Physiological and pathological changes to the eye and vision during and after pregnancy.

Pregnancy introduces a multitude of changes in the body, including hormonal fluctuations and metabolic changes, which can lead to atypical ocular signs and symptoms. Ocular manifestations range from fluctuations in vision, to microstructural changes in the retina and choroid, to dry eye disease. This narrative review highlights the range of pregnancy-related effects on the eye and vision that are likely to present in the context of routine eyecare. Specifically, physiological ocular changes and pathological ocular changes that manifest for the first time, or are exacerbated, in uncomplicated pregnancy are discussed. The literature has evolved from simply noting differences in the eye between pregnant and non-pregnant groups, to refining knowledge of the proposed underlying pathophysiology with the advent of newer technologies in eyecare. A particular focus of this review is navigating when pregnancy changes in the eye occur or peak during the gestational period, and whether the changes are short-lived or might extend past pregnancy. While many pregnancy-associated changes are temporary and resolve post-partum, it is also recognised that some changes persist after pregnancy, with a notable absence of literature on ocular changes with loss or termination of pregnancy. Currently or previously pregnant women (or those planning to become pregnant), and other health professionals, should be educated about the importance of seeking eyecare before, during and after pregnancy.

Metabolic Changes in Myocardium and Skeletal Muscles of C57BL/6 Mice after Noncardiac Surgery.

Approximately 10% of patients without cardiovascular disorders suffer myocardial injury and have a 10% risk of death within 30 days after noncardiac surgery. Preoperative stress increases the risk of myocardial injury after noncardiac surgery (MINS). The mechanisms of MINS are poorly understood. Lack of physical activity and the development of weakness and fatigue are consequences of many noncardiac surgery types. The relationship between surgery and changes in the morphofunctional state of muscles in the postoperative period is still unclear now. The study showed for the first time that metabolic and hormonal changes caused by preoperative stress + surgery or surgery alone underlie MINC in the postoperative period in C57BL/6 mice. Minor increases in triglyceride-glucose (TyG) index were for the first time identified as indicative of ischemic/hypoxic damage to the myocardium and skeletal muscles. More research is necessary to perform to better understand the effects of preoperative stress and noncardiac surgery on the myocardium and muscle performance, as well as the risks and benefits of perioperative treatment.

Physiological changes in the mammary glands during a female's life.

The intricate development and physiological dynamics of the mammary glands, orchestrated by a delicate interplay of hormones, are crucial for reproductive function and lactation. Beginning with intrauterine clusters evolving into mature glands, hormonal fluctuations throughout puberty and the menstrual cycle finely tune mammary tissue growth. Oestrogens stimulate the proliferation of epithelial cells, while progesterone orchestrates the formation of lactiferous glands. During pregnancy, oestrogen and progesterone induces hyperplasia of lobules and ducts, preparing the breast for lactation. Prolactin is vital for lactation and stimulates milk production during pregnancy and postpartum. As shown by ultrasonography, physiological changes during lactation reflect glandular tissue transformation for milk secretion. Clinical and physiological changes, including increased blood flow, contribute to mammary growth and firmness, complicating clinical examination. Ultrasonographic findings reveal variability in women's glandular and fat tissue distribution, suggesting that milk production is not solely determined by anatomical factors. Though not directly linked to milk production, blood flow dynamics hint at a threshold for optimal lactation. Understanding these complex hormonal and physiological mechanisms is crucial for comprehending mammary development, function, and clinical assessment.

Leveraging Dental Stem Cells for Oral Health during Pregnancy: A Concise Review.

Pregnancy induces significant changes in oral health because of hormonal fluctuations, making it a crucial period for preventive measures. Dental stem cells (DSCs), particularly those derived from the dental pulp and periodontal ligaments, offer promising avenues for regenerative therapies and, possibly, preventive interventions. While the use of DSCs already includes various applications in regenerative dentistry in the general population, their use during pregnancy requires careful consideration. This review explores recent advancements, challenges, and prospects in using DSCs to address oral health issues, possibly during pregnancy. Critical aspects of the responsible use of DSCs in pregnant women are discussed, including safety, ethical issues, regulatory frameworks, and the need for interdisciplinary collaborations. We aimed to provide a comprehensive understanding of leveraging DSCs to improve maternal oral health.

Hormonal Imbalance in Obesity and Arthritis: Points of Contact.

