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Obesity: Epidemiology, pathophysiology and insights from fMRI 07 Nov 2019

Obesity, an excessive accumulation of adipose tissue posing a threat to health, is a multi-system condition, and is associated with a multitude of metabolic complications. Obesity now constitutes a major global health threat. The rising prevalence of obesity can be explained by a mismatch between our current environment and the biological systems that control body weight. However, to date, most therapeutic strategies are ineffective at producing longterm sustained weight loss, with the exception of bariatric surgery, which remains the most effective treatment for severe obesity. 

However, despite the success of bariatric surgery in delivering sustainable weight loss and improvement in obesity-related morbidity, effective non-surgical treatments are urgently needed, necessitating an increased understanding of body weight regulation. Neuroimaging studies are significantly contributing to identifying the neurophysiological changes seen in obesity and help increase our understanding of the mechanisms driving the favourable eating behaviour changes and sustained weight loss engendered by bariatric surgery.

These studies have revealed a key interplay between peripheral metabolic signals, homeostatic and hedonic brain regions and genetics. Findings from brain functional magnetic resonance imaging (fMRI) studies have consistently associated obesity with an increased motivational drive to eat, increased reward responses to food cues and impaired food-related self-control processes. 

The presentation provides an update on current epidemiology of obesity, as well as an overview of our current understanding of obesity with a focus upon the role that fMRI studies have played in enhancing our pathophysiology and covers the relevance of imaging the central nervous system using fMRI to improve our understanding of energy homeostasis and body weight regulation, a gateway for development of novel, improved treatments for obesity.

Educational aims:
• Epidemiology of obesity
• Pathophysiology of obesity
• Body weight regulation
• The role of fMRI brain research in improving our understanding of body weight regulation and potential
implications for future obesity treatments

References and citations:
Makaronidis JM, Batterham RL. Obesity, body weight regulation and the brain: insights from fMRI. Br J Radiol.
2018:20170910.

0.5 CPD credit
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Duration:22 mins


Speaker info

Janine Makaronidis

Dr Janine Makaronidis Clinical Research Associate, University College London Hospitals NHS Foundation Trust Dr Janine Makaronidis is a Clinical Research Associate at the UCL Centre for Obesity Research in Professor Batterham’s team. Her main research interests include the neuroendocrine control of appetite and taste and the role of gut hormones on body weight regulation. She is currently out of programme from higher medical specialty training in endocrinology and diabetes in the London Deanery with an interest in working with people affected by diabetes and obesity, particularly adolescents and young adults. After completing her core medical training in the North West of England, she moved to London in 2015 to take a position as an NIHR Academic Clinical Fellow in endocrinology and diabetes at University College London. In 2017, she completed her MSc in Endocrinology at Queen Mary University of London.