All about your “hunger hormones”: Leptin and Ghrelin
and how they control weight loss
58% of adults in Singapore have an unhealthy weight, while 20.7% have obesity. Here’s how weight loss medication can help.
Key Takeaways:
Despite trying several weight loss plans and working out regularly, some people still find it hard to lose weight.
Sometimes, difficulty in losing weight might be due to the dysregulation of hormones that can be exacerbated by the excess weight itself.
Hunger hormones like Leptin and Ghrelin are critical players in regulating body weight.
Leptin, known as the "fullness hormone," signals when it's time to stop eating, while Ghrelin, the "hunger hormone," stimulates cravings when you're hungry.
A combination of lifestyle changes and medications can help combat Leptin resistance, lower Ghrelin levels and aid weight loss.
Weight loss medications are proven to kickstart the process and help recalibrate those hunger hormones.
Singapore’s obesity rate is increasing
Based on the 2019/2020 National Population Health Survey by the Ministry of Health Singapore, 10.5% of residents in Singapore aged 18 to 74 years are obese. Obesity was found to be more common among males than females, and among adults aged 30 to 59 years old.
Should you be concerned?
The answer is yes. Beyond our physique, it is important to keep a healthy weight for our overall health.
However, achieving and maintaining a healthy weight is not as simple as it seems. There’s more to losing weight than just watching the calories you consume and burn.
Some people have tried one or more proven weight loss plans, and exercised with regular cardio and strength training workouts – yet still cannot lose weight and keep it off despite their best efforts.
Is this something you can relate to?
To say that this is frustrating is an understatement. Some people would get discouraged and abandon all efforts altogether – thus leading to an unhealthy road of poor eating, lack of exercise and weight gain.
But here’s something that is worth considering: sometimes, difficulty in losing weight might be due to hormonal imbalances.
Let’s learn more about Leptin and Ghrelin, our body’s hunger hormones, and how they influence our weight.
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Leptin and Ghrelin, Hunger Hormones
Leptin
Leptin is your body’s "fullness signal”. This hormone is released by your adipose tissue (body fat) and regulates hunger by telling our brain when to stop eating – providing the sensation of feeling full.
Leptin regulates your energy balance, so you don’t get a hunger response when your body doesn’t need energy.
When you lose weight, Leptin has a more profound effect. When your body fat decreases, your Leptin levels also decrease. The decrease in Leptin levels signals your body to think that it is starving. The result? Because your body thinks that it is starving, you are driven to eat more. This makes it harder to lose weight. That is also why you tend to feel hungry when you embark on a calorie restrictive diet.
When you gain weight, Leptin levels increase to combat your desire to eat. Yet, beyond a point, the brain begins ignoring Leptin – this is a sign of Leptin resistance. When this happens, your body loses its signal for satiety which can put you on a vicious cycle where you gain more weight from increased eating due to lack of satiety signals. This, in turn, further weakens the satiety signals.
Ghrelin
Ghrelin, the "hunger hormone", is a hormone produced by the stomach. It acts like a hunger alert system. When your stomach is empty or mostly empty, it releases Ghrelin. Normally, Ghrelin levels are highest right before mealtimes – this causes you to feel hungry and that is when we seek out food.
Ghrelin has other functions too, including:
Increasing food intake and helping you store body fat
Raises sugar levels: Ghrelin increases blood sugar by reducing insulin (the hormone that lowers blood sugar) levels and sensitivity. This makes it harder for the body to use glucose.
Protects the heart: Research shows giving ghrelin to animals with heart problems improves heart health. Studies on human participants with heart failure or abnormal rhythms report similar results.
Stop muscle wasting: With age, muscles weaken and shrink. Ghrelin fights this and might be an excellent way to treat muscle-weakening diseases like sarcopenia.
Protect bones: Ghrelin is good for bones too. It makes cells (osteoblasts) that strengthen bones.
There are a few reasons that lead to high or low Ghrelin, including:
High Ghrelin
The levels of Ghrelin in your body tend to increase and decrease, depending on how much you eat. So if you are restricting your food intake – as is the case when you are on a calorie-restricted diet – your Ghrelin levels go up. And when your Ghrelin levels go up, you will feel hungrier. That is why a lot of people find it difficult to sustain weight loss diets – the more we restrict our caloric intake, the hungrier we become.
Low Ghrelin
People with obesity often have low Ghrelin levels. Some researchers believe that this is because people who have obesity are naturally more sensitive to Ghrelin, which is why they feel much hungrier – due to the lower Ghrelin levels.
Recap: Ghrelin and Leptin are just two of many hormones that influence our weight and control our appetite. Leptin decreases your appetite, while Ghrelin increases it.
Can we influence Leptin and Ghrelin to help us lose weight?
The good news is we can keep our Leptin, Ghrelin and other hormone levels healthier. Here are some evidence-backed ways:
1. Get enough sleep
The quality and number of hours of sleep affects the body's hormonal balance. Most adults need between 7 to 9 hours of sleep daily. A few studies show that those who sleep 5 to 6 hours per day see an associated increase in obesity risk. However, those getting 7 to 8 and 9 to 10 hours of sleep daily fare better.
Research also found that when people sleep only 4 hours for two nights in a row, their body makes less Leptin and more Ghrelin which makes them feel hungrier and less full after eating. Another study also indicated that people who did not get 7 hours of sleep had 10% more Ghrelin.
