Obesity: not a 'self image' problem – Greg Stevens – The Kernel

My recent article, You eat too much, elicited strong emotional reactions from many readers. The letters and comments still flooding in that express outrage and anger at the article follow two main themes I think are worth addressing.

The first is what I will call “special cases”. What about people who are on medication that cause weight gain? What about people who are injured in an accident? What about people who binge-eat in their sleep and don’t even realize it? Does it really make sense to blame them them for being overweight?

The people who point out these special circumstances are doubtless very well-intentioned. But I think the reflexive tendency to focus on these anecdotal stories is unhelpful.

Look at the numbers for a moment. Over 35 per cent of Americans are obese. Do you really believe that all, or even most, of these individuals fall into these “special case” scenarios? Are they all sleep-eating, or on special medications that cause weight gain? Is it not more likely that even when you factor out people with such “special circumstances”, there are still a large number of people left over who simply have bad habits?

I understand that the people who focus on special cases mean well, because they are trying to introduce nuance into the conversation. They are trying to say: “Don’t paint with a broad brush!”

But by chronically focusing on special case exceptions, rather than personal responsibility, these stories become the excuses that every obese person can latch on to. Every person then imagines him or herself as a “special case” and declares: “Why even bother? It’s out of my control!”

For most people, that is simply not the case.

The second theme is “I struggle with being pudgy”. Many people shared their own stories about growing up as pudgy kids, and always trying to eat right and exercise, and yet nothing seemed to help. These were sincere and emotional stories from people who have battled their entire lives to “lose that last 10-20 pounds”.

They were offended by statements in my article such as: “If you want to make a change, put down the ice cream scoop and pick up a gym membership. It really is that simple.” They wrote to tell me from their own experience: they know it isn’t “that simple”.

I completely understand the frustration that many people feel, battling their entire lives to get into better shape, and often never seeing the results that they want. Many people I know – perhaps most people I know – have lived their entire lives with the quiet desperation of not being completely satisfied with their physical self-image.

But let’s be clear: that is not what this article is about.

The article “You eat too much” is about obesity. Obesity is not “feeling a little fat”. It is not the pudgy little girl who can’t seem to lose that last 10 pounds. It is not the person who works out every day, and counts calories, and still just can’t fit into those 32-inch waist jeans.

There is a huge difference, both psychologically and literally, between someone who “can’t lose that last 10 pounds” and someone who is obese.

When talking about chronic dissatisfaction, seeing yourself as “slightly overweight”, then all of the complexities of issues like self-acceptance and cultural standards of beauty become very important. But that’s not the case with obesity.Obesity is not about self-image, and it is not about whether one can be both “round and sexy”.

It’s about being dangerously, medically overweight.

Perhaps this issue is so sensitive that no amount of clarity would be “clear enough” to prevent this misunderstanding. If that is the case, then that is part of the problem with our culture.

But if we allow people to conflate obesity with “being a little overweight”, then we will never be able to have a serious conversation that addresses obesity for what it is: a serious medical issue that requires changes in behaviour before and above all else.

NOW READ: You eat too much

Pregnancy Weight Gain Linked to Childhood Obesity | WebProNews

Pregnancy Weight Gain Linked to Childhood Obesity

Though recent data has shown that childhood obesity numbers are falling in a number of U.S. states, health officials in the country are still referring to obesity as an epidemic. This week, a new study has shown that expectant mothers may have more direct, biological influence on the size of their children than previously thought.

The study, published Monday in the journal PLoS Medicine, shows that high weight gain during pregnancy is directly linked to an increased risk of obesity for the children up until age 12. The study’s authors believe that helping women limit their weight gain during pregnancy could have an impact on the fight against obesity in the U.S.

“From the public health perspective, excessive weight gain during pregnancy may have a potentially significant influence on propagation of the obesity epidemic,” said Dr. David Ludwig, lead author of the study and the director of the Boston Children’s Hospital’s Obesity Prevention Center. “Pregnancy presents an attractive target for obesity prevention programs, because women tend to be particularly motivated to change behavior during this time,”

The study looked at 41,133 mothers and children in the state of Arkansas over 12 years, cross-referencing birth records and school BMI records. Statistical comparisons were then made between siblings, ruling out demographic, genetic, and environmental influences. Excessive weight gain in the study was defines as 40 or more pounds, which correlated to an 8% increase in the risk of a child being obese.

Though the difference in BMI from mothers who gained the least weight during pregnancy to those who gained the most is only one-half of a BMI unit, Ludwig and his colleagues believe this effect could contribute to hundreds of thousands of obesity cases nationwide.

Antidepressants may raise diabetes risk

People taking antidepressants are at a higher risk of type 2 diabetes, a new study has warned.

A number of studies have been carried out to establish whether antidepressants are linked with diabetes but results have varied depending on the methods used, type of medication and the number of participants.

In a systematic review, researchers at the University of Southampton found that people taking antidepressants are at a higher risk of type 2 diabetes.

However, the study cautioned that it is not certain whether the medication is responsible for the condition.

Researchers assessed 22 studies and three previous systematic reviews that looked into the effects of antidepressants on diabetes risk. Overall, people taking antidepressants were more likely to have diabetes.

However, the researchers warned that different types of antidepressants may carry different risks and long-term prospective randomised control trials are needed to look at the effects of individual tablets.

The team said that there are “several plausible” reasons why antidepressants are associated with an increased risk of diabetes.

For example, several antidepressants are associated with significant weight gain which increases the risk of type 2 diabetes.

However, they also said that several studies which explored this association still observed an increased risk of diabetes after adjustment for changes in body weight, implying other factors could be involved.

“Our research shows that when you take away all the classic risk factors of type 2 diabetes; weight gain, lifestyle etc, there is something about antidepressants that appears to be an independent risk factor,” said Dr Katharine Barnard, Health Psychologist from the University of Southampton.

“While depression is an important clinical problem and antidepressants are effective treatments for this debilitating condition, clinicians need to be aware of the potential risk of diabetes, particularly when using antidepressants in higher doses or for longer duration,” said Richard Holt, Professor in Diabetes and Endocrinology at the University.

Five meals a day prevents youth obesity | Yle Uutiset | yle.fi


Mittanauha

A new 5-a-day rule seems to be in the offing.

Image: Arja Lento / Yle

Master of Health Sciences Anne Jääskeläinen’s doctoral research shows that a regular five meal rhythm on weekdays protects against overweight and obesity in young people – as well as in infants who might be prone to overly padded waistlines.

According to the study, even those who are genetically more susceptible to weight gain will not pack on more kilos than their more genetically fortunate peers if they stick to the five a day rule.

The results also show that if a father was overweight before the mother’s pregnancy, the risk factors are almost the same as if the mother was overweight before the pregnancy began – for both girls and boys. In addition, mothers who packed on the pounds at the start of their pregnancy increased the risk of continuing the trend in their offspring.

The study brings new information on early risk factors associated with young Finns at risk of overweight and obesity.

Healthy gut bacteria prevent obesity: Study




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(NaturalNews) The key to shedding those excess pounds and achieving that lean figure you have always dreamed about could be as simple as eating more bacteria. A new study out of Washington University in St. Louis has found that maintaining healthy and balanced gut bacteria — that is, the beneficial microbes that naturally populate your intestinal tract — may help prevent weight gain and actually fight obesity, which now plagues more than one-third of all Americans.

Dr. Jeffrey Gordon and his colleagues made this important discovery after observing the effects of intestinal germs implanted into several groups of pathogen-free mice. WU graduate student Vanessa Ridaura, who worked alongside Dr. Gordon for the study, took gut bacteria from four pairs of twins, each of which included both an obese and a lean sibling. One pair of the twins was also identical, which was meant to rule out any possibility that weight differences might somehow be inherited.

The team transplanted gut bacteria from these eight individuals into the intestines of young mice, which were specifically bred to lack their own natural bacteria, and watched for variations in how these mice developed over time. In the end, it was noted that the mice who received gut bacteria from the obese individuals tended to not only gain more weight than the other mice but also undergo some serious metabolic changes that left them significantly more unhealthy.

What helped further prove that the bacterial source made all the difference was the fact that all the mice ate the same amount of food, and yet only those implanted with the obese bacteria experienced weight gain and health deterioration. The reason, say experts, is that obese people tend to harbor a less diverse array of beneficial bacteria in their guts, while leaner people possess the bacterial variations and balance necessary to maintain a proper and healthy weight.

But the findings do not stop here. After performing this first set of experiments, the team decided to put mice from both the lean and obese groups into cages with one another to observe how cross-exposure to different bacterial profiles might affect the mice’s health and weight. For those who are unaware, mice tend to eat feces, which contain intestinal bugs and other markers of gut composition.

