously obese, due probably to adipocyte hyperplasia.

I went into it a bit in this thread: http://paleohacks.com/questions/65101/is-the-hypothalamus-ill-equipped-to-cope-with-obesity#axzz1bwWOce4q

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Sounds like the prelude to a quick fix "cure" that will carry with it a never ending list of known and unknown side effects. But it will be sold, and make billions only to pay out millions in damages so net effect = MO MONEY!

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I think quick-fix has been tried before, too. Ever read The Last Chance Diet? – thhq Oct 27 2011 at 19:57
I'm glad one of the two Jays changed his name. Now I hope I'll be able to tell you guys apart. – Paul Oct 27 2011 at 20:08
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This study was small and flawed. Starting folks off on 500 cals a day for 10 weeks is certainly a good way to wreck metabolisms, and the post-weight-loss diet/counseling left a lot to be desired in terms of health or weight loss maintenance. But re the conclusions:

What is clear, however, is that obesity is not merely a problem of failed willpower or an unhealthy food environment.

Sounds good so far.

Solving it will require far better treatments than we've got now

Or at least better understanding of the causes. Getting away from eat less, move more would be a good start.

, perhaps including drugs that can balance dieters' hormones and restore normal appetite. A combination of medications will probably be required,

As if! Translated: "It will take us quite some time to come up with the right medications that will enable people to eat the high calorie, nutrient-deficient Western diet and maintain a desired weight without scary complications from the drugs."

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At least one person in the paleosphere (ItsTheWoo) claims leptin injections have allowed her to manage leptin deficiency and maintain weight loss. Sounds like a drug that could "balance dieters' hormones"...

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"Leptin injections may help maintain weight loss" (2006, small study): "Doctors...found that injecting the hormone leptin into their patients who had lost weight helped them maintain weight loss by restoring pre-weight loss levels of leptin....They then administered leptin injections bid to 10 patients who had lost 10% to 12% of their body weight. Most of the body's changes that typically work against maintaining a reduced body weight were reversed once the levels of leptin were restored to the higher levels seen before weight loss." – Dorado Galore Oct 27 2011 at 20:45
Link to preceding: pharmacytimes.com/publications/issue/2006/2006-02/… – Dorado Galore Oct 27 2011 at 20:46
Inthewoo talks about her experience. Her experience was not indicative of what amgen found. – The Quilt Oct 27 2011 at 22:02
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In the Amgen synthetic trials is was shown that leptin can induce adipocyte apoptosis so it can kill off the excess cells that are made from IR adipocyte growth.

Here is a quote from an NIH article,

“Leptin, produced in adipose tissue, acts both centrally and peripherally to orchestrate complex metabolic and behavioral changes that increase loss of adipose tissue, including suppressing food intake and increasing thermogenesis. In addition, recent evidence indicates that leptin acts centrally to trigger an apoptotic process resulting in adipocyte deletion. Loss of adipocytes by apoptosis may provide an explanation for the unexpected delay in return to initial energy status following leptin treatments. This review summarizes the major aspects of leptin-induced adipose tissue apoptosis, including some of the newest findings about possible mechanisms of action.”

http://www.ncbi.nlm.nih.gov/pubmed/12815275

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your view on leptin....its soooooo backwards – Mallory Oct 28 2011 at 17:51
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Sadly, I'm living proof that it's true. I'm very strong-willed (aka stubborn and tenacious) yet I have lost and regained 50 or more pounds FIVE times! Since going primal, I've lost 25+ but I still have 40 or 50 to go and I'm struggling with wheat/sugar cravings.

On my first 2 months of primal, I lost over 30 pounds at right around 75g per day of carbs but then I got too cocky and went on a "weekend" junk food binge and I was able to get back onto primal but nowhere as low as 75 daily grams of carbs. I accidentally had done the Dr Jack Kruse leptin reset protocol and I plan to try it again very soon because I believe it's the best solution for me long term.

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I'm in the same boat with you Nance. I've lost and gained large quantities of weight a few times as well. – vdh1979 Oct 27 2011 at 21:31
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This is the dawning of the age of amphetamines.

Redux. Drugs? Seriously hasn't that already been tried?

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Well from what I've read researchers don't really understand hunger/satiety entirely........ I follow blood type O diet, it's paleo-esque, so for me I have to eat animal protein and fats to keep the hunger at bay. Yet within my genotype which is Hunter there is constant discussion of the "hunger" issue. On the one hand I have a high metabolism so I can eat more-- the most I have weighed in 15 years is like 110--- yet the reason I have kept my body fat down is because I know what to eat. At some point there needs to be discussion that the reason people can't lose the weight and keep it off is because they don't know specifically what to eat. Just telling people to eat less and move more or eat Paleo isn't good enough imo. I'm pure paleo gene wise & managed my weight in hs thru 6 days a week of intense cardio and a starvation diet more or less. The second I started back on meal frequency and regular food it was a trainwreck of cravings, hunger, fat gain etc till the day I started eating high protein. People say this way of eating is just a fad but I've been doing it 15 years and have my hunger under control to some degree. Maybe I just locked on to what works for me based on my genetics...... because truly not everyone is going to eat everything in sight just from eating a bagel.

Article from J. Stanton about hunger/satiety etc: http://www.gnolls.org/2304/why-are-we-hungry-part-1-what-is-hunger-liking-vs-wanting-satiation-vs-satiety/

Ori Hofmekler explains that you must get control over your hunger-- easier said than done for most people: http://www.defensenutrition.com/articles/food_making_you_old.php

I personally think suppressing insulin is key for most people also. But some people can eat carbs.... whether you like that fact or not.

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