UK science fights worldwide obesity epidemic

Obesity - with its associated risks of diabetes, cardiovascular disease, stroke and cancer - is now a global problem.

Obesity - with its associated risks of diabetes, cardiovascular disease, stroke and cancer - is now a global problem. Once seen as a condition of the affluent west, it is now a fact of life in developing countries too. The World Health Organisation has labelled obesity ‘an epidemic’ and predicts that it will affect approximately 700million adults worldwide by 2015. Worryingly, according to WHO, “childhood obesity is already epidemic in some areas - and on the rise in others.”

This is why tackling obesity – which costs the UK’s National Health Service £1billion a year - is a priority for the UK government. The Department of Health is working with the food industry to establish the Food and Health Action Plan to improve diet and nutrition, while in January, the government launched its Change4Life healthy living campaign with the backing of international companies including Tesco, Kellogg's and Unilever. In February, Foresight – a group of senior decision-makers and budget-holders from relevant Departments, Research Councils and other organisations - invited leading policy makers from around Europe to an international workshop to discuss the challenges of fighting obesity. Funding, via the Medical Research Council, supports academic institutions and organisations involved in the study of obesity. In this area, the UK is an international centre of excellence, with leading universities researching obesity and associated diseases.

“The UK is a world-leader in understanding the genetics of human obesity,” says Professor Stephen O’Rahilly, Professor of Clinical Biochemistry and Medicine at the University of Cambridge. “For example, the genes causing severe childhood obesity were first discovered by our group in Cambridge. In terms of obesity genetics study, three or four of the world’s top scientific groups come from the UK. In terms of developing novel therapeutics, Professor Steve Bloom, from Imperial College London, has been the pre-eminent academic in his field - and admirably active.”

Recent breakthroughs by UK institutions include the discovery of genetic variants that influence risk of obesity, a finding uncovered via an international investigation led by Oxford and Cambridge researchers in a programme supported by, among others, the European Commission, the Academy of Finland, GlaxoSmithKline, and the German National Genome Research Net. In January, a report was published of a 10-year study by scientists at Imperial College London - in partnership with French National Research Institute CNRS and other international institutions - which identified the genetic mutations that increase the risk of childhood obesity. Currently, the University of Leeds, the University of Surrey and the Medical Research Council are working with international partners – including the University of Copenhagen, the Budapest University of Technology and Economics, and Unilever Nederland BV - on the Diogenes Project, an international programme seeking new insights and routes to obesity prevention.

Dr Jason Halford is Reader in Appetite and Obesity and Director of the Kissileff Human Ingestive Behaviour Laboratory at the University of Liverpool. He says: “The UK is excellent at discovery. We are also leaders in European clinical trials for anti-obesity drugs. I do not believe we can solve the obesity problem with a product; but I do believe we are beginning to understand what causes obesity. The discovery science is starting to catch up.” Historically, says Dr Halford, the UK has been THE centre for anti-obesity drug development: sibutramine, for example, a leading anti-obesity drug, was developed in the UK.

Dr Halford is Deputy Chair and Chair Elect of the 42-year-old Association for the Study for Obesity, the first academic obesity research society in the world, with members including clinicians, nutritionists, surgeons, food scientists and pharmacologists. “The ASO gave rise to all other international obesity research groups,” he says. “It also gave rise to the first academic journal on obesity - the International Journal of Obesity - and the International Association for the Study of Obesity (IASO) which now runs that journal and represents all the national societies at the global policy level.” Dr Halford is also part of the Liverpool Obesity Research Network, a consortium of academics who have been involved in drug discovery work and examining the effectiveness of drugs in clinical trials.

Last year, the Institute of Metabolic Science was launched in Cambridge. This aspires to become a world-leader in understanding the biological basis of diabetes, obesity and related disorders and translate those scientific discoveries into improved patient care and disease prevention. Professor Stephen O’Rahilly is the institute’s Co-Director. “We would like to produce anti-obesity drugs, ultimately,” he says. “Take this analogy: in the war on obesity, industry is good at producing the weaponry. But every army needs military intelligence. My view is that academia can deliver that intelligence in the way that no biotech company can.” Hence, Professor Stephen O’Rahilly and his academic colleagues are currently sharing early phase drug development and decision-making with scientists from GlaxoSmithKline. “We are combining the strengths and knowledge-base of GSK with our own scientific strengths,” he says. “That’s an exciting model for the future.” In spring 2009, GlaxoSmithKline will begin to market the weight-loss treatment, Alli, in the UK and throughout Europe. Unusually, Alli is an over-the-counter product that went through clinical trials prior to launch – and is the first non-prescription product for weight-loss approved by the European Commission.

In the UK food sector, international companies such as Nestle, Danone and Unilever are big players in weight control. The Nestlé Research Centre and Imperial College London have a strategic partnership and joint research programme which has now expanded to include new studies into the mechanisms of body weight control.

Yet obesity research is still a relatively early science, says Professor O’Rahilly, and exciting possibilities lie ahead. “Ten years ago we didn’t understand anything about the inherent factors which led some people to remain lean and others to become obese. The last decade has been a period of transformation for our science.”