Not surprisingly, this grouping of the mice and the resultant exposure to varying bacterial profiles led to a phenomenon called bacterial swapping, in which bacteria from each of the mice comingled with one another to create new bacterial profiles. But what came as a surprise was the fact that bacteria from the lean mice invaded the intestines of the obese mice, triggering positive changes in both weight and metabolism.

“It was almost as if there were potential job vacancies,” explained Dr. Gordon about the apparently deficient bacterial profiles of the obese mice. At the same time, the positive changes observed in the obese mice were not reciprocal in the lean mice, meaning the introduction of bacteria from the obese mice did not result in any negative changes in the lean mice.

According to Michael Fischbach from the University of California, San Francisco, who was not involved in the study but spoke to The New York Times about it, these findings provide “the clearest evidence to date that gut bacteria can help cause obesity.” Adding to this sentiment, Dr. Jeffrey S. Flier from Harvard Medical School told reporters that the findings, which were recently published in the journal Science, are “pretty striking.”

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Healthy gut bacteria prevent obesity: Study

Your Gut Bacteria May Predict Your Obesity Risk – WebMD

Your Gut Bacteria May Predict Your Obesity Risk

By Randy Dotinga

HealthDay Reporter

WEDNESDAY, Aug. 28 (HealthDay News) — Bacteria in people’s digestive systems — gut germs — seem to affect whether they become overweight or obese, and new research sheds more light on why that might be.

The findings, from an international team of scientists, also suggest that a diet heavy in fiber could change the makeup of these germs, possibly making it easier for people to shed pounds.

“We know gut bacteria affect health and obesity, but we don’t know exactly how,” said Dusko Ehrlich, a co-author of the two new studies and coordinator of the International Human Microbiome Standards project.

The research finds that “people who put on the most weight lack certain bacterial species or have them at very low levels. This opens ways to develop bacterial therapies to fight weight gain,” he said.

Experts believe the gut, where the body processes food, is crucial to weight gain and weight loss.

“It is now well known that bacteria in our gut play an important role in our health and well-being, possibly as important as our own immune response and proper nutrition,” said Jeffrey Cirillo, a professor at Texas AM Health Science Center’s department of microbial pathogenesis and immunology. “This means that disruption of the bacteria in our gut by use of antibiotics or eating foods that help only particular bacteria grow can have effects upon our entire bodies.”

A study released last March in the journal Science Translational Medicine suggested that gastric bypass surgery led to weight loss — in mice — because it changed the makeup of the bacteria in their intestines.

In one of the new studies, which are both published in the Aug. 29 issue of the journal Nature, researchers analyzed the gut bacteria of 169 obese Danish people and 123 Danish people who were not obese.

The gut germs in the obese people were less diverse than in the others, and had more abnormalities in terms of metabolism. Also, obese people with a less diverse supply of germs gained more weight.

It’s not clear how the bacteria and obesity are related. But the research suggests that the metabolisms of the germs themselves are connected to the overall metabolism in the humans where they live, Cirillo said.

The finding could also have a practical application, the researchers said.

“The study lays ground for a simple test, which should tell people what their risk for developing obesity-linked diseases is,” study co-author Ehrlich said. If they are, he said, diet changes may be necessary.

In a second study, researchers monitored gut bacteria as 49 overweight and obese people tried to lose weight with diets that were low-fat and low-calorie but high in protein plus fiber-rich foods like vegetables and fruits. The diet appeared to actually change the bacterial makeup in the guts of the participants.

“Although these are relatively early and small studies on the topic, they suggest that management of our own diets can improve the richness of the flora within our guts and decrease our chances of becoming obese,” said Cirillo. “This does not mean that changes in diet will be effective for all people or that they can prevent obesity no matter how much someone eats, but that they can help the situation.”

Good gut bacteria could protect obese people from heart disease and diabetes …

  • Scientists have discovered a link between obesity-related diseases and levels of bacteria found in the intestines
  • They also found that gut flora with low levels of bacterial diversity functions differently to those with a variety of microorganisms
  • Results
    suggest it is not only weight gain and dietary habits that play a role
    in the development of medical conditions in obese people

By
Emma Innes

13:18 EST, 28 August 2013


|

13:18 EST, 28 August 2013

Good bacteria in the gut protect obese people from heart attacks and strokes, according to scientists.

