New Developments in Appetite Control

Saturday, March 5, 2011: 4:00 PM-5:30 PM
Point Hilton at Squaw Peak
This presentation will focus on the endocannabinoid system in our bodies. These chemical messengers play a crucial role in appetite and have been used in many medical treatments to stimulate appetite and prevent muscle wasting. They have also been used to address food cravings, obesity and metabolic syndrome. We will look at their role in the brain and how our bodies use a unique regulatory system to address weight issues.
The endocannabinoids (anandamide and 2-AG) were first discovered in porcine brain in 1992.  Their receptors were identified shortly after and the amount of research multiplied to 100 publications per month. Their unique style of regulation (different from serotonin or dopamine) is an "on demand" mechanism rather than a reuptake mechanism which is unique to these transmitters. They are located in the brain and in the peripheral body-mostly dealing with immune mechanism. There are several interaction with leptin and insulin but their overall invovement with energy homeostatis and metabolism is enlightening. Blocking the CB1 receptors increases glucose tolerance. Direct injection of anandamide into the hypothalamus causes hyperphagia.  It affects energy metabolism in fat cells, pancreatic cells, brain cells ( inhibits GABA), liver, muscle and adipose tissue.  The research is there, the outcome of the research leads to new possibilities of appetite control and our understanding of this important system.  Dieting causes enhanced levels of anandamide and the same effect is seen in menopause. So why didn't blocking the receptors (Rimonabant) solve the obesity issue? This will be discussed as will possible other treatment possibilities.
CB1 receptor activation increases blood glucose levels via several potential mechanisms, including inhibition of insulin release, and of glucose utilization by peripheral tissue and brain cells. It stimulates appetite and ingestive behavior through central mechanisms -primarily the hypothalamus. The receptor acrivation facilitates the growth of fat deposits. Endocannabinoids are involved in stress recovery in the body and we will look at that from a benefical phylogenetic component of the system. Why are these receptors found all over the body and so little is known about their role compared to the other biochemical systems? The goal will be to stimulate discussion on possible implications of this system and possible ways a better understanding will lead to treatment.
Primary Presenter:
Vicki Berkus, M.D., Ph.D, CEDS

I have been in private practice for 5 years as a psychiatrist specializing in eating disorders. I have been a past president of IAEDP and on the board for 7 years. I have authored a book titled "10 Commitments to Mental Fitness" Reed Publishers. The patients have taught me the most about eating disorders and allowed me to present at numerous conferences. I headed the in-patient Eating Disorders program at Sierra Tucson for 8 years. I left Arizona to take a position in Tampa Florida as the chief science officer for American Medical Technologies-a medical investment group.

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