The role of peptide YY in integrative gut physiology and potential role in obesity

PURPOSE OF REVIEW: Obesity is an increasing global epidemic. Several central and peripheral hormones and neurotransmitters are involved in appetite control. Peptide YY (PYY) - one of the major anorexigenic (satiation-causing) gastrointestinal peptides - when administered peripherally, leads to decreased food intake and hunger scores. RECENT FINDINGS: The vagus nerve, brainstem, and hypothalamus play an important role in PYY-mediated appetite control. In some studies, fasting and postprandial PYY levels are decreased in obese subjects. In others, levels are no different between obese and nonobese subjects. One study showed that obese subjects must consume more calories to increase PYY to levels seen in nonobese subjects. Surgical weight-loss procedures lead to increased fasting and postprandial PYY levels that are thought to contribute to weight loss achieved with these procedures. SUMMARY: These findings lend some support for the association between PYY and obesity that could lead to possible new therapeutic options in obesity. PYY exerts anorexigenic effects; it is possible that surgical weight-loss procedures work synergistically with PYY to promote weight loss. Further investigation is needed to clarify whether PYY actually causes reduced calorie intake or whether the rate of food delivery to the ileo-colonic segment influences PYY levels, thus affecting satiation.