title: Gastrointestinal hormones and their role in obesity.
abstract: OBJECTIVE
  Pandemic obesity is the most pressing health issue of this century. The most successful treatment so far is bariatric surgery, but for various reasons, surgery cannot be applied to all patients who require treatment. Gastrointestinal hormones are likely to play a key role in the success of bariatric surgery. This article examines in detail three of these gut hormones: peptide YY, oxyntomodulin and pancreatic polypeptide, and reviews how recent developments may offer new targets for therapy.
  
  
  RESULTS
  Both the free fatty acid 2 and the melanocortin 4 receptors have been discovered to regulate peptide YY and glucagon-like peptide-1 secretion, and drugs targeting these may represent new antiobesity therapies. Dual agonism of glucagon-like peptide-1 and glucagon receptors, for example with oxyntomodulin, has synergistic effects in reducing appetite and increasing energy expenditure. Plasma pancreatic polypeptide concentration correlates with visceral adiposity, and may serve as a biomarker for metabolic syndrome.
  
  
  CONCLUSIONS
  Gut hormones continue to show promise on an individual basis as anti-obesity treatments, but combination therapies are needed to achieve beneficial effects comparable to bariatric surgery. Innovative pathways for stimulating native gut hormone secretion may well provide an alternative method for weight loss without necessitating the administration of gut hormone analogues via injection.
authors.affiliation: Department of Investigative Medicine, Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK.
authors.forename: Sirazum M
authors.initials: SM
authors.lastname: Choudhury
authors.forename: Tricia M
authors.initials: TM
authors.lastname: Tan
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Bloom
mesh_terms: D015415:Biomarkers / Q000378:metabolism*; D006801:Humans; D009765:Obesity / Q000378:metabolism*; D053772:Oxyntomodulin / Q000378:metabolism*; D010191:Pancreatic Polypeptide / Q000378:metabolism*; D019894:Peptide YY / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D053772:Oxyntomodulin; D019894:Peptide YY; D010191:Pancreatic Polypeptide