4.7 Review

New Horizons: Is Obesity a Disorder of Neurotransmission?

Journal

JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
Volume 106, Issue 12, Pages E4872-E4886

Publisher

ENDOCRINE SOC
DOI: 10.1210/clinem/dgab421

Keywords

obesity; neurotransmitters; melanocortin; neurometabolic pharmacology; antipsychotics

Funding

  1. Canada Research Chairs
  2. Reseau Quebecois de Recherche sur les Medicaments
  3. Cardiometabolic health, Diabetes and Obesity Research Network
  4. Fondation Insitut Universitaire de Cardiologie et de Pneumologie de Quebec
  5. Sentinel North program (Canada First Research Excellence Fund)
  6. Sleep Research Society
  7. Sentinel North Partnered Research Chair in Sleep Pharmacometabolism

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The article discusses the possibility of obesity as a disease of the nervous system, suggesting the nervous system as an effective target for treating obesity, but also pointing out the risks and costs involved. It also examines the brain pathways regulating energy balance and how medications affect body weight, aiming to provide the endocrine community with a helpful conceptual framework.
Obesity is a disease of the nervous system. While some will view this statement as provocative, others will take it as obvious. Whatever our side is, the pharmacology tells us that targeting the nervous system works for promoting weight loss. It works, but at what cost? Is the nervous system a safe target for sustainable treatment of obesity? What have we learned-and unlearned-about the central control of energy balance in the last few years? Herein we provide a thought-provoking exploration of obesity as a disorder of neurotransmission. We discuss the state of knowledge on the brain pathways regulating energy homeostasis that are commonly targeted in anti-obesity therapy and explore how medications affecting neurotransmission such as atypical antipsychotics, antidepressants, and antihistamines relate to body weight. Our goal is to provide the endocrine community with a conceptual framework that will help expending our understanding of the pathophysiology of obesity, a disease of the nervous system.

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