Obesity is a growing global health crisis intricately connected to various chronic conditions, including arthritis. This paper explores the intricate web of hormonal changes in the context of obesity and their profound influence on the development and progression of arthritis. Hormones, such as leptin, insulin, cortisol, and estrogen, all altered in obesity, play pivotal roles in inflammation, cartilage degradation, mechanical stress, and pain associated with obesity-related arthritis. Additionally, the mechanical stress placed on weight-bearing joints by excess body weight accelerates joint wear and tear, contributing to arthritis. Genetic factors, shared biomarkers, and pathways further link these conditions. Recognizing these connections is vital for healthcare professionals and individuals facing the challenges of obesity and arthritis, offering insights into strategies for prevention, management, and intervention. This comprehensive understanding of the complex interplay between hormonal changes, obesity, and arthritis sheds light on multifaceted mechanisms underlying this intricate relationship.

Physiological Changes in Pregnant Women Due to Hormonal Changes.

Pregnancy affects many organ systems and causes significant physiological changes that are mainly caused by changes in hormone levels. This review explores the complex interactions between pregnancy-related hormonal changes and renal function, providing insights into the practical applications of these relationships. Extensive literature searches were conducted, combining data from several sources to produce thorough knowledge. Essential discoveries include changes in renal hemodynamics, calcium/phosphorus level variations, thyroid gland hypertrophy, changed function, and cardiovascular adaptations. The review also addresses how sex hormones affect immunological responses, emphasizing their importance for conditions like multiple sclerosis. Additionally impacted is the gastrointestinal tract, which results in symptoms like nausea and heartburn. Comprehending these physiological changes is essential for proficient therapeutic handling, guaranteeing the best possible health for both the mother and the fetus. The study emphasizes the importance of specialized medical treatment during pregnancy and calls for more investigation to clarify the intricacies of these physiological changes.

Hormonal Changes in Women with Epilepsy.

Epilepsy is a prevalent neurological disorder among women globally, often requiring long-term treatment. Hormonal fluctuations in women with epilepsy (WWE) can have reciprocal effects on epilepsy and antiseizure medications (ASMs), posing significant challenges for WWE. Notably, WWE commonly experience endocrine alterations such as thyroid dysfunctions, low bone metabolism, and reproductive hormone irregularities. On the one hand, the presence of hormones in women with epilepsy affects their susceptibility to epilepsy as well as the metabolism of antiseizure medications in various ways. On the other hand, epilepsy itself and the use of antiseizure medications impact the production, secretion, and metabolism of hormones, resulting in low fertility, increased risk of pregnancy complications, negative offspring outcomes, and so on. In order to develop more precise treatment strategies in the future, it is necessary to comprehend the explicit relationships between hormones, epilepsy, and antiseizure medications, as well as to elucidate the currently known mechanisms underlying these interactions.

Effects of major analgesics on male fertility: A systematic literature review.

OBJECTIVE: To verify, based on a systematic literature review, the effects of the main analgesics on male fertility. DATA SOURCES: The studies were analyzed from the PubMed, SciELO and LILACS databases. STUDY SELECTION: The articles selected for the present review included: cohort studies; cross-sectional studies, clinical trials; complete studies; studies with animal models that addressed the proposed theme and that were published within the stipulated period from March 1, 2013, to March 31, 2023, in English, Portuguese and Spanish. These would later have to go through inclusion stages such as framing the type of study and exclusion criteria. DATA COLLECTION: Author's name, year of publication, study population, number of patients, analgesic, administration time, dose, and effect. CONCLUSIONS: There are in vitro and in vivo studies that link paracetamol and ibuprofen to endocrine and seminal changes that are harmful to male fertility. However, more clinical research is needed to determine the doses and timing of administration that affect fertility. The effects of aspirin on male fertility are still unclear due to the lack of studies and consistent methodologies. There is not enough research on dipyrone and its relationship with male fertility, requiring more studies in this area.

Effects of male paratroopers' initial body composition on changes in physical performance and recovery during a 20-day winter military field training.

