New research reveals how obesity affects brain chemistry, impacting healthcare.

Obesity and the Brain: How It Affects Food Intake

Obesity is not just a matter of willpower. New medical data suggests that it may permanently alter the way the human brain reacts to food intake. This revelation has prompted calls from physicians and public health experts to include obesity medications in insurance coverage.

According to the National Institutes of Health, over 42% of American adults have been diagnosed with obesity, and nearly 31% are medically overweight. The prevalence of obesity has been steadily increasing in adults, children, and teenagers since 2000.

The Impact on Nutrient Sensing

A recent study conducted by research scientists and obesity medicine specialists from Yale School of Medicine revealed that even after losing weight through diet and exercise, medically obese individuals still experienced a deficiency in nutrient sensing. The study focused on a specific region of the brain called the striatum, which plays a crucial role in regulating eating behavior.

Participants were divided into two groups based on their body mass index (BMI) – “lean” and “obese.” They were fed through a feeding tube to eliminate the pleasure of eating and solely focus on nutrient intake. The study found that lean participants experienced decreased striatal activity and increased dopamine levels when fed sugars and fats, leading to feelings of fullness. However, obese participants did not show the same response, indicating a reduced capacity to process nutrient intake and experience satiation.

Even when obese participants managed to lose 10% of their body weight in 12 weeks, their brain chemistry related to satiation remained unchanged. Lead author Mireille Serlie explained that these findings challenge the notion that obesity is solely caused by a lack of willpower. The study suggests that there is a genuine difference in the brain’s ability to sense nutrients, which may explain why it is difficult for individuals with obesity to maintain weight loss.

A Call for Change

Angela Fitch, president of the Obesity Medicine Association, emphasizes that obesity should be treated as a disease with fundamental biological processes that are dysfunctional. Instead of relying solely on diet and exercise, the study’s results indicate that the dysfunctional relationship between the gut and brain needs to be addressed through medical interventions.

Fitch recommends that anti-obesity medications, such as Wegovy and other semaglutide products, should be covered by medical insurance. She believes that obesity should be recognized as a standard benefit on all policies, including Medicare. Some private companies and insurance plans have already started covering anti-obesity medications, and Fitch believes that with cooperation from health insurance companies, drug manufacturers, and pharmacy benefit managers, access to care can be increased to meet the growing demand for anti-obesity medicine.

Obstacles Ahead

Implementing these recommendations may face challenges. The American Medical Association recently advised against using BMI as the primary indicator for obesity due to its connection to historical harm and racist exclusion. Additionally, patient adherence to prescribed medications, such as semaglutide, could pose problems for insurance coverage.

Despite these obstacles, addressing obesity is crucial. The World Obesity Federation and the World Health Organization estimate that by 2035, over half of the world’s population will be overweight or obese. This not only poses a significant strain on public health resources but also carries substantial economic costs, potentially exceeding the total spending on COVID-19 in 2020.

It is time to recognize the complex nature of obesity and take proactive steps to address it. By understanding the impact on the brain and advocating for comprehensive medical interventions, we can make progress in combating this global health crisis.