A study has found a link between the medical problems caused by being overweight, and the bacterial species in the intestines.

People with less of these bugs are more likely to develop metabolic disorders such as cardiovascular diseases and diabetes.

Good bacteria in the gut protect obese people from heart attacks and strokes, according to scientists

Good bacteria in the gut protect obese people from heart attacks and strokes, according to scientists. People with more good bacteria are less likely to develop heart disease and diabetes

A flora with decreased bacterial richness seems to function entirely differently to the healthy variety with greater diversity.

Professor Jeroen Raes, of Vrije University in Belgium, said: ‘This is an amazing result with possibly enormous implications for the treatment and even prevention of the greatest public health issue of our time.

‘But we are not there yet. Now we need studies in which we can monitor people for a longer period.’

Metabolic conditions are becoming endemic because of people failing to exercise and eating foods that are high in sugar and fat.

It is expected obesity levels will nearly double from 400 million in 2005, to more than 700 million in 2015 – and the trend is expected to persist at least until 2030.

Professor Raes and his colleagues examined the intestinal flora of 169 obese and 123 non-obese Danes and found those with low species diversity had more metabolic abnormalities, such as increased body fat and insulin resistance.

A flora with decreased bacterial richness seems to function entirely differently to the healthy variety with greater diversity

A flora with decreased bacterial richness seems to function entirely differently to the healthy variety with greater diversity

Professor Raes said: ‘We were able to distinguish between two groups based on their intestinal flora: people with a large richness of bacterial species in their intestines, and people with less bacterial species.

‘A species-rich bacterial flora appeared to function differently compared to the poorer variety. It was surprising to see obese and non-obese people were found in both groups.’

The scientists found the group with lower species richness in the intestinal flora were more susceptible to developing obesity-related conditions and chronic inflammation.

The obese people in this group were more at risk of cardiovascular conditions than the obese people in the other group.

The results are important because they suggest it is not only weight gain and dietary habits that play a role in the development of medical complications in obese people.

In a second study published in the same journal, Professor Stanislav Ehrlich of the National Institute of Agronomic Research in Jouy-en-Josas, France, showed eating plenty of fruit and vegetables can boost gut microbes.

He looked at 49 obese or overweight individuals and found increasing consumption of high-fibre foods led to more bacterial richness and improved some clinical symptoms associated with obesity.

The finding supports previous research linking diet composition to the structure of gut microbe populations – and suggests a permanent change may be achieved through adopting an appropriate diet.

A QUARTER OF PEOPLE LACK HEALTHY LEVELS OF GUT BACTERIA

Humans have about 3.5lbs of bacteria living in their intestines, according to a new study.

However, a quarter of people have guts which house fewer bacteria than they should do to ensure we stay healthy.

One in four people are lacking the healthy bacteria which help break down our food and maintain a healthy digestive system, scientists have discovered.

Experts looking at intestinal bacteria from 292 people in Denmark found that about a quarter of people have up to 40 per cent less gut bacteria than average.

These people are more likely to be obese and suffer from mild inflammation in the digestive tract and in the entire body.

This is known to affect metabolism and increase the risk of type 2 diabetes and cardiovascular diseases.

Author of the study Oluf Pedersen, professor and scientific director at the Faculty of Health and Medical Sciences, University of Copenhagen, says we need plenty of bacteria in our guts in order to improve our health.

He compares the human gut and its bacteria with a tropical rainforest and explains that we need as much diversity as possible, and – as is the case with the natural tropical rainforests – decreasing diversity is a cause for concern.

In the study, which is published in the scientific journal Nature, Professor Pederson said: ‘It appears that the richer and more diverse the composition of our intestinal bacteria, the stronger our health.

‘The bacteria produce vital vitamins, mature and strengthen our immune system, and communicate with the many nerve cells and hormone-producing cells in the intestinal system.

‘And, not least, the bacteria produce a wealth of bioactive substances which penetrate into the bloodstream and affect our biology in countless ways.’

The comments below have not been moderated.