Changes in physiological markers and physical performance in relation to paratroopers' initial body composition were investigated during a 20-day winter military field training (MFT) and the subsequent 10-day recovery period. Body composition, serum hormone concentrations and enzymatic biomarkers, and physical performance of 58 soldiers were measured before, during, and after MFT. Comparisons were done according to soldiers' body fat percentage before MFT between low-fat (<12% body fat) and high-fat (>12% body fat) groups. Correlations between body fat percentage preceding MFT and changes in muscle mass, physical performance, and serum hormone concentrations and enzymatic biomarkers were investigated. It was hypothesized that soldiers with a higher fat percentage would have smaller decrements in muscle mass, physical performance, and serum testosterone concentration. The change in muscle and fat mass was different between groups (p < 0.001) as the low-fat group lost 0.8 kg of muscle mass and 2.0 kg of fat mass, while there was no change in muscle mass and a loss of 3.7 kg of fat mass in the high-fat group during MFT. Fat percentage before MFT correlated with the changes in muscle mass (R2 = 0.26, p < 0.001), serum testosterone concentration (R2 = 0.22, p < 0.001), and evacuation test time (R2 = 0.10, p < 0.05) during MFT. The change in muscle mass was correlated with the changes in evacuation test time (R2 = 0.11, p < 0.05) and countermovement jump test results (R2 = 0.13, p < 0.01) during MFT. Soldiers with a higher initial fat percentage lost less muscle mass, and had smaller decrements in some aspects of physical performance, as well as in serum testosterone concentration during MFT.

Sex-specific considerations in nanomedicine: highlighting the impact of the menstrual cycle on drug development.

Tweetable abstract The female menstrual cycle is one of the most overlooked sex-specific factors in drug distribution and response. Unlocking the potential of nanomedicine demands a fundamental understanding of the impact biological sex has on drug distribution, efficacy and adverse effects.

Physiological and Biochemical Adaptations to a Sport-Specific Sprint Interval Training in Male Basketball Athletes.

The present study compared the effects of incorporating traditional sprint interval training (SIT) or basketball-specific SIT (SSIT) into typical off-season training of male basketball players. Adaptations to and effect size (EF) of interventions on aerobic fitness [evaluated using Yo-Yo intermittent recovery test level-1 (Yo-Yo IR1)], change of direction [T-test (TT) and Illinois agility test (IAT)], vertical jump (VJ), standing long jump (SLJ), linear speed, maximal strength [one repetition maximum test in leg press (1RMLP)], and hormonal status were examined. Male athletes (age = 25.7 ± 2.0 years; height = 188.1 ± 7.9 cm; body mass = 85.9 ± 8.0 kg) were randomly assigned to one of three groups of SIT (n = 10): three sets of 10 × 15 sec all-out intervals with 1:1 recovery between bouts and a 3-min recovery between sets; SSIT (n = 10): the same intervals as SIT + basketball-specific ball drills while running; and CON (n = 10): two sessions per week of regular basketball technical and tactical drills. SIT and SSIT resulted in significant changes compared with baseline in maximal oxygen uptake (4.9%, ES = 2.22 vs. 6%, ES = 2.57), TT (-1.8%, ES =-0.46 vs. -2.7%, ES = -1.14), IAT (-4.5%, ES = -2.01 vs. -5.4%, ES = -1.93), VJ (7.5%, ES = 0.58 vs. 12%, ES = 0.95), linear sprint time (-2.9%, ES = -0.32 vs. -4.3%, ES = -0.69), Yo-Yo IR1 (18.5%, ES = 2.19 vs. 23.7%, ES = 2.56), serum testosterone (28%, ES = 1.52 vs. 29.7%, ES = 1.59), and cortisol (-6.53%, ES = -0.37 vs. -12.06%, ES = -0.64). Incorporating SIT and SSIT into typical off-season basketball training triggers adaptive mechanisms that enhance aerobic and anaerobic performance in male basketball players. The effect size values indicate more significant effects of SSIT than SIT in most physiological and sport-specific adaptations. Such a superior effect could be attributed to the more basketball-specific movement pattern of the SSIT. Such interventions can be used by the coaches and athletes for designing the training load and for better training adaptations throughout the training seasons and competition periods.

Particularities of physical training and control of risk factors in the transgender and gender-diverse population.

The transgender and gender-diverse (TGD) population holds significant relevance concerning exercise and sports practices. Specific challenges are highlighted, such as physical inactivity driven by internal and external reasons, including discrimination in sports environments. Psychological aspects and hormonal therapy effects create implications for hindering participation in sports competitions. Disparities in cardiovascular risk factors are also mentioned, emphasizing the need for inclusive sports policies based on scientific evidence. The article underscores the importance of addressing social, psychological, and medical aspects to promote the physical and mental health of the TGD population, particularly in the professional sports area.

