The venerable Dr. Mike Eades does a nice job explaining about leptin and hunger, and how carb restriction affects these things - more powerfully than drugs.
The drug rimonabant (Acomplia) that failed to pass
muster with the FDA panel last week works by blocking some of the hunger
receptors in the brain. In other words, those who take the drug – assuming it
works as touted – will be less hungry. Less hunger means less food consumption.
Less food consumption typically results in weight loss. So, if you take
rimonabant, assuming you don’t become suicidal and do yourself in (the big
worry of the FDA panel since the major side effects are varying degrees of
psychoses), you should lose some weight. But there is a better, cheaper way.
The low-carbohydrate diet working through the hormone
leptin reduces hunger much more than rimonabant on its best day. And without the
risk of serious side effects. And without the $250 per month for
the drug.
http://www.proteinpower.com/drmike/metabolism/leptin-low-carb-and-hunger/
The summary:
1. Fat makes leptin, so as fat decreases leptin decreases, signaling the brain to make the human hungry. This way, the human cannot run out of fuel - unless the hunger is not sufficiently motivating (it usually is - funny what millions of years of evolution will do for you) to get the human out to hunt/gather; or, there's inadequate amounts of stuff to be hunted/gathered.
2. Obese folks have mucho leptin - much more than normal, but their body does not translate the leptin into decreased hunger.
3. The reason the obese are not leptin sensitive starts with triglycerides - when trigs are high, leptin does not cross the blood brain barrier (BBB), so for practical purposes, the leptin does not exist.
4. Carbohydrate restriction helps restore this process by reducing triglyceride levels, which allows leptin to cross the BBB, and restore leptin sensitivity.
Fructose also seems to have a negative effect on leptin sensitivity.
Once again, it's the neolithic levels of carb intake, exacerbated by high neolithic-fructose intake, which drives the system off its energy management program, resulting in humans feeling hungry when they are not in need of more food.
Minor edits 27 July 2012
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