SO, YOU ATE less and exercised more and managed to lose weight. But now what you lost is piling back on. You're hungrier than ever and you can't seem to resist food. Once again, it's all your fault, right?

Wrong. Blame evolution, and the fact that for the vast majority of human history, famine was a bigger threat than flab. Even your seeming lack of will power is tied up in the complex biological systems that drive humans who have lost weight to regain it, according to new brain-scan research by scientists at Columbia University Medical Center.

'Loosely put, after you've lost weight, you have more of an emotional response to food and less ability to control that response,' says Michael Rosenbaum, lead author of the study in this month's Journal of Clinical Investigation.

The key driver of this system is leptin, a hormone secreted by fat cells. When humans (and rodents) lose 10% or more of their body weight, leptin falls rapidly and sets off a cascade of physiological changes that act to put weight back on. Skeletal muscles work more efficiently, thyroid and other hormones are reduced -- all so the body burns 15% to 20% fewer calories.

'If you have two people of the same weight, but one lost 10% of his body weight to reach that point, that person will either need to burn 300 to 400 calories more per day, or eat 300 to 400 calories less to stay at that weight,' says Dr. Rosenbaum. That's enough to put back more than 11 kilograms a year.

This mechanism kicks in whether people are obese or relatively lean before they lose weight -- and researchers believe the effect can last for years. However, in previous studies, when subjects were given replacement leptin, the metabolic changes were reversed and they were able to maintain their weight loss. In effect, their bodies were tricked into overlooking the fact that it had lost weight.

The latest study shows that the metabolic changes resulting from weight loss are mirrored in altered brain activity. The Columbia researchers carefully controlled the intake of six hospitalized obese patients using liquid diets. Their weight was reduced by 10% and they were given either replacement leptin or a placebo. At each stage, researchers observed their brain activity using functional MRIs when they were shown food and nonfood items.

The scans showed that in the weight-reduced state, the subjects had more blood flow in areas of the brain related to emotional and sensory responses to food and less in areas involving control of food intake. When they were given replacement leptin, those changes were reversed and brain activity returned to what it had been before they lost weight.

There are still many unknowns about how blood flow in the brain corresponds to behavior. 'I can't look at these scans and say, in 30 seconds, you're going to eat a banana,' says Rudolph Leibel, a co-author of the Columbia study who helped discover leptin in the 1990s at Rockefeller University. Still, he says, it is further evidence of the powerful biological one-two punch that leptin delivers to people who have lost weight: 'These people act as if they were hungrier and combined with reduced energy expenditure, that's the 'perfect storm' for gaining weight.'

Researchers originally thought leptin signaled the body to stop eating and hoped that it might be harnessed as a weight-loss drug. Instead, leptin's role is to prevent weight loss, and a drop in leptin levels sends the body into survival mode when food is scarce and fat stores decline. That makes sense from an evolutionary standpoint, but helps fuel obesity in modern times. For most of human history, 'you had to spend a lot of energy to get food,' says Dr. Leibel. Now, 'anyone can summon an unlimited amount of food just with a cellphone.'

Scientists think that leptin may still have a role as a drug for maintaining weight loss, which they now see as a different mechanism than losing weight in the first place. Amylin Pharmaceuticals Inc. of San Diego, which bought the rights to leptin from Amgen Inc. in 2006, is testing it, in combination with pramlintide, a diabetes drug. Large-scale human trials won't start until next year at the earliest.

In the meantime, how do some people manage to overcome the biological imperatives? Generally by watching their food intake very carefully and continuing to increase their physical activity. 'Anybody who has lost weight and kept it off will tell you that they have to keep battling,' says Dr. Rosenbaum. 'They have essentially reinvented themselves, and they are worthy of the utmost admiration and respect.'

沒(méi)錯(cuò)，你減少飲食又加強(qiáng)鍛煉，終于成功減輕了體重。但現(xiàn)在體重又在逐漸反彈。你比任何時(shí)候都感到饑餓，似乎抵擋不了食物的誘惑。減肥計(jì)劃又失敗了，這全是你的錯(cuò)，對(duì)嗎？

錯(cuò)。現(xiàn)在你可以將其怪罪于人類(lèi)的進(jìn)化�；仡櫲祟�(lèi)歷史，絕大部分時(shí)間，饑餓對(duì)人造成的威脅都要超過(guò)肥胖。表面上看，你是缺乏意志力才導(dǎo)致減肥后體重反彈；但根據(jù)哥倫比亞大學(xué)醫(yī)學(xué)中心(Columbia University Medical Center)科學(xué)家最新的腦部掃描研究，實(shí)際上這涉及到復(fù)雜的生物系統(tǒng)。

Corbis這一研究成果刊登在本月的《臨床研究期刊》(Journal of Clinical Investigation)上。研究報(bào)告的主要作者麥克爾•羅森巴姆(Michael Rosenbaum)表示，簡(jiǎn)單的說(shuō)，這是因?yàn)槟銣p肥之后會(huì)對(duì)食物有更多的情緒反應(yīng)，同時(shí)對(duì)這種反應(yīng)的控制力也會(huì)下降。