I’ve just finished a course of antibiotics and am having some natural yoghurt with breakfast each day to try to restore my good bacteria – still don’t feel so good – so I’m wondering whether to lash out the $30 or so for some refrigerated probiotics – I had once before and felt great soon after – hmm – maybe …

Frankly
,

Sydney, Australia,
29/8/2013 02:22

Kefir is one of the options. Lactofermentation is another one. people have been doing it for centuries. It is easy, it is cheap, you can do it. The only thing, you have to get over your fear of bacteria instilled in you by the advertising of antibacterial products.

Margareth
,

LV,
28/8/2013 22:54

In response to ‘Thomas. Hexham, UK’ there’s much research (finally!) into the importance of the human microbiome (our unique mix of gut/ intestinal bacteria) in relation to our health. The best ways – in my opinion – to increase the ‘good’ bacteria is to eat a balanced diet,* very* much limiting processed foods and sugars especially. Also, avoid broad spectrum antibiotics (which wipe out good bacteria and allow bad bacteria to flourish) unless absolutely necessary. Finally, find a really good broad probiotic – a good one will help to repopulate your gut with a diverse range of the ‘good’ bacteria.

Rachel_NZ
,

Auckland,
28/8/2013 22:48

Does a lack of the ‘right’ bacteria cause obesity, or does obesity cause a lack of the ‘right’ bacteria?

Norfolk Dumpling
,

Great Yarmouth,
28/8/2013 22:37

I’d be more interested in the different enzymes present and variations in their expression over time and on specific diets. There is great difficulty isolating all the bacteria present in the gut flora whereas the enzymes they produce can be easily measured. Also, it would be necessary to know which enzymes- even different types of the same enzyme so methods of identifying these would be required.

It seems odd if they haven’t used this approach which is called metabolomics/proteomics because it is agreed for many areas of microbial ecology to be the best. It will lead to more very interesting information about the role of gut flora particularly any links to cancers in the gut and diet and other gastoenteric diseases as well as modulation of the immune response.

ken mist
,

paris,
28/8/2013 22:37

I got my water Kefir off ebay for 3 quid, been using it for over a year now and never looked back, cleared up my acne too

Mark
,

Sheffield,
28/8/2013 22:27

The generational legacy of taking antibiotics for everything, including things they don’t help/cure.

MyOpinionIsDifferent
,

GrowUp, United Kingdom,
28/8/2013 22:18

Non of it will replace a good diet and exercise. It’s not rocket science and it takes effort.

worried for the future
,

Leeds England,
28/8/2013 22:08

As someone else said – kefir. Google it. I make my own.

Brighton Boy
,

Brighton sometimes,
28/8/2013 22:07

Good bacteria is really relating to taking a good probiotic supplement daily and eating lots of live yogurt .

petra
,

Sandon,
28/8/2013 22:05

The views expressed in the contents above are those of our users and do not necessarily reflect the views of MailOnline.

Long-term study finds Australian adults increasingly at risk of diabetes and …

One of the most comprehensive studies tracking the health of Australians has released findings that paint a disturbing picture of the nation’s battle with diabetes and obesity.

The AusDiab study was funded through a National Health and Medical Research Council grant and followed 11,000 Australians for 12 years.

Researchers found the incidence of diabetes remained very high, with almost 270 adult Australians diagnosed each day, and people aged 25-34 were gaining more weight than other age groups.

Patients with diabetes were also found more likely to suffer other conditions as well.

Prevalence of depression in patients with diabetes was 65 per cent, which was much higher than those without diabetes.

Study leader Professor Jonathan Shaw says the link between diabetes and depression is complex.

One of the biggest contradictions is that we are seeing people living longer but with higher rates of chronic diseases.

“It appears there’s a bit of a two-way street here. People with depression are more likely to develop conditions like diabetes, partly because they feel less able to pursue healthy lifestyles,” Professor Shaw said.

“But partly because there are also some – not fully understood – metabolic pathways that link the two.”

Professor Shaw says people with diabetes also had twice the rate of cognitive impairment compared to those without diabetes.

“One of the biggest contradictions is that we are seeing people living longer but with higher rates of chronic diseases. So their quality of life is compromised by disease,” he said.

Professor Shaw says a person who is aged 80 in 2013 may have been living with diabetes or high blood pressure for 20 years, which has a damaging effect over time.

“As we get better at managing chronic disease, we’re seeing people living longer and with higher rates of frailty and cognitive impairment,” he said.

Women and young people at greater risk of obesity

In line with previous trends, obesity levels continued to rise.

The report found that the average gain in waist circumference over the 12 years of the study was 5.3 centimetres and it was greater in women than men.

