Our Experts, Your Health

When your brain won’t pick up the phone for your gut

The important connection between our brain and our gut is far overlooked. The way in which our brain and stomach communicate is through hormones. In simple terms, think of hormone-gut communication happening via the telephone. Most of the time, our stomach is “on hold.” That’s why it can take a while to get that feeling of fullness when you eat.  Sometimes, the phone lines go down due to metabolic issues. In these instances, it’s time to call the repair man (your primary care doctor or specialist) to help you get reconnected. Let’s take a look at how the hormones work and how medications can target our body to “Pick up the phone!”

Ghrelin (think of this as the ‘grrrr I’m hungry’ hormone), for most individuals, is the hormone that you feel the strongest. Ghrelin tells the body to increase energy intake. Generally, when you are at the point where you feel hunger pains, you have waited too long in between meals or are intentionally cutting calories in your daily diet plan. The body senses it is going without food, and ghrelin starts to roar, telling the body to eat. When the body feels the hungry hormone but lacks the satiety hormone (leptin), it’s difficult not to over-eat.

Let’s talk more about satiety hormones, starting with GLP-1.  GLP-1 is a gut hormone in the body that signals the feeling of fullness. Studies have shown that taking GLP-1 might help in weight loss because it makes a person feel full sooner.

An FDA approved drug called Belviq works in the neurotransmitter message center in the hypothalamus of the brain. Belviq acts on serotonin with the effect of decreasing appetite and increasing satiety. Although GLP-1 and Belviq have shown promising successes, it is important to note that weight loss with these medications tends to top out at 2-5% of body weight. Lifestyle changes and possibly other interventions are necessary for dramatic weight loss.

Replenishing or increasing gut hormones is not a cure-all for overweight and obesity. These therapies are used as a tool to help the body recognize those low or no responses to food. These therapies are just part of the puzzle for some people’s weight loss. It is important to remember that smart, healthful food choices and physical activity are the way to maintain a life-long healthy weight.


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