Weight loss due to diabetes medication?

It depends on the effect in the brain.

Until now it has been unclear why a certain diabetes medication has lead to reduced hunger and to weight loss in some patients. A recently published study in the scientific journal Diabetes Care has shown a weight reducing effect induced by the so-called GLP-1-Analoga. However, the effect only occurs if the hypothalamus interacts particularly strong with other brain areas.

GLP-1-Analoga imitate the effect of GLP-1-hormons from the human gut, which increase insulin secretion and thus, improve glucose metabolism. Scientists of the Integrated Research and Treatment Centre (IFB) AdiposityDiseases, from the University Medicine Leipzig and the Max-Planck-Institute for Human Cognitive and Brain Sciences have tested the effects of the GLP-1-Analogon Exenatide on brain activities and the sensation of hunger.

For the scientific study, participants received an infusion with Exenatide. During the following functional magnetic resonance imaging the test persons were shown pictures of food while their brain activity had been measured. Afterwards, all participants were allowed to eat as much as they wanted from a buffet. Parallel, the caloric intake of each person was measured accurately. On the trial day the test persons were asked several times to estimate their own feeling of being hungry on a standardized scale.

Half of the study participants felt a reduced feeling of hunger after the diabetes medication. Thus, they consumed 24 per cent less calories while eating from the buffet than test persons who only received a placebo. However, the other half of the participants did not show a response to the diabetes medication and therefore had no decreased caloric intake compared to the placebo group. Test persons with a reduced caloric intake after the Exenatide infusion showed a highly increased interaction of the hypothalamus with other brain areas (connectivity).

This increased connectivity may be the reason for feeling less hungry and finally, for loosing weight with some diabetes patients taking  GLP-1-Analoga. The reasons for the effect of Exenatide on the brain activity of some people have not been clarified yet and will have to  be investigated in follow-up studies.

Prof. Dr. Michael Stumvoll, Scientific Director of the IFB AdiposityDiseases emphasizes: “Such studies contribute to understand the multifactorial causes of morbid obesity and the response of individual subgroups to a particular therapy. If obese patients belong to the group that shows the described effect of GLP-1-analoga, this medication could be used for weight loss therapies. Additionally, it would avoid costs and side effects with patients who do not respond.”

* Randomized, double-blind and placebo-controlled clinical study:
Schlögl H, Kabisch S, Horstmann A, Lohmann G, Müller K, Lepsien J, Busse-Voigt F, Kratzsch J, Pleger B, Villringer A, Stumvoll M.:  Exenatide-induced reduction in energy Intake is associated with increase in hypothalamic connectivity. Diabetes Care, 2013 March 5.
Keywords: IFB-research, obesity treatment