Hypothalamic Inflammation: Is There Evidence for Human Obesity?
With increasing awareness of the obesity epidemic have come research efforts to understand the pathophysiology of body weight and appetite regulation. Clinical trials of diet-induced weight loss demonstrate the difficulty of achieving long term success in obese and overweight individuals, leading investigators to examine the question of what mechanisms makes weight loss so difficult. This has lead to a greater focus on neurologic and hormonal reasons that could explain why maintenance of lost weight is so challenging. Injury to the hypothalamic areas known to play a role in feeding and body weight regulation is being studied. Mechanisms of hypothalamic injury include increased inflammation, gliosis/scarring, and apoptosis of anorexigenic neurons in rodent models of diet induced obesity. Although there is evidence of hypothalamic damage due to interference of cell signaling and eventual loss of weight regulating neurons in rodent models, there is limited data thus far on whether we can apply this mechanism of injury to human obesity.