La población trans y de género diverso (TGD) tiene una gran relevancia en relación con la práctica de ejercicio y deporte. Se destacan desafíos específicos, como la inactividad física motivada por razones internas y externas, incluida la discriminación en entornos deportivos. Existen aspectos psicológicos y efectos de la terapia hormonal que generan implicaciones para la dificultar participación en competiciones deportivas. También se menciona la disparidad en los factores de riesgo cardiovascular y se plantea la necesidad de políticas deportivas inclusivas basadas en evidencia científica. El artículo enfatiza la importancia de abordar los aspectos sociales, psicológicos y médicos para promover la salud física y mental de la población TGD, especialmente en el ámbito deportivo profesional.

Herbal and chemical seed potentiations improve the redox health of aged seeds of indigenous aromatic rice cultivars through regulation of oxidative window, gene expression, and restoration of hormonal homeostasis.

Previous studies associated with seed potentiation support the critical role of metabolic readjustment in restricting the loss of seed vigor and viability of aged seeds. However, their exact role in the regulation of 'oxidative windows' of potentiated seeds is rarely studied and hence is the subject of the present investigation. Seed potentiation of two contrasting indigenous aromatic rice cultivars, differing in sensitivity towards redox attributes (Oryza sativa L., Cultivars Tulaipanji and Jamainadu), with standardized doses of hydrogen peroxide (20 mM), triadimefon (250 µM), herbal extract (1% aqueous extract of Lantana camara flower) and distilled water before accelerated aging (RH 92% and 41 °C for 24 h) found to have significant impact on redox regulation of aged seeds and improvement of germination phenotypes. The efficacy of integrated RBOH-ascorbate-glutathione/catalase pathway, redox status and other redox fingerprints in the metabolic landscape of potentiated-aged seeds vis-a-vis non-potentiated-aged seeds corroborate the impact of seed potentiation on the regulation of 'oxidative window' of experimental rice seeds. Gene expression analysis of central redox hub enzymes (Osrboh, OsAPx2, OsGRase, OsCatA) strongly substantiates the impact of seed potentiation on transcriptional regulation of genes for redox homeostasis in accelerated aged seeds. The novelty of the current effort is that it suggests a positive nexus between seed potentiation-induced redox regulation and hormonal homeostasis. The efficacy of seed potentiation on the redox regulation of experimental accelerated aged seeds is found to be cultivar-specific and comparatively better in the cultivar Tulaipanji as compared to the cultivar Jamainadu and in the order herbal extract, hydrogen peroxide, hydropriming and triadimefon. Supplementary Information: The online version contains supplementary material available at 10.1007/s12298-023-01375-9.

Aflatoxin Contamination: An Overview on Health Issues, Detection and Management Strategies.

Aflatoxins (AFs) represent one of the main mycotoxins produced by Aspergillus flavus and Aspergillus parasiticus, with the most prevalent and lethal subtypes being AFB1, AFB2, AFG1, and AFG2. AFs are responsible for causing significant public health issues and economic concerns that affect consumers and farmers globally. Chronic exposure to AFs has been linked to liver cancer, oxidative stress, and fetal growth abnormalities among other health-related risks. Although there are various technologies, such as physical, chemical, and biological controls that have been employed to alleviate the toxic effects of AF, there is still no clearly elucidated universal method available to reduce AF levels in food and feed; the only mitigation is early detection of the toxin in the management of AF contamination. Numerous detection methods, including cultures, molecular techniques, immunochemical, electrochemical immunosensor, chromatographic, and spectroscopic means, are used to determine AF contamination in agricultural products. Recent research has shown that incorporating crops with higher resistance, such as sorghum, into animal feed can reduce the risk of AF contamination in milk and cheese. This review provides a current overview of the health-related risks of chronic dietary AF exposure, recent detection techniques, and management strategies to guide future researchers in developing better detection and management strategies for this toxin.

