Gastrointestinal hormones and the control of food intake and energy metabolism
Gastrointestinal (GI) hormones are increasingly recognized for their roles in the control of appetite and obesity. In this chapter, we review selected regulatory factors secreted from the gut including ghrelin, glucagon-like peptide 1 (GLP-1), cholecystokinin (CCK), peptide YY (PYY), fibroblast growth factor 19 (FGF19), and bile acids as they relate to appetite, energy balance, obesity, and obesity-related disease states. We also describe emerging pharmacologic interventions that impact these hormones and promote weight loss. In this rapidly developing field, we have only limited understanding of the broad range of actions of the gastrointestinal hormones, including their interplay with gut microbiota. Not surprisingly, data in the pediatric population are limited. Further research is critical to understand how gastrointestinal hormones affect pediatric obesity and may lead to therapeutic strategies for metabolic and nutritional diseases.
