Central regulation of energy homeostasis intelligent design: how to build the perfect survivor.

The perfect survivor must be able to eat and store as many calories as possible when food is readily available as a buffer against periods of scarcity. He must also reduce energy expenditure when food is scarce and efficiently and accurately restore lost adipose stores when food is again available. These processes are dependent on information relayed to a distributed central network of metabolic sensing neurons through hard-wired neural, metabolic, and hormonal signals from the periphery. These sensing neurons engage neuroendocrine, autonomic, and motor processes involved in arousal, motor activity, and the ingestion, absorption, assimilation, storage, and expenditure of calories. A raised threshold in these metabolic sensors for detecting inhibitory signals from increasing adipose stores allows continued intake of excess calories when they are readily available. Unfortunately, this mechanism for surviving periods of feast and famine predisposes the perfect survivor to become obese when highly palatable, energy dense foods are readily available at low energetic cost. It further assures that raised adipose stores are metabolically defended against attempts to lower them. Thus, effective treatment of obesity will only come with a better understanding of the physiological, metabolic, and neurochemical processes that ensure this defense of an elevated body weight.