Particularidades del entrenamiento físico y el control de los factores de riesgo en la población trans y de género diverso / Particularities of physical training and control of risk factors in the transgender and gender-diverse population

Resumen La población trans y de género diverso (TGD) tiene una gran relevancia en relación con la práctica de ejercicio y deporte. Se destacan desafíos específicos, como la inactividad física motivada por razones internas y externas, incluida la discriminación en entornos deportivos. Existen aspectos psicológicos y efectos de la terapia hormonal que generan implicaciones para la dificultar participación en competiciones deportivas. También se menciona la disparidad en los factores de riesgo cardiovascular y se plantea la necesidad de políticas deportivas inclusivas basadas en evidencia científica. El artículo enfatiza la importancia de abordar los aspectos sociales, psicológicos y médicos para promover la salud física y mental de la población TGD, especialmente en el ámbito deportivo profesional.

Abstract The transgender and gender-diverse (TGD) population holds significant relevance concerning exercise and sports practices. Specific challenges are highlighted, such as physical inactivity driven by internal and external reasons, including discrimination in sports environments. Psychological aspects and hormonal therapy effects create implications for hindering participation in sports competitions. Disparities in cardiovascular risk factors are also mentioned, emphasizing the need for inclusive sports policies based on scientific evidence. The article underscores the importance of addressing social, psychological, and medical aspects to promote the physical and mental health of the TGD population, particularly in the professional sports area.

Anatomical Changes of the Vulva Due to Childbirth and Aging.

The female reproductive system consists of several structures. These organs are constantly undergoing changes throughout the lifetime of a woman. Most of these occur due to changes in estrogen and progesterone levels at key transitions in life such as puberty, pregnancy, and menopause. Laxity and atrophy occur during pregnancy and menopause, respectively, can cause significant symptomology for women. Although some women do have return to normal anatomy following pregnancy, many do not and develop pelvic organ prolapse that worsens over their lifetime. Symptoms are often underreported, but for those who do have symptoms, surgical intervention may be warranted.

Adverse Changes in Body Composition During the Menopausal Transition and Relation to Cardiovascular Risk: A Contemporary Review.

The menopausal transition period in aging women is strongly associated with weight gain. Evidence shows that weight changes during menopause increases the risk of developing cardiovascular disease (CVD) in postmenopausal women. However, the potential mechanisms that cause weight gain and adverse changes to body composition specifically during the menopausal transition period remain to be elucidated. In this contemporary review, we examined recent evidence for adverse changes in body composition at midlife during the menopausal transition and the link to increased CVD risk and described factors that may contribute to these changes, including normal chronological aging, hormonal factors (decreased estrogen, etc.), behavioral factors (changes in diet, physical activity), or other emerging factors (e.g., sleep). This review focused on identifying factors that make the menopausal transition period a critical window for prevention of CVD. Future study is needed to decipher the extent to which hormonal changes, age-related factors, and behavioral factors interact with and contribute to increased CVD risk in women undergoing menopause. Understanding the causes of weight gain during the menopausal transition may help to inform strategies to mitigate adverse CVD outcomes for women transitioning through menopause.

High Prevalence of Hormonal Changes and Hepatic Osteodystrophy in Frail Patients with Cirrhosis-An Observational Study.

Background/Aim: Hormonal changes and hepatic osteodystrophy are less often studied complications of cirrhosis. This study describes the variance in hormones and osteodystrophy between Frail and Not frail patients with cirrhosis. Methods: 116 outpatients with cirrhosis were prospectively enrolled in this study. Frailty assessment was done using Liver Frailty Index (LFI). Sociodemographic assessment, anthropometry, nutritional assessment, hormone profile, and dual-energy X-ray absorptiometry scan were done in all patients. Results: 116 patients, predominantly males (100 (86.2%) with mean age of 50.16 years (95% CI, 48.43-51.89) were included. Malnutrition was more common in Frail group as compared to Not frail group. Subjective global assessment (SGA) class-B patients were significantly more in Frail group (37 (74%) vs 3 (4.5%), P = 0.001). The prevalence of lower parathyroid hormone (PTH) (14 (28%) vs 2 (3%)), testosterone (33 (66%) vs 15 (22.7%)), vitamin D3 (44 (88%) vs 39 (59.1%)), and cortisol (37 (74%) vs 37 (56.1) levels was higher in Frail group (P < 0.05). The number of patients diagnosed with osteodystrophy (34 (68%) vs 21 (31.8%), P = 0.001) was significantly higher in Frail group. The marker of osteoclastic activity, ß-cross laps, was significantly elevated in the Frail group both in males (736 (655-818) vs 380 (329-432), P = 0.001) and (females 619 (479-758) vs 313 (83-543), P = 0.02). Bone mineral density (BMD) at lumbar spine (LS) and neck of femur (NF) had significant correlation with LFI (ρ = 0.60, P = 0.001 for LS and ρ = 0.59, P = 0.001 for NF), serum testosterone (ρ = 0.58, P = 0.001 for LS and ρ = 0.53, P = 0.001 for NF), ß-cross laps (ρ = 0.38, P = 0.001for LS and ρ = 0.35, P = 0.000 for NF), vitamin D3 (ρ = 0.23, P = 0.04 for LS and ρ = 0.25, P = 0.01 for NF), PTH (ρ = 0.52, P = 0.001 for LS and ρ = 0.48. P = 0.001 for NF), and cortisol (ρ = 0.50, P = 0.001 for LS and ρ = 0.45, P = 0.001 for NF) levels. Conclusion: This is the first study that highlights the high prevalence of hormonal changes and hepatic osteodystrophy in frail patients with cirrhosis and opens a new dimension for research and target of therapy in this field.

