Introduction
In the UK, 25% of adults are obese and a further 37% are overweight leading to poor health and premature death. Being overweight increases the risk of diabetes, hypertension and high cholesterol, leading to an increased risk of heart disease and strokes. It is associated with more than 13 different types of cancer including colon cancer and post-menopausal breast cancer. Being overweight increases the pressure on joints leading to back pain and an increased need for knee and hip replacements. People who are obese experience higher rates of anxiety and depression. Successfully tackling obesity, through a combination of prevention and treatment, is crucial to improve the health of the nation, reduce the pressures on the NHS and enhance economic productivity.
Research in this theme will unite population health and clinical scientists with frontline practitioners. It will cover three key areas: treatment of obesity, prevention of weight gain, and personalise care by identifying people at the greatest risk.
The Health Survey for England shows that 47% of adults are trying to change their diet to lose weight and we will work closely with our participant panel to understand the needs of people who are overweight and their experiences of health services.
Treatment of obesity
We will develop interventions to treat established obesity and test whether this can improve the care of people with conditions such as fatty liver disease (see Diabetes and Metabolism theme) and atrial fibrillation (see Cardiovascular theme). We will evaluate the economic impact of these interventions on health and social care budgets. If successful we will develop new models of care so that weight management is given more attention as part of routine medical care.
To listen to a podcast about Prof Aveyard’s study helping doctors to offer support to patients who are overweight, click here: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31893-1/abstract
Prevention of obesity
We want to develop new ways to help everyone to reduce the risk of excess weight gain, focusing in particular on how to achieve a healthier diet by changing the way we shop for food. We will use technology to support people to make healthier food purchases, whether online or in physical stores. These tools will provide people with cues towards healthier purchases, such as suggesting healthier alternative products or tracking the nutritional quality of the shopping basket during real shopping sessions. We will also monitor the activities of the food industry by measuring changes in the nutritional composition of processed foods, and model the short, medium and long term changes in health outcomes that would result from changes in the food supply.
Watch a video in which Prof Jebb talks about helping people to change their diet:
Identifying people at risk
Although many people are overweight, not everyone will develop obesity-related diseases. If we can identify people at high risk at an early stage we can prioritise them for support to manage their weight.
We will analyse data from large population cohorts, including the UK Biobank which contains detailed measures of fat deposition, collected using magnetic resonance imaging (MRI: see Imaging), and the Oxford Biobank which has in-depth metabolic phenotyping. This research will form the basis of new experimental studies to test the functional pathways linking excess weight to disease, leading to the development of risk stratification tools that can be used in routine clinical care.
Watch a podcast about Prof Karpe’s research into the links between obesity and diabetes: