[Central nervous appetite regulation: mechanisms and significance for the development of obesity].

This review focuses on neurotransmitter and neuropeptide actions on food ingestion, as well as on some of the mechanisms that may lead to the development and maintenance of obesity. In particular, the role of hypothalamic amines (catecholamines, serotonin) in appetite control is described. Thus, hypothalamic noradrenaline appears to stimulate food intake, while an enhanced brain serotonergic neurotransmission leads to a suppression of food ingestion, preferentially of carbohydrate intake. The involvement of brain serotonin neurons in appetite control is most attractive, since serotonin synthesis and release is readily affected by either precursor loading (i.e., 1-tryptophan) or pharmacological manipulation (e.g., drugs such as fenfluramine or fluoxetine). Recent data now suggest that at least a subgroup of obese patients is characterized by a disturbed serotonergic neurotransmission, thus exhibiting behaviors such as carbohydrate craving. Among neuropeptides involved in appetite control, the most attractive candidate appears to be corticotropin-releasing hormone which is released by neurons of the paraventricular nucleus and produces a stress-like activation of the organism, and has a strong appetite-suppressant effect.