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The interplay between the adrenergic system and obesity: a systematic review
Beatriz Araújo1,2, Fernanda Leite1,3,4, Laura Ribeiro5,6
1Department of Public Health and Forensic Sciences, and Medical Education, Medical Education Unit, Faculty of Medicine of the University of Porto, Porto, Portugal.
International Journal of Obesity (2005)
|October 11, 2025
Summary
Individuals with obesity exhibit a hyperadrenergic state, with altered noradrenaline and adrenaline levels and a reduced sympathetic response. Weight loss interventions can improve these adrenergic dysregulations.
Area of Science:
- Endocrinology
- Metabolic Disorders
- Neuroscience
Background:
- Obesity presents a significant global health challenge.
- Sympathetic nervous system (SNS) dysregulation, particularly involving the adrenergic system, is implicated in obesity's development.
- Understanding the adrenergic system's role is crucial for obesity research.
Purpose of the Study:
- To systematically review the literature on the adrenergic system's involvement in obesity.
- To explore the relationship between catecholamine levels and obesity.
- To identify research gaps in this field.
Main Methods:
- A comprehensive search of PubMed, Web of Science, and Scopus databases was conducted.
- Studies published before June 2023, focusing on plasma or urinary adrenaline and noradrenaline in adults with obesity, were included.
- Boolean search terms included "obese/obesity" AND "adrenaline/noradrenaline/epinephrine/norepinephrine".
Main Results:
- 35 studies involving 2588 subjects met the inclusion criteria.
- Evidence indicates a hyperadrenergic state in obesity, with elevated noradrenaline and reduced adrenaline.
- Obesity-associated comorbidities, excluding hypertension, exacerbate adrenergic overdrive; weight loss interventions improve SNS response.
Conclusions:
- The adrenergic system and obesity are intricately linked, involving complex catecholamine interactions.
- This review synthesizes current evidence on adrenergic dysregulation in obesity.
- Findings provide insights for future research and clinical strategies in obesity management.
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