Chapter 9 Leptin/Grehlin: The Counterbalance

Balance.  Over and over we find that Mother Nature created balance in our life.  In the last chapter, you learned about the balance between the pancreatic enzymes of insulin and glucagon.  When our blood sugar is high, the pancreas makes insulin to bring the levels down.  When our blood sugars are low, then the pancreas produces glucagon to release stored sugar to supply necessary energy.

In this chapter, I want to introduce you to another balance system.  In the normal process of fat storage, the fat cells themselves create a hormone called leptin, the “satiety hormone”.  The message that it gives to the body is, “you have enough food, now go out and get some physical work done”.  The counterbalance signal is a hormone produced by the stomach called ghrelin.  We call ghrelin the “hunger hormone” and we will cover it later in this chapter and in the upcoming bariatric surgery chapter.

For now, though, just understand that when people eat non-processed, everyday foods and get plenty of physical activity everything is in balance and life is well coordinated.

Back in 1954, scientists were evaluating a strange mutant strain of mice that was three times fatter than normal mice and had appetites that seemed like they were never satisfied.  We would later learn that these mice were leptin deficient. The gene responsible for this deficiency was called the obesity gene and mice that had two copies of the gene were called “ob ob” mice.  It was not until 1994 that a Rockefeller molecular geneticist, Dr. Friedman was finally able to isolate the hormone that was associated with this genetic mutation.  They named it leptin and it seemed to be a “master hormone” that regulated eating, physical activity, and even reproduction.   Could this be the answer for the obesity crisis?  Perhaps all we needed to do was give everyone leptin, maybe even put it in the drinking water supply!

As you might imagine, 10,000 research articles suddenly appeared.  It had worked so well in animals, but the humans had a strange finding.  Obese humans had too much leptin!  This proved to be very discouraging.  One pharmaceutical company had spent millions trying to patent the application of this genetic information.  Now it appeared that only a small number of humans had the strange genetic combination that allowed them to lose weight when given leptin. So, what were the rest of the people supposed to do?  Plenty of leptin was available, but it didn’t work like it did with the mice.  Instead, the findings showed leptin resistance, which means we stay hungry and don’t want to exercise.  So everything that you have learned about insulin resistance, you can apply to leptin resistance. 

Now let us look at the hormone ghrelin and perhaps, finally we can put our two “balance hormones” together.  Ghrelin was first discovered to be produced in the large outer curve of the stomach.  Later it was learned that it was also produced in small amounts in other organs, the small bowel, pancreas, adrenal gland, and even ovaries.  This hormone works in our “hind brains”.  You will remember that this is the autonomic or automatic part of our brains.  It is the part of our brain that is not readily under the control of our “front brain” or conscious mind where we make deliberate decisions like when to cross the street to avoid traffic or when to pay our taxes.  Studies have shown that when people are given ghrelin they become aware of hunger.  That is why we call it the hunger hormone.  It is possible that this hormone may also make us want to stop physical activity.  So now you may have another excuse for not keeping those resolutions to do daily physical exercise. 

Multiple studies have documented that when you lose weight by “dieting”, your ghrelin levels increase.  You may have experienced this over and over.  You “white knuckle” your way to a 20 pound loss only to experience raw cravings that are beyond conscious management if you are going to do anything else in life except manage your food cravings.  This is the effect of ghrelin and a host of other “hind brain” signals.  If you have the “heavy biology”, any weight loss is sensed as a total disaster to your body’s efforts to maintain life by your brain. 

It now appears that once again, the “clash” is between a perfectly orchestrated biology that finds itself in a conflict with a terribly distorted environment.  When everything is working in harmony, you would glad to have your hind brain signaling that you need to eat more to replace the weight you had lost.  This would be critical for your survival. 

But it’s not like that now, is it?  You are desperately trying to keep your weight off, and have no desire to regain it! 

I know where your mind is already going.  Why don’t “they” just make a medication that can correct this imbalance between ghrelin and leptin?  You thought it, didn’t you?  Well it is not because of not trying, but so far you will not read about any available drugs to correct this leptin/ghrelin problem.  I will, however, tell you about other medications that can help you accommodate for “this clash”, when your “hind brain” is hormonally demanding that you regain any weight that you have lost.