Impact of weight loss achieved through a multidisciplinary intervention on appetite in patients with severe obesity

Am J Physiol Endocrinol Metab. 2018 Jul 1;315(1):E91-E98. doi: 10.1152/ajpendo.00322.2017. Epub 2018 Jan 23.


The impact of lifestyle-induced weight loss (WL) on appetite in patients with obesity remains controversial. This study aimed to assess the short- and long-term impact of WL achieved by diet and exercise on appetite in patients with obesity. Thirty-five (22 females) adults with severe obesity (body mass index: 42.5 ± 5.0 kg/m2) underwent a 2-yr WL program focusing on diet and exercise. Body weight (BW), cardiovascular fitness (V̇o2max), appetite feelings, and plasma concentrations of insulin, active ghrelin (AG), glucagon-like peptide 1 (GLP-1), peptide YY (PYY), and cholecystokinin (CCK), in the fasting and postprandial states, were measured at baseline (B), week 4 (W4), and 1 and 2 yr (and average values for all fasting and postprandial time points computed). BW was significantly reduced and V̇o2max (ml·kg-1·min-1) increased at all time points compared with B (3.5, 8.1, and 8.4% WL and 7, 11, and 8% increase at W4 and 1 and 2 yr, respectively). Basal hunger and average hunger and desire to eat were significantly increased at 1 and 2 yr. Basal fullness was significantly increased at W4, and average ratings were reduced at 1 yr. Average AG and PYY were significantly increased, and insulin was reduced, at all time points compared with B. Average GLP-1 was reduced at W4, and CCK was increased at 2 yr. After lifestyle-induced WL, patients with severe obesity will, therefore, have to deal with increased hunger in the long term. In conclusion, sustained WL at 2 yr achieved with diet and exercise is associated with increased hunger feelings and ghrelin concentration but also increased postprandial concentrations of satiety hormones.

Keywords: fullness; ghrelin; glucagon-like peptide 1; hunger; peptide YY; weight reduction.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anaerobic Threshold
  • Appetite Regulation*
  • Body Mass Index
  • Diet, Reducing
  • Exercise
  • Female
  • Glucagon-Like Peptide 1 / blood
  • Humans
  • Hunger
  • Life Style
  • Male
  • Middle Aged
  • Obesity / psychology*
  • Obesity / therapy*
  • Obesity, Morbid
  • Patient Care Team
  • Peptide YY / blood
  • Weight Loss*


  • Peptide YY
  • Glucagon-Like Peptide 1