在這個(gè)系統(tǒng)中，主要的推動(dòng)力是瘦素(leptin)，這是脂肪細(xì)胞分泌的一種激素。當(dāng)人或嚙齒類(lèi)動(dòng)物體重下降10%或更多時(shí)，瘦素的水平就會(huì)急劇下降，引發(fā)一連串的生理變化，促使體重回升。在這個(gè)過(guò)程中，骨骼肌會(huì)更加有效地工作，甲狀腺等激素的分泌也會(huì)相應(yīng)下降，因此身體可以減少15%-20%的熱量消耗。

羅森巴姆表示，假設(shè)兩個(gè)人體重相同，但其中一個(gè)是體重下降10%才達(dá)到這一水平，那么這個(gè)人每天需要多消耗300-400卡路里，或少攝入300-400卡路里的熱量才能維持當(dāng)前體重。這一熱量足以使他一年體重反彈超過(guò)11公斤。

無(wú)論你在減肥前是肥胖還是相對(duì)苗條，這一機(jī)制都會(huì)發(fā)揮作用；研究人員相信這一影響可以持續(xù)數(shù)年。但在此前研究中，研究對(duì)象攝入瘦素替代品后，成功地逆轉(zhuǎn)了這一新陳代謝變化過(guò)程，進(jìn)而保持了減肥成果。實(shí)際上，瘦素替代品“欺騙”了他們的身體，讓身體忽略了曾經(jīng)減肥的事實(shí)。

最新研究顯示，減肥帶來(lái)的這一新陳代謝變化也反映在大腦活動(dòng)的變化上。哥倫比亞大學(xué)醫(yī)學(xué)中心的研究人員對(duì)六位采用流食的肥胖癥住院患者的進(jìn)食量進(jìn)行了精確控制。這些患者的體重都下降了10%，被分成使用瘦素的試驗(yàn)組和使用安慰劑的對(duì)照組。研究人員利用功能性核磁共振成像技術(shù)(MRI)，觀察患者在各個(gè)階段看到食物與非食物時(shí)的腦部活動(dòng)。

掃描結(jié)果顯示，研究對(duì)象在減肥后，其腦部和食物有關(guān)的情緒與感覺(jué)反應(yīng)區(qū)域血流量加大，而和控制進(jìn)食有關(guān)的區(qū)域的血流量減少。當(dāng)研究對(duì)象攝入瘦素替代品后，這類(lèi)變化就被逆轉(zhuǎn)，腦部活動(dòng)重新回到減肥之前的狀態(tài)。

但在腦部血流量如何與行為產(chǎn)生聯(lián)系的問(wèn)題上，仍有許多未解之謎。該研究報(bào)告的合著者之一魯?shù)婪?bull;利貝爾(Rudolph Leibel)說(shuō)，“我無(wú)法看著掃描就斷言你30秒內(nèi)會(huì)吃根香蕉”。利貝爾上個(gè)世紀(jì)90年代曾在洛克菲勒大學(xué)(Rockefeller University)參與了瘦素的發(fā)現(xiàn)。他還說(shuō)，這進(jìn)一步表明，減肥后瘦素的變化引發(fā)人體明顯的生物學(xué)變化，通過(guò)強(qiáng)大的雙重機(jī)制實(shí)現(xiàn)體重反彈。他介紹稱(chēng)，研究對(duì)象一方面顯得更加饑餓，另一方面能量消耗降低，這為體重反彈創(chuàng)造了絕佳條件。

研究人員最初認(rèn)為，瘦素能向人體發(fā)出停止進(jìn)食的信號(hào)，并希望將其用作減肥藥。但實(shí)際上，瘦素的作用是阻止體重下降，瘦素水平的下降會(huì)使人體進(jìn)入生存模式，這是人體應(yīng)對(duì)食物匱乏、脂肪儲(chǔ)存下降的不利狀況的運(yùn)轉(zhuǎn)模式。從進(jìn)化角度來(lái)說(shuō)，這一反應(yīng)機(jī)制合情合理，但面對(duì)現(xiàn)代的肥胖問(wèn)題卻適得其反。利貝爾說(shuō)，回顧人類(lèi)歷史，大多數(shù)時(shí)間人類(lèi)都需要消耗大量能量去獲取食物；而現(xiàn)在你只需一個(gè)電話就可以召來(lái)取之不盡的食物。

科學(xué)家認(rèn)為，瘦素仍可能被用來(lái)幫助維持體重不反彈。科學(xué)家現(xiàn)在認(rèn)為保持體重不反彈和減肥是兩種不同的機(jī)制。圣地亞哥的Amylin Pharmaceuticals Inc.于2006年從Amgen Inc.購(gòu)買(mǎi)了瘦素的專(zhuān)利權(quán)，目前正在對(duì)瘦素和糖尿病藥物普蘭林（月太）聯(lián)合作用的效果進(jìn)行試驗(yàn)。大規(guī)模人體試驗(yàn)最早將于明年開(kāi)始。

與此同時(shí)，有些人又是怎樣克服這一生物系統(tǒng)，成功保持體重的呢？通常來(lái)說(shuō)，這些人會(huì)非常小心地控制飲食，并繼續(xù)加強(qiáng)身體鍛煉。羅森巴姆說(shuō)，任何減肥后又成功保持身材的人都會(huì)告訴你，他們的秘密就是堅(jiān)持。這些成功者戰(zhàn)勝了生物系統(tǒng)，他們值得我們最高程度的欽佩與尊敬。