Obesity is associated with central µ-opioid receptor (MOR) downregulation

[sdnuser001]

Mesolimbic opioid-dopamine interaction is disrupted in obesity but recovered by weight loss following bariatric surgery - Translational Psychiatry

Obesity is a growing burden to health and the economy worldwide. Obesity is associated with central µ-opioid receptor (MOR) downregulation and disruption of the interaction between MOR and dopamine D2 receptor (D2R) system in the ventral striatum. Weight loss recovers MOR function, but it...

www.nature.com

Explains so much...

Now just need to think of the most polite way I can explain to patients that being obese is why they hurt 🤔

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[clubdeac]

And obesity’s been shown to be a pro inflammatory state likely increasing and amplifying overall pain. I tell patients that all the time and then give them a Mediterranean diet handout

 

[Ducttape]

er...

um...

this is not about pain. this is an obesity study.

this is about whether opioid channels may contribute to overeating, and whether targetting the opioid dopamine channels may lead to less overeating and weight loss.

never in this entire article is any pain scale taken.

you both are making vast generalizations that are not supported by the study.

Bariatric surgery and concomitant weight loss recover the interaction between MOR and D2R in the ventral striatum in the morbidly obese. Consequently, the dysfunctional opioid-dopamine interaction in the ventral striatum is likely associated with an obese phenotype and may mediate excessive energy uptake. Striatal opioid-dopamine interaction provides a feasible target for pharmacological and behavioral interventions for treating obesity.

Conclusions​

Obesity is associated with disrupted opioid-dopamine interaction in the ventral striatum, but this is recovered by weight loss after bariatric surgery. The dysfunction of opioid-dopamine interaction might be an important factor underlying overeating.

i would recommend reading the abstract and the conclusion in the future

 

[Ducttape]

this is an article about obesity and pain:

The effect of obesity on pain severity and pain interference - PubMed

<span><b>Aim:</b> Obesity is one of the most prevalent comorbidities associated with chronic pain, which can severely interfere with daily living and increase utilization of clinical resources. We hypothesized that a higher level of obesity, measured by BMI, would be associated with increased...

pubmed.ncbi.nlm.nih.gov

this is also an article linking obesity with increased pain:

The effect of obesity on pain and disability in chronic shoulder pain patients - PubMed

Shoulder pain may associated with obesity and we recommend the addition of weight control to the treatment of patients with shoulder pain.

pubmed.ncbi.nlm.nih.gov

 

[Doctodd]

phentermine and/or ozempic/mounjaro are very effective for weight loss....cash pay or Rx.

 

[Ferrismonk]

Contrave (bupropion/naltrexone) is for weight loss. It's basically a dopamine drug (see other thread about Fibro and DA) and an opioid blocker (naltrexone). Works well.

 

[BobBarker]

Mounjaro and its future derivative drugs will end obesity as we know it for people that have any motivation/self control. It is a clear refinement from the first and second gen GLP1s.

 

[drusso]

er...

um...

this is not about pain. this is an obesity study.

this is about whether opioid channels may contribute to overeating, and whether targetting the opioid dopamine channels may lead to less overeating and weight loss.

never in this entire article is any pain scale taken.

you both are making vast generalizations that are not supported by the study.




i would recommend reading the abstract and the conclusion in the future

I'm board certified in pain and addiction, and I attest that the two problems share overlapping neurobiology. Maintaining a healthy weight can lower VAS rating by at least 3 points.

 

[bedrock]

Mounjaro and its future derivative drugs will end obesity as we know it for people that have any motivation/self control.

If people "have any motivation/self control", they wouldn’t be obese.

I’m not holding my breath for the next new drug to now suddenly cure obesity when dozens have already failed.

 

[bedrock]

Reminds me of a quote from the TV show Better Off Ted, which is an Office type workplace corporate comedy. In one of my favorite scenes, of a board meeting they are talking about the development of a brain chip which allows the customer to lose weight because the chip causes healthy foods to now taste sweet. One the executives then says about the financial prospects of the device with a smirk---"Elective brain surgery doesn't test that great (in focus groups).................... but it still tests better than dieting and exercise"

 

[lobelsteve]

If people "have any motivation/self control", they wouldn’t be obese.

I’m not holding my breath for the next new drug to now suddenly cure obesity when dozens have already failed.

