[Body-weight regulation in children: a key to obesity physiopathology understanding].
Body weight is regulated within a narrow, individualized range despite large daily caloric mismatches. This process which maintains a stable level of body weight is known as adipostat. Peripheral adiposity signals, mainly leptin and ghrelin, communicate the status of energy stores in the body to the hypothalamus, which in turn coordinates adaptive responses to energy imbalances via reciprocal alterations in appetite and energy expenditure. Obese individuals also display behavioral and metabolic adjustments to weight perturbations as if their adipostat attempts to maintain their elevated body-weight. Efforts to reduce the weight of obese subjects from the elevated levels they ordinarily display are frequently ineffective because their adipostat actively resists by stimulating appetite and reducing energy expenditure. These adaptive responses to weight loss may be an explanation to understand the traditional failure of obesity treatment. Strategy of directly altering the energy-regulating system may be a promising therapeutic approach.
Tounian
P
P
Service de gastro-entérologie et nutrition pédiatriques, hôpital d'enfants Armand-Trousseau, AP-HP, Paris, France. p.tounian@trs.ap-hop-paris.fr
D001835:Body Weight / Q000502:physiology*; D002648:Child; D004734:Energy Metabolism; D006801:Humans; D009765:Obesity / Q000503:physiopathology* / Q000628:therapy