Adipose tissue as an endocrine organ and the regulation of appetite
White, brown and beige fat, the adipokines (leptin, adiponectin) and adipose steroid enzymes, the arcuate POMC and NPY/AgRP circuits with the gut signals that feed them, monogenic obesity and lipodystrophy, the hormonal adaptations that drive weight regain, worked energy-balance numbers, and how obesity drugs and bariatric surgery act on these pathways.
Tier 2Medical sciences concept
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Adipose tissue is an endocrine organ: it signals energy stores (leptin), regulates insulin sensitivity (adiponectin), makes oestrogen (aromatase) and regenerates cortisol (11β-HSD1).
- Appetite is set in the arcuate nucleus of the hypothalamus, where POMC neurons (stop eating) and NPY/AgRP neurons (eat) integrate leptin, insulin, ghrelin and gut peptides.
- Common obesity is a state of high leptin and leptin resistance. Low-leptin states are lipodystrophy, starvation and rare congenital deficiency.
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Sources
- Williams Textbook of Endocrinology, 15th editionElsevier (Melmed S, Auchus RJ, Goldfine AB, Rosen CJ, Kopp PA, editors), 2024
- Markovic TP, Proietto J, Dixon JB et al. The Australian Obesity Management Algorithm: a simple tool to guide the management of obesity in primary care. Obes Res Clin Pract 2022;16:353-63AU/NZAustralian and New Zealand Obesity Society (ANZOS), 2022
- Sumithran P, Prendergast LA, Delbridge E et al. Long-term persistence of hormonal adaptations to weight loss. N Engl J Med 2011;365:1597-604AU/NZNew England Journal of Medicine, 2011
- Hall KD, Sacks G, Chandramohan D et al. Quantification of the effect of energy imbalance on bodyweight. Lancet 2011;378:826-37The Lancet, 2011
- Medicine status: semaglutide (Wegovy), established cardiovascular disease with obesityAU/NZPharmaceutical Benefits Scheme, Australian Government, 2026
- Blondin DP, Nielsen S, Kuipers EN et al. Human brown adipocyte thermogenesis is driven by beta2-AR stimulation. Cell Metab 2020;32:287-300Cell Metabolism, 2020
- Last updated
- 14 November 2026
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