December 2004
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IN THIS ISSUE

What's New in Obesity Research? [RETURN TO TOP]

Coming this month in the Journal of Clinical Endocrinology & Metabolism (JCE&M):
Embargoed until December 7

What Effect Does Increased Hunger Hormone Have on Energy and Activity?

Ghrelin is a gut-brain hormone that signals hunger. Despite its known stimulatory effects on appetite and eating behavior, little information on its relationship with energy expenditure in normal-weight people is available. To address this, researchers in the study "Relationship Between Ghrelin and Energy Expenditure in Healthy Young Women" examined the relationship between serum ghrelin and a number of weight related factors. After assessing factors such as resting metabolic rate, thermic effect of feeding, substrate utilization, body composition and physical activity in healthy young women, investigators speculate that serum ghrelin may play a role in the regulation of energy level and act as a hormonal marker for people who burn energy most efficiently.

Fat, Protein or Carbohydrate: Study of Surgical Intervention Provides Insight on the Role of Caloric Intake

Researchers believe that ADMA, an endogenous nitric oxide-synthase inhibitor, may be a cardiovascular risk marker associated with the metabolic syndrome. In the study "Weight Loss Reduces Circulating Asymmetrical Dimethylarginine (ADMA) Concentrations in Morbidly Obese Women," researchers, who studied middle-aged women with a body mass index of 49 +- 1 kg/m2 before gastroplastic surgery and a body mass index of 34 +- 1 kg/m2 after surgery, found that levels of ADMA, which are elevated in morbidly obese patients, were significantly reduced by massive weight loss. This suggests that reducing total caloric intake leads to a decrease in ADMA levels and an improvement in metabolic health.

Translating Research Into Practice: Commentary on the ADMA study from Dr. Glenn D. Braunstein
"We know that reducing weight is the key to reducing cardiovascular risks associated with metabolic syndrome. This new study adds to our understanding of two options for treating the extremely obese. Understanding both the role of diet and surgery will help physicians and patients make decisions about whether surgical treatments for obesity are appropriate."

For more information on Dr. Braunstein, please see the "Expert Resources" section of this issue of The Endocrine Edge.

Obesity: Nature or Evolution?

In the study "Adiposity Signaling and Biological Defense Against Weight Gain: Absence of Protection or Central Hormone Resistance?," investigators explore two theories about how our bodies balance energy intake and energy expenditure. Both are based on the model that under ideal conditions, human body systems regulate intake and expenditure to stabilize body fat mass and achieve a homeostatic (balanced) internal environment. However, the current obesity crisis and ability of many individuals to gain weight consistently over time contradict the model. So why aren't human's "balancing out?" The researchers investigate two theories - the "Absence of Protection" model and the "Central Resistance" model - to answer that question. "Absence of Protection" argues that energy homeostasis operates to defend against weight loss, and that nature never allowed for the defense against weight gain. "Central Resistance" argues that under normal circumstances, the homeostatic environment protects against both weight gain and weight loss, and that obesity, in turn, must have evolved from genetic or acquired defects that impair the functionality of the homeostatic system. Those who support the "Central Resistance" model must, therefore, demonstrate that hormonal resistance occurs in the brain of obese people and that such resistance plays a role in the development of obesity. The researchers conclude that as obesity increasingly becomes a problem in our society, studies that identify its underlying causes take on enormous importance in order to help clinicians aid patients in preventing and treating obesity.

See these studies and more in the upcoming issue of JCE&M from The Endocrine Society. To interview an author or to obtain a copy of the studies discussed above, contact The Endocrine Society.



Expert Resources [RETURN TO TOP]

Glenn D. Braunstein, M.D.
Chair, Media Advisory Committee for The Endocrine Society
Co-Chair, Endocrine Society Obesity Advisory Board

Glenn D. Braunstein, M.D., currently serves as Chair of the Department of Medicine at Cedars-Sinai Medical Center in Los Angeles and is the James R. Klineberg, M.D., Chair in Medicine. Dr. Braunstein is board certified in internal medicine with a subspecialty of endocrinology, diabetes and metabolism. His research interests lie in reproductive endocrinology and he is the Immediate Past President of the Endocrinologic and Metabolic Drugs Advisory Committee of the Food and Drug Administration. A renowned researcher and clinician, Dr. Braunstein can provide perspective on recent research, including that highlighted in this month's issue of JCE&M and clarify its impact on clinical practice.

To schedule an interview with Dr. Braunstein, please contact Marisa Lavine at 301-941-0255 or via e-mail at mlavine@endo-society.org



Other Happening/Events [RETURN TO TOP]

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Revised Obesity Numbers
Recently, the Centers for Disease Control and Prevention (CDC) announced that a report on obesity, which was released last spring, included inflated numbers on the impact of obesity. Data from this report was included in The Endocrine Society's obesity handbook-The Endocrine Society Weighs In: A Handbook on Obesity in America and throughout the Obesity in America Web site. As a result of this announcement, the Society is currently updating the handbook as well as the Web site. The revised numbers will be added as the CDC releases the new data. Please visit www.ObesityinAmerica.org for the latest information.

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FDA News
The U.S. Food and Drug Administration (FDA) plans to release a proposal in December that will tell food manufacturers for the first time to list on packages the percentage of daily recommended calories the product contains.
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ENDO 2004 Webcasts
The Endocrine Society now offers more than 20 hours of endocrine research online through its ENDO 2004 Webcasts at www.endo-society.org The Webcasts provide detailed information about current science related to several areas of endocrinology including obesity. Topics include Global and Childhood Obesity, Controversies in Treating Obesity and Secondary Causes of Obesity. The easy to view format includes slide graphics with accompanying audio from talks that were given during The Endocrine Society's annual meeting.

To request a username and password, which will provide access to the Webcasts, please contact Marisa Lavine at media@endo-society.org



Fast Facts [RETURN TO TOP]

fastfacts icon
Would Faster Identification of Obesity Limit Its Associated Complications?
  • More than half of endocrinologists surveyed recently by The Endocrine Society (56 percent) report that more than half of the obese patients referred to them by another physician are typically referred after complications from obesity have already appeared. Nearly two-thirds of respondents (64 percent) say that of these referred patients, complications resulting from obesity could have been prevented if patients had been referred earlier.
  • The majority of endocrinologists in the same survey (62 percent) believe lack of insurance significantly discourages patients' access to care.

If you have any questions about this issue of The Endocrine Edge or The Endocrine Society, please contact Marisa Lavine at 301-941-0255 or via e-mail at mlavine@endo-society.org or media@endo-society.org.

*The Endocrine Society conducted an online survey of its membership through its Web site between January 26 and February 16, 2004. The survey yielded a response from 250 endocrinologists. The confidence level of the survey is 95 percent.