Cited by 591Adipose Tissue and MetabolismRegulation of Appetite and ObesityAdipokines, Inflammation, and Metabolic Diseases

The DOI matches its Crossref record; 208 of the 208 references it cites were found in a registry or an index; none of the 243 sources its claims cite is checked for support yet.

Cellular bioenergetics as a target for obesity therapy

Open access
Tseng, Yu-Hua, Cypess, Aaron M., Kahn, C. Ronald·2010·Nature Reviews Drug Discovery

Abstract

Obesity develops when energy intake exceeds energy expenditure. Although most current obesity therapies are focused on reducing calorific intake, recent data suggest that increasing cellular energy expenditure (bioenergetics) may be an attractive alternative approach. This is especially true for adaptive thermogenesis — the physiological process whereby energy is dissipated in mitochondria of brown fat and skeletal muscle in the form of heat in response to external stimuli. There have been significant recent advances in identifying the factors that control the development and function of these tissues, and in techniques to measure brown fat in human adults. In this article, we integrate these developments in relation to the classical understandings of cellular bioenergetics to explore the potential for developing novel anti-obesity therapies that target cellular energy expenditure.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This review argues that increasing cellular energy expenditure through adaptive thermogenesis—especially in brown adipose tissue (BAT) and skeletal muscle—is an attractive alternative strategy for obesity therapy. It integrates bioenergetics, the rediscovery of functional BAT in adult humans, developmental regulators of brown fat, and candidate therapeutic approaches, while emphasizing unresolved safety and efficacy questions.

Key findings

  • Obesity develops when energy intake exceeds energy expenditure; current FDA-approved weight-loss drugs mainly reduce intake, but targeting energy expenditure may help overcome homeostatic reductions in BMR and defend against weight regain.
  • Adult humans possess functional UCP1-positive BAT, identified by PET/CT; prevalence estimates vary from <10% in retrospective case series to 96% among younger people after cold stimulation, and BAT activity correlates inversely with BMI and percentage body fat.
  • Human BAT may be quantitatively important: as little as 50 g of BAT (<0.1% of body weight) could utilize up to 20% of basal caloric needs if maximally stimulated, and BAT is estimated to be 100–200 times more effective as a thermogenic organ per gram than muscle.
  • Potential therapeutic approaches include increasing brown fat differentiation (e.g., BMP-7, FGFs), activating BAT (e.g., β3 agonists, thyroid mimetics, TGR5 agonist INT-777), promoting skeletal muscle thermogenesis (e.g., resveratrol, AICAR, GW1516), and increasing general mitochondrial uncoupling (e.g., DNP, which at 3–5 mg/kg increased energy expenditure by 20–30% but is unsafe).

Methods

  • Narrative review; no primary data, systematic search strategy, or formal meta-analysis is described.
  • Synthesizes classic cellular bioenergetics, rodent and human studies, PET/CT imaging findings, developmental biology of brown fat, and pharmacological approaches.
  • Main analysis is qualitative integration of literature to identify therapeutic targets and remaining questions.

Limitations

  • The paper states that many questions remain: whether chronic increases in peripheral energy expenditure cause compensatory appetite increases; the exact contributions of BAT and skeletal muscle to human adaptive thermogenesis, especially after overfeeding; and the cellular lineage and developmental fate factors for energy-dissipating brown fat.
  • The paper states high safety concerns for anti-obesity treatments and notes unresolved BAT thermogenesis safety questions, including whether stimulated BAT could induce necrosis, raise body temperature dangerously, or increase cardiac demand enough to contraindicate treatment in the elderly or those with heart disease.
  • Evident from the text: this is a narrative review rather than a systematic review, and PET/CT limitations are noted—CT cannot yet distinguish brown from white fat, and factors such as dietary fatty acids and beta-adrenergic blockers can alter 18F-FDG uptake.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1038/nrd3138

Cites

208 of 208 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

0 of 243 cited sources checked · 0 supported · 0 flagged

Show all 99 claims

  • It may state two separate claims as one. 75
  • Probably not a substantial claim. 18
86 of 86
  • The paper relies on this without support.

    Obesity develops when energy intake exceeds energy expenditure.

    “Obesity develops when energy intake exceeds energy expenditure.”
    “Obesity develops when energy intake exceeds energy expenditure.”
  • The paper relies on this without support.

    Any treatment for obesity must reduce energy intake, increase energy expenditure, or have an effect on both.

    “Since the laws of thermodynamics must be obeyed, any treatment for obesity must reduce energy intake, increase energy expenditure, or have an effect on both.”
  • The authors state this as an assumption.

    The laws of thermodynamics must be obeyed.

    “Since the laws of thermodynamics must be obeyed, any treatment for obesity must reduce energy intake, increase energy expenditure, or have an effect on both.”
  • The paper relies on this without support.

    Obesity is a growing worldwide epidemic and new effective anti-obesity therapies are needed.

    “With the growing worldwide epidemic of obesity, it is clear that new and effective anti-obesity therapies are desperately needed.”
  • The paper relies on this without support.

    Exercise has profound beneficial effects on virtually all biological systems and is an effective way to burn excess energy.