“Younger people don’t seem to think about diseases in relation to their weight or their waist circumference, but that’s where most of the weight gain is occurring,” Professor Shaw said.

“They’ve stopped doing exercise they did as a young single person – they’ve taken on a lot of family responsibilities – but they don’t yet feel any great connection or risk of developing diseases such as diabetes.

“That’s where we need to focus our efforts on preventing weight gain, because it’s much easier to prevent weight gain than it is to achieve weight loss.”

Despite public education campaigns, more than a third of people in the study were not meeting the physical activity guidelines of 30 minutes of exercise a day.

Obesity remains one of the biggest risk factors for type two diabetes.

That’s where we need to focus our efforts on preventing weight gain, because it’s much easier to prevent weight gain than it is to achieve weight loss.

Researchers measured how much exercise people do, and how much time they were sitting down every day.

Professor Shaw says from this, they found many people’s perceptions were inaccurate.

“People significantly overestimate the amount of exercise they’re doing by about 50 per cent, and they underestimate by about half the amount of time they’re spending sitting down.”

Professor Shaw says tools exist to help people live healthier lives.

“We need to be prepared to take some tough decisions but it’s not impossible. Look what we have achieved with gun control, smoking cessation and water restrictions,” he said.

Professor Shaw says a Preventative Health Task Force came up with a raft of recommendations designed to make Australia healthier.

“Many of those ideas are now sitting on shelves gathering dust. Everything should be on the table: taxation levers, town planning, office space layout needs to be reconsidered to tackle the growing personal and community impact of chronic disease,” he said.

Weight Discrimination Linked To Obesity

Childhood obesity

Matt Cardy/Getty Images

See Also

One-third of American adults are obese, a health crisis that is typically linked to eating too much food, eating the wrong kind of foods, and not getting enough exercise.

But there are also psychological factors at play. 

New research from Florida State University shows that making people feel bad about their bodies actually increases the risk of obesity, rather than encouraging people to lose pounds.

Weight discrimination, also known as fat-shaming, includes teasing, bullying someone to lose weight, and other biases that appear in the workplace or relationships linked to weight.

More than 6,000 men and women from the U.S. participated in the four-year survey to test whether weight discrimination is associated with becoming obese or staying obese.

Subjects reported their experiences with weight and other types of discrimination that had been directed toward them between 2006 and 2010, and their body mass index was recorded at the start and end of the study.

Participants who were overweight at the beginning of the study were about 2.5 times more likely gain weight and become obese by follow-up if they reported weight discrimination, according to research published in the journal PLOS One on July 24.

Weight discrimination was equally harmful to participants who were already obese. These participants “were over three times more likely to remain obese at follow-up, rather than drop below the obesity threshold, than those who did not experience such discrimination,” according to the study.

“Weight discrimination is associated with behaviors that increase risk of weight gain, including excessive food intake and [lack of] physical inactivity,” the researchers conclude. “Heightened attention to body weight is associated with increased negative emotions and decreased cognitive control.”

SEE ALSO: 
Maine’s Top Chef Shows Us The Right Way To Steam And Eat A Lobster

How 'obesity gene' triggers weight gain

FTO picture no labels

An international team of researchers
has discovered why people with a variation of the FTO gene that affects one in six
of the population are 70 per cent more likely to become obese.

A new study led by scientists
at UCL, the Medical Research Council (MRC) and
King’s College London Institute of Psychiatry shows that people with the
obesity-risk FTO variant have higher circulating levels of the ‘hunger hormone’,
ghrelin, in their blood. This means they start to feel hungry again soon after
eating a meal.

Real-time brain imaging
reveals that the FTO gene variation also changes the way the brain responds to ghrelin,
and to images of food, in the regions linked with the control of eating and reward.

Together these findings explain
for the first time why people with the obesity-risk variant of the FTO gene eat
more and prefer higher calorie foods compared with those with the low-risk
version, even before they become overweight. The research, funded by the MRC
and the Rosetrees Trust, is published today in the Journal of Clinical Investigation.

Individuals with two copies of the obesity-risk FTO variant are biologically programmed to eat more. Not only do these people have higher ghrelin levels and therefore feel hungrier, their brains respond differently to ghrelin and to pictures of food – it’s a double hit.

Dr Rachel Batterham, UCL metabolism Experimental Therapeutics