2. Switch to a low-fat, natural, unprocessed diet
Diet high in fats and sugars can interfere with how Leptin works in the brain, making it less effective at signaling when you're full. Leptin can't communicate properly to its receptor, therefore making it difficult to curb your appetite.
A more natural, unprocessed diet can help fix this, while also decreasing Ghrelin levels – thereby helping curb hunger.
Soluble Fibers
Soluble fibers boost the Leptin effect on the brain. A meta-analysis of several studies revealed that those whose meals included dietary fibers reported feeling fuller with lower Leptin levels.
Fiber intake also fills the stomach and decreases Ghrelin. In a study with 30 overweight women, a fiber-rich diet increased feelings of fullness.
Protein
Increasing your protein intake can boost Leptin sensitivity and reduce Ghrelin levels making you less hungry and more satiated after meals. In a study where participants increased their protein intake from 15% to 30% while maintaining a steady carbohydrate consumption, participants saw a consistent reduced food intake which was due to heightened Leptin sensitivity. Participants then saw an average weight loss of 5 kg over two weeks.
Fat
Triglycerides, a type of fat found in your blood, can disrupt Leptin effectiveness by blocking its transport to the brain. By switching to a low-fat diet, you can help keep your Leptin levels healthier.
A study showed that when participants switched to a low-fat diet for two weeks, they saw an 18% drop in their free Leptin concentrations. The participants then lost an average of 5.2 kg body weight. More importantly, this enhanced Leptin sensitivity persisted beyond the study duration. This made losing weight easier.
3. Weight Loss Medications
Finally, there are FDA-approvedweight loss medications that help jumpstart your weight loss journey. These medications can help to regulate hunger and satiety as your weight goes down. The medication combats the effects of decreased Leptin and increased Ghrelin that results when we try to lose weight - these changes in Leptin and Ghrelin often result in extreme hunger, which make it difficult to sustain our weight loss journey.
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NOVI Health’s holistic approach to weight management as featured in the Straits Times:
“Dr Sue-Anne Toh, co-founder of technology-enabled healthcare provider Novi Health, said… patients will first have to consult a doctor to assess their suitability for the medication. If prescribed [with medication], they will get consultations and digital coaching by Novi Health’s dietitian and health coach. This ensures that patients are better supported to manage potential side effects, and get the most sustainable and optimal results with the medication.”
And in this Straits Times article as well:
“…we work hard to equip and empower people with the skill sets and the knowledge, through personalised health coaching programmes, to help them maintain a healthy body composition and keep the weight off without lifelong dependency on [medication]..”
Shifting the Scales: Weight Loss Medications that Can Help Balance Our Hunger Hormones
If despite best efforts, weight loss proves elusive, it may be time to consider how medically-backed weight loss treatments can help regulate our hunger hormones. Here are some of them:
GLP-1 Receptor Agonists: Liraglutide and Semaglutide
GLP-1 agonists, specifically liraglutide and semaglutide, influence the parts of the brain responsible for regulating appetite and food intake. In one study participants taking liraglutide (1.2 mg/day) experienced a moderate decrease in free Leptin and maintained a 12% weight reduction for a year.
These GLP-1 receptor agonists help to control weight by addressing several hormones in various ways:
Increases production of the hormone that lowers blood sugar level, especially after taking food.
Reduces production of the hormone that increases fasting sugar, optimizing fasting sugar levels.
Slows gastric emptying and decreases appetite, which makes you eat less, feel full longer, lose weight and also slows the release of glucose from your food.
Overhauls “hunger and craving hormones”, working on the reward center of the brain, reducing cravings.
However, these weight loss medications are not available over the counter in Singapore and you will need to consult a doctor in order to get them. Not all clinics carry these, so you should call ahead before making an appointment.
Naltrexone and Bupropion
The combination of naltrexone and bupropion target the hypothalamus and the mesolimbic dopamine circuit—these are both crucial for controlling your food intake. As a result, they can help reduce food consumption. A meta-analysis of 14 studies revealed that the combination of naltrexone-bupropion led to a weight loss of 5-10% in patients.
Orlistat
Orlistat acts by inhibiting the secretion of lipase, a crucial enzyme to help absorb fat absorption in the intestines. Reduced fat absorption boosts Leptin sensitivity. Research shows that Orlistat leads to a notable reduction in Leptin levels, and eventually to weight loss of up to 8.5 kg in men and 5.7 kg in women.
Is it time to consider weight loss medications?
If traditional weight loss methods, like diet and exercise, have not been successful for you, weight loss medications might help you shed those excess weight.
Of course, you will need to consult with your doctor to review your weight loss treatment plan. The best way to go about it safely would be to consider a holistic medical weight loss program that incorporates a specialist doctor consultation, ongoing guidance, and weight loss medication.
NOVI Optimum Plus is a medically supervised pathway to rebalance your body. The holistic program includes:
GLP-1 RA medication. Patients treated lost an average of 15% body weight over 1 year.
Specialist doctor consultation. You will be guided by our local doctors specializing in weight management over video call or in-person at our clinic.
Digital diet and fitness coaching. You will be guided remotely by a dedicated health coach to help you achieve your weight goals.
Lose up to 15% of your weight over 1 year
Starting at just $12/day, NOVI Optimum Plus ensures ongoing guidance, timely program adjustments, and the motivation you need for sustainable weight loss.