Context: By enhancing energy expenditure and suppressing appetite, melanocortin peptides derived from POMC play a primary role in the hypothalamic regulation of body weight. In a recent study in normal weight adults, the 6-week intranasal administration of the MSH/ACTH_4-10 core fragment of POMC resulted in a distinct reduction of body weight and body fat, accompanied by significant decreases in leptin and insulin plasma concentrations.

Objective: The present study aimed to generalize this finding to overweight patients.

Design, Subjects and Intervention: MSH/ACTH_4-10 (0.5 mg) and placebo were intranasally administered once in the morning and once in the evening over a period of 12 weeks in 23 overweight men (body mass index, mean±SEM: 29.72 ± 0.43 kg/m²).

Results: MSH/ACTH_4-10 did not induce any significant reduction in body weight, body fat, and plasma levels of insulin and leptin as compared with the effects of placebo. Melanocortin treatment was accompanied by reduced cortisol concentrations.

Conclusions: We conclude that contrasting with normal weight humans, overweight subjects are not susceptible to the effects of melanocortin administration on hypothalamic weight regulatory systems. In overweight subjects, a decreased sensitivity to ACTH/MSH peptides may derive from alterations at the level of the melanocortin receptor or at subsequent steps in the processing of the body fat signal.