Abstract
Many recent findings have been reported on the somatic and psychological aspects of mechanisms related to the regulation of eating. In this paper, we describe therapeutic methods for obesity from these points of view. 1) A clinical outline of the psychological and somatic profiles of obese patients. Personality traits including depression, neuroticism, low self-esteem, and low impulse control have been reported for obese patients. In contrast, research using functional magnetic resonance imaging (fMRI) has reported the possibility that the response reward system during meals is genetically different in obese and normal subjects. In addition, the presence of obesity-related genetic polymorphisms that interfere with weight loss by affecting the basal metabolism rate has been reported. 2) Research on eating and systems that regulate metabolism. When the metabolic control system responsible for preventing weight gain breaks down, fat cells are enlarged. As a result, local inflammation and secretary abnormality of adipocytokine begins. This cycle exacerbates the obesity. 3) Research on appetite in our department. When healthy women under hypnosis imagined eating, their feelings of hunger and their electrogastrograms were similar to what would be seen when eating a real meal. However, none of the eating-related peptides, including ghrelin, showed a significant change. In another study, food intake from a buffet style meal was not correlated with eating-related peptides. Interoceptive awareness and self-reproach were related to caloric intake by multiple regression analysis of psychological tests. 4) New therapeutic approaches to obesity. From the viewpoints of pharmacotherapy and the psychotherapy, the prevention of weight rebound is currently an important theme.