Medically, obesity is way more complicated than that.

 

[Ducttape]

obesity is not about self control or self motivation.

that may form a portion of the obesity problem, but other factors - in particular, genetic and nutritional - are significant.

 

[bedrock]

Medically, obesity is way more complicated than that.

Then why have obesity rates tripled over the past 60 years?

The small amount of people with true genetic/endocrine syndromes hasn’t tripled.

 

[drusso]

obesity is not about self control or self motivation.

that may form a portion of the obesity problem, but other factors - in particular, genetic and nutritional - are significant.

Craving, loss of control, use despite harm.

 

[Ferrismonk]

Then why have obesity rates tripled over the past 60 years?

The small amount of people with true genetic/endocrine syndromes hasn’t tripled.

I used to agree with this, but I've seen people (not patients) who have literally fasted a month straight and still did not lose weight.

This is pure speculation, but I wouldn't be surprised if the American diet over the last 70 years hasn't chemically altered how our body deals with food, nutrition, and weight. Yes, I mean down to the epigenetic level.

 

[lobelsteve]

Then why have obesity rates tripled over the past 60 years?

The small amount of people with true genetic/endocrine syndromes hasn’t tripled.

Multifactorial.
Food supply.
Stress.
Loss of family unit.
TV/PC/phones. (screen time).

 

[Ducttape]

other potential factors -

changes in lifestyle
improvement in food availability
possibly - high fructose sugar usage

 

[Doctodd]

Mounjaro and its future derivative drugs will end obesity as we know it for people that have any motivation/self control. It is a clear refinement from the first and second gen GLP1s.

speaking of which, my local CVS is on back order for both Mounjaro and Ozempic. If CVS is on backorder, i assume most pharmacies are.

 

[deleted131481]

I'd argue changes in food nutrition are by far the #1 reason for increasing obesity/metabolic syndrome.

For my patients to eat well, it's going to cost twice as much and take twice as much time to obtain and prepare. Not going to happen.

 

[clubdeac]

I'd argue changes in food nutrition are by far the #1 reason for increasing obesity/metabolic syndrome.

For my patients to eat well, it's going to cost twice as much and take twice as much time to obtain and prepare. Not going to happen.

Plus healthy eating is not nearly as enjoyable, doesn’t produce the same dopamine high and won’t provide a quick fix for one’s existential ennui.

Highly processed foods and exorbitant levels of high fructose corn syrup are not only addictive but likely result in long term detrimental metabolic, epigenetic and hormonal changes.

Feed people real food at appropriate quantities and we wouldn’t have an obesity epidemic

 

[drusso]

Plus healthy eating is not nearly as enjoyable, doesn’t produce the same dopamine high and won’t provide a quick fix for one’s existential ennui.

Highly processed foods and exorbitant levels of high fructose corn syrup are not only addictive but likely result in long term detrimental metabolic, epigenetic and hormonal changes.

Feed people real food at appropriate quantities and we wouldn’t have an obesity epidemic

 

[psycho-matic]

If people "have any motivation/self control", they wouldn’t be obese.

I’m not holding my breath for the next new drug to now suddenly cure obesity when dozens have already failed.

This is anecdotal, of course, but I've lost almost 25 pounds on Mounjaro in the past 3 months. It takes away my cravings like nothing else has. It's a game changer for me.

 

[Laryngospasm]

Like most things in medicine.. there is almost certainly something we are missing with obesity. As for the increase over the last 100 years we’ve gone from scarcity of food + hard work to being lazy with a surplus of ultra processed food where almost everything has sugar added. And not to be a jerk but no one can fast for a long period of time without losing weight. I do think there are some metabolic/endocrine derangements that are poorly understood due to environmental factors. We didn’t evolve to have three large meals a day every day that’s for sure..

 

[callmeanesthesia]

Like most things in medicine.. there is almost certainly something we are missing with obesity. As for the increase over the last 100 years we’ve gone from scarcity of food + hard work to being lazy with a surplus of ultra processed food where almost everything has sugar added. And not to be a jerk but no one can fast for a long period of time without losing weight. I do think there are some metabolic/endocrine derangements that are poorly understood due to environmental factors. We didn’t evolve to have three large meals a day every day that’s for sure..