Leptin, Obesity, and Leptin Resistance: Where Are We 25 Years Later
Open accessAbstract
Leptin, a hormone that is capable of effectively reducing food intake and body weight, was initially considered for use in the treatment of obesity. However, obese subjects have since been found to have high levels of circulating leptin and to be insensitive to the exogenous administration of leptin. The inability of leptin to exert its anorexigenic effects in obese individuals, and therefore, the lack of clinical utility of leptin in obesity, is defined as leptin resistance. This phenomenon has not yet been adequately characterized. Elucidation of the molecular mechanisms underlying leptin resistance is of vital importance for the application of leptin as an effective treatment for obesity. Leptin must cross the blood-brain barrier (BBB) to reach the hypothalamus and exert its anorexigenic functions. The mechanisms involved in leptin transportation across the blood-brain barrier continue to be unclear, thereby preventing the clinical application of leptin in the treatment of obesity. In recent years, new strategies have been developed to recover the response to leptin in obesity. We have summarized these strategies in this review.
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Persistent higher concentration of leptin in plasma can lead to leptin resistance.
“On the other hand, persistent higher concentration of leptin level plasma can also lead to leptin resistance (45, 47).”
From Sparse System Identification of Leptin Dynamics in Women With Obesity (2022) · cites this paper as [47]
Additional contributing factors to obesity-mediated HPT axis suppression include paternal genetics, leptin resistance, and obesity-associated elevations in pro-inflammatory cytokines.
“Additional contributing factors include paternal genetics, 68 leptin resistance, 69 and obesity‐associated elevations in pro‐inflammatory cytokines (reviewed in Grossmann 56 ).”
From The role of the androgen receptor in the pathogenesis of obesity and its utility as a target for obesity treatments (2022) · cites this paper as [69]
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Leptin‐based glycopeptide induces weight loss and simultaneously restores fertility in animal models
Kovalszky, I., Surmacz, E., Scolaro, L. M., Cassone, M., Ferla, R., Sztodola, A., Oláh, J., Hatfield, M. P. D., Lovas, S., & Otvos, L. (2009) · Diabetes Obesity and Metabolism · doi:10.1111/j.1463-1326.2009.01170.x · Cited by 29 · see citing works
Kleinert, M., Kotzbeck, P., Altendorfer‐Kroath, T., Birngruber, T., Tschöp, M. H., & Clemmensen, C. (2018) · Molecular Metabolism · doi:10.1016/j.molmet.2018.04.008 · Cited by 28 · see citing works
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Anti-Obesity Phenotypic Screening Looking to Increase OBR Cell Surface Expression
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Flagged first, then by citations
Cited by
Sorted by citations
Therapeutic Peptides: Current Applications and Future Directions
Wang, L., Wang, N., Zhang, W., Cheng, X., Yan, Z., Shao, G., Wang, X., Wang, R., & Fu, C. (2022) · Signal Transduction and Targeted Therapy · doi:10.1038/s41392-022-00904-4 · Cited by 2,131 · see citing works
Leptin and Obesity: Role and clinical implication.
Obradovic, M., Sudar-Milovanovic, E., Soskic, S., Essack, M., Arya, S., Stewart, A. J., Gojobori, T., & Isenovic, E. R. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2021.585887 · Cited by 1,121 · see citing works
Obesity as a Risk Factor for Dementia and Alzheimer’s Disease: The Role of Leptin
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The incretin/glucagon system as a target for pharmacotherapy of obesity
Del Prato, S., Gallwitz, B., Holst, J. J., & Meier, J. J. (2022) · Obesity Reviews · doi:10.1111/obr.13372 · Cited by 77 · see citing works
“to be caused, in part, by downregulation of a feedback loop by the high leptin levels.(49) Food intake is also regulated by the mesolimbic reward system and has been shown to activate some of the same circuits involved in drug addiction.”
BackgroundAppetite control: Hormones or diet strategies?
Freire, R. H., & Alvarez-Leite, J. I. (2020) · Current Opinion in Clinical Nutrition & Metabolic Care · doi:10.1097/mco.0000000000000675 · Cited by 37 · see citing works
Venkatesh, V. S., Grossmann, M., Zajac, J. D., & Davey, R. A. (2022) · Obesity Reviews · doi:10.1111/obr.13429 · Cited by 22 · see citing works
Obesity and Exercise: New Insights and Perspectives
James, N. M., & Stanford, K. I. (2025) · Endocrine Reviews · doi:10.1210/endrev/bnaf017 · Cited by 20 · see citing works
Optimised Skeletal Muscle Mass as a Key Strategy for Obesity Management
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“(In a rodent-based model of obesity, a reduction in IMCL content resulted in an improvement in insulin sensitivity within the SM [43,84].)”
Sparse System Identification of Leptin Dynamics in Women With Obesity
Amin, M. R., Pednekar, D. D., Azgomi, H. F., van Wietmarschen, H., Aschbacher, K., & Faghih, R. T. (2022) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.769951 · Cited by 14 · see citing works
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- Authors
- Izquierdo, A. G., Crujeiras, A. B., Casanueva, F. F., & Carreira, M. C.
- Affiliations
- Instituto de Salud Carlos III (ES)
- Universidade de Santiago de Compostela (ES)
- Corresponding author
- Casanueva, Felipe F.
- Carreira, Marcos C.
- Venue
- Nutrients
- Publisher
- MDPI AG
- Published
- 2019-11-08
- Volume
- 11
- Issue
- 11
- Pages
- 2704
- ISSN
- 2072-6643 (ISSN-L)
- PMC
- PMC6893721
- OpenAlex
- W2987043898
- Cited by
- 525
- References
- 92
- Citations by year
- 2026: 39 · 2025: 76 · 2024: 92 · 2023: 105 · 2022: 111 · 2021: 72 · 2020: 30
- FWCI
- 6.37
- Type
- journal article
- Language
- en
- Open access
- gold
- dx.doi.org
- Licence
- Locations
- Nutrients (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Hispana (submittedVersion, cc-by)
- Repositorio institucional da Universidade de Santiago de Compostela (University of Santiago de Compostela) (submittedVersion, other-oa)
- RUNA. Repositorio Institucional del Sergas (Servicio Gallego de Salud (SERGAS)) (submittedVersion, cc-by)
- Funders
- Instituto de Salud Carlos III (CP17/00088, PI17/01287)
- European Regional Development Fund (CP17/00088)
- Topics
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
- Keywords
- leptin, leptin resistance, obesity, anorectic effect, blood-brain barrier, hypothalamus, leptin transport, leptin therapy
- MeSH terms
- Blood-Brain Barrier, Brain, Capillary Permeability, Feeding Behavior, Humans, Obesity, Signal Transduction, Weight Gain, Anti-Obesity Agents, Leptin, Adiposity
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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