Endocrine Abstracts

The key centre regulating energy balance is the hypothalamus. It receives several inputs. First there is the input from the CNS. Higher centres (psychological input) give information about food palatability, likely environmental dangers during feeding etc. There is also information of a more basic kind (sleep/wake cycles, pain, metabolic disturbance etc). Secondly there is somatic afferent input, for example from the vagus, which is mainly processed and relayed through the bra...

We have established a cohort of 700 subjects with severe early-onset obesity. The average age of onset of clinical presentation of obesity is less than 5 years of age and the mean body mass index standard deviation score is >4. In this cohort, we have detected three independent probands with congenital leptin deficiency, and they and their families are currently undergoing a long-term therapeutic trial of leptin replacement therapy with beneficial effects on energy balance,...

It is now accepted that the medical consequences of obesity require and justify effective medical strategies to be used alongside attempts at lifestyle modification. Evaluation of , and true clinical outcomes require trials of many years duration.At present drug treatment is limited. Two drugs have been approved by NICE after systematic reviews. Orlistat inhibits gastric and pancreatic lipases to produce 30% fat malabsorption. A number of trials for up t...