Right now, treatments to lose weight are the order of the day, with a clear protagonist like Ozempic. The problem is that beyond the aesthetic effects that are achieved, there are many doubts about both the side effects as well as all the effects it has on the body. But little by little science you understand much better how they achieve their effectwhich seems like a real miracle for many.
What we knew. In general, these treatments They are ‘copies’ of GLP-1 which is a hormone that we produce normally in our body and makes us have the feeling of satiety. The moment we increase it exogenously we have a greater feeling of satiety that allows patients to lose weight (although with a risk of bouncing when treatment is stopped).
But beyond this effect, the action it could have directly on the brain was something that had only been explored in animals. Now, a new study published in Nature has crossed this frontier thanks to Casey Halpern’s team, which has taken advantage of a “unique opportunity” to observe, for the first time in humans, the impact of Mounjaro (tirzepatide) directly into the reward center of the brain.
Why it is important. The discovery of how the brain can ‘hack’ our body to eat much less opens many doors for us in the field of pharmacology to be able to continue working on definitive treatment. against obesitybecause we are seeing that it is something in high demand by many people who find it necessary to have this help (although it is not a miracle) to be able to reduce their weight. And we even see how in the United States purchasing is becoming more and more accessible.
And we say that it is a miracle, because Ozempic or Mounjaro does part of the work, but we must not leave aside the change in eating habits to adjust the diet and be able to maintain it after stopping the treatment. The problem is that there are people who after stopping the treatment continue eating normally, and logically they see that there was no miracle involved.
How it was done. The study focused on a 60-year-old woman with treatment-resistant obesity and type 2 diabetes. This patient was already taking Mounjaro for diabetes, and coincidentally, she was participating in another trial to treat dysregulated eating.
This coincidence allowed the researchers to do something unprecedented: use the electrodes, already implanted in its nucleus accumbens (NAc)for hear brain activity while the drug took effect. And this brain nucleus is really important as it is the center of pleasure in humans and reward, that is, it is the point that can be modulated to restrict food consumption.
The sign of craving. Those cravings we have for eating a little chocolate, a greasy pizza or a hamburger are something we all have because it is what gives us pleasure. In this case it was seen that the signal changed over the months, specifically the delta-theta frequency band.
In the first months of treatments with Mounjaro, the patient had no desire for food in that sense of craving. Something that corresponded to a null signal in this nucleus, so it could be said that the medication was silencing this ‘noise’ that is generated in the pleasure center.
The problem is that in the fifth to seventh months, despite being on the maximum dose of medication, the patient again had severe concern about food. And here again the signal in the nucleus had spiked to match that of those people who had no treatment.
An advantage for the future. The most important finding here is that the change in the brain preceded the behavior. That is, before having a relapse this signal was increasing as if it were a warning signal. That is, a future where a sensor can detect this brain signature and alert the patient or doctor that the effectiveness of the drug is decreasing, before that the person will feel the cravings again in an uncontrolled way.
Much ahead. This is a study with a single person, and it has many limitations and its conclusions logically cannot condition the clinical activity of the use of these medications. What it is useful for (and a lot) is to understand that the brain has a lot to do with this weight loss as if it were a real button to control eating habits.
Perhaps silencing this brain nucleus in a very specific and sustained way may be the ‘holy grail’ that weight loss science seeks to control these cravings that can ruin a diet imposed by specialists. Although there is still a lot to investigate and it is only a first door for other medications that can complement Ozempic or Mounjaro, which has given great results.
Images | Shawn Day Victoria Shes
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