Hormonal Changes after R-CHOP Chemotherapy in Patients with Diffuse Large B-Cell Lymphoma: A Prospective Study.

Background and Objectives: There is a lack of data regarding hormonal metabolic abnormalities resulting from the R-CHOP regimen (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisolone), a commonly used chemotherapy in diffuse large B-cell lymphoma (DLBCL). This study aimed to determine the incidence of hormonal and metabolic changes after R-CHOP therapy. Methods and Methods: This prospective cohort study initially included 17 DLBCL patients. Hormonal tests, including gonadal function, thyroid function, and ACTH stimulation tests for cortisol and metabolic markers, were performed before the 1st and after the 5th cycle of R-CHOP. The paired t-test was used to evaluate the changes. Statistical significance was set at p < 0.05. Results: Out of 17 patients, two died before the last follow-up, and 15 completed the study. LH levels were significantly higher in males after the 5th cycle (p = 0.04), while no significant changes were observed in other hormonal levels. After the 5th cycle, the only trend toward statistical significance was observed with higher FSH in males, higher blood glucose, and cholesterol. After the 5th cycle of chemotherapy, seven patients had at least one hormonal dysfunction, three patients had alterations in their thyroid function tests. Three patients had adrenal insufficiency (AI), one of whom also had secondary hypothyroidism concomitant with hypogonadism and AI. Additionally, two males had hypogonadism, and impaired fasting glucose was observed in three patients. Conclusions: Hormonal and metabolic abnormalities can occur in DLBCL after the 5th R-CHOP cycle. A high level of awareness and careful observation is of value in detecting these abnormalities, as some can be lethal.

Impaired Brain Satiety Responses After Weight Loss in Children With Obesity.

CONTEXT: Obesity interventions often result in increased motivation to eat. OBJECTIVE: We investigated relationships between obesity outcomes and changes in brain activation by visual food cues and hormone levels in response to obesity intervention by family-based behavioral treatment (FBT). METHODS: Neuroimaging and hormone assessments were conducted before and after 24-week FBT intervention in children with obesity (OB, n = 28), or children of healthy weight without intervention (HW, n = 17), all 9- to 11-year-old boys and girls. We evaluated meal-induced changes in neural activation to high- vs low-calorie food cues across appetite-processing brain regions and gut hormones. RESULTS: Among children with OB who underwent FBT, greater declines of BMI z-score were associated with lesser reductions after the FBT intervention in meal-induced changes in neural activation to high- vs low-calorie food cues across appetite-processing brain regions (P < 0.05), and the slope of relationship was significantly different compared with children of HW. In children with OB, less reduction in brain responses to a meal from before to after FBT was associated with greater meal-induced reduction in ghrelin and increased meal-induced stimulation in peptide YY and glucagon-like peptide-1 (all P < 0.05). CONCLUSION: In response to FBT, adaptations of central satiety responses and peripheral satiety-regulating hormones were noted. After weight loss, changes of peripheral hormone secretion support weight loss, but there was a weaker central satiety response. The findings suggest that even when peripheral satiety responses by gut hormones are intact, the central regulation of satiety is disturbed in children with OB who significantly improve their weight status during FBT, which could favor future weight regain.