    “There is no doubt that exercise has profound beneficial effects on virtually all biological systems, and is an effective way to burn excess energy.”
  • The paper relies on this without support.

    Findings from mouse models of obesity and thermogenesis are predictive of human therapeutic outcomes.

    “When systemically expressed in mice, BMP-7 leads to reduced weight gain 101, suggesting that it may have anti-obesity potential, although more study is needed to determine an optimal therapeutic approach and if there will be any unwanted side effects.”
  • The paper relies on this without support.

    TGR5 stimulates GLP-1 production in enteroendocrine cells, improving glucose metabolism through insulinotropic effects.

    “In addition, TGR5 stimulates GLP-1 production in enteroendocrine cells that may improve glucose metabolism through its insulinotropic effects.”
  • The paper relies on this without support.

    Preclinical observations suggest that resveratrol and its analogues such as SRT1720 are safe and may have applications in the treatment of obesity and insulin resistance in humans.

    “Preclinical observations have suggested that resveratrol and its analogues such as SRT1720 are safe and may have applications in the treatment of obesity and insulin resistance in humans.”
  • The paper relies on this without support.

    Increased mitochondrial uncoupling leads to energy inefficiency and increased energy expenditure.

    “Increased mitochondrial uncoupling leads to energy inefficiency and increased energy expenditure.”
  • The paper relies on this without support.

    BMP-7 is pharmaceutically available and already in use for orthopedic procedures in the US under Humanitarian Device Exemptions.

    “BMP-7 is pharmaceutically available and is already in use for orthopedic procedures in the US under Humanitarian Device Exemptions.”
  • The paper relies on this without support.

    Shivering thermogenesis occurs in muscle and complements non-shivering thermogenesis, which occurs primarily in BAT in response to cold.

    “Shivering thermogenesis occurs in muscle and complements non-shivering thermogenesis, which occurs primarily in BAT in response to cold.”
  • The paper relies on this without support.

    Three types of thermogenesis occur in skeletal muscle: exercise-induced thermogenesis, NEAT, and cold-induced shivering thermogenesis.

    “Three types of thermogenesis occur in skeletal muscle: exercise-induced thermogenesis, non-exercise activity thermogenesis (NEAT), and cold-induced shivering thermogenesis (ST).”
  • The paper relies on this without support.

    Another important mechanism for heat production in skeletal muscle involves ATP turnover and maintenance of the calcium gradient mediated by SERCA proteins.

    “Another important mechanism for heat production in skeletal muscle involves ATP turnover and maintenance of the calcium gradient mediated by the sarcoplasmic reticulum calcium ATPases (SERCA proteins) (Figure 2c).”
13 of 13

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Adult human BAT is described in two different locations

    Minor

    The first statement places adult human BAT between the shoulder blades; the next places its most common location in the neck. The first statement appears to have meant BAT in rodents and human babies, but as written the two conflict.

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Citations

Cites

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Show all 208 references

Research works printed but not linked: 1

  1. Neumann, R. O. Experimentelle Beitrage Zur Lehre von den taglichen Nahrungsbedarf des Menschen unter besonderer Bernuksichtigung der notwendigen Eiweissmenge. Archiv fur Hygeine 45, 1–87 (1902) (in German).

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Metadata

Authors
Tseng, Y.-H., Cypess, A. M., & Kahn, C. R.
Affiliations
Joslin Diabetes Center (US)
Corresponding author
  • Tseng, Yu-Hua
  • Kahn, C. Ronald
Venue
Nature Reviews Drug Discovery
Published
2010-06
Volume
9
Issue
6
Pages
465-482
ISSN
  • 1474-1776 (ISSN-L)
  • 1474-1784
OpenAlex
W2057337991
Cited by
591
References
208
Citations by year
2026: 11 · 2025: 18 · 2024: 16 · 2023: 32 · 2022: 35 · 2021: 37 · 2020: 31 · 2019: 46 · 2018: 37 · 2017: 53 · 2016: 43 · 2015: 53 · 2014: 67 · 2013: 40 · 2012: 43
FWCI
3.60
Type
journal article
Language
en
Open access
Locations
  • Nature Reviews Drug Discovery (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health
  • National Institute of Diabetes and Digestive and Kidney Diseases (R01DK077097, DK-082659, K23DK081604, P30DK046200, DK046200, DK077097, DK081604, P30DK036836, R01DK082659)
  • National Center for Research Resources (UL1RR025758, KL2RR025757, RR025758, RR025757)
Topics
  • Health Sciences › Medicine › Physiology (medical) › Adipose Tissue and Metabolism
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adipokines, Inflammation, and Metabolic Diseases
Keywords
obesity treatment, cellular bioenergetics, energy expenditure, adaptive thermogenesis, brown adipose tissue, skeletal muscle thermogenesis, anti-obesity drugs, energy balance
MeSH terms
Uncoupling Protein 1, Adenosine Triphosphate, Adipose Tissue, Brown, Energy Metabolism, Humans, Ion Channels, Mitochondria, Obesity, Transforming Growth Factor beta, Cell Lineage, Thermogenesis, Mitochondrial Proteins

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