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Wednesday, 21 March 2012

Ghrelin Or Gremlin - To Coin A Phrase

Title with acknowledgement to Richard Robinson
Did anyone see last nights Horizon Programme about Obesity .... the ultimate facts?

The programme pointed to some distinct differences between people in terms of their suceptibility to overweight, with focus on two hunger and satiety hormones, ghrelin and Pyy3-36. The programme suggested that bariatric surgery would correct the appetitive brain and make fatty sugary foods unattractive.

Having watched the programme, I feel that it was unduly reductionist. For example the distinct differences between the hunger and satiety hormones ghrelin and Pyy may have been caused by overeating and may not be endogenous. There are many other less well understood appetitive hormones which play a role in eating.behaviour.

The brain changes in bariatric patients affecting reward systems and the drive to eat high fat/sugar foods might well be influenced by gut function. Bariatric patients do tell me that they feel transformed by their operations. However the programme did not inform us about the cons of surgery.

I have sought the opinion of someone who is overweight and not an obesity professional, who didn't find this programme very useful. He said, I don't want surgery, is this the only thing that I can do?

It might be useful to have people believe that obesity is "not their fault". There are differences between individuals in terms of genes, life experiences, cognitive function, maternal eating habits in pregnancy, emotional resilience, environment and physiologcal makeup. So obesity treatment will remain complex and personal. One day there may well be a brave new world where each child showing risks for obesity can be fitted with a gut implant to control their appetitive brain. Until then, the battle against our fat cells continues.

1 comment:

  1. Thanks Deanne for this article, I completely agree and thought too that although some salient points were made about obesity not being a person's fault or down to willpower, the overall impression that surgery was a cure all phenomena made me feel rather dismayed. This takes away any attempt at self efficacy surely? Or the ability for each individual to change and be "at cause" for themselves. Let's just have the op, or develop a pill or go externally outside of ourselves for the fix shall we? That's really going to help people take action if that's the message they heard! Shame we can't make another programme with more of a non surgically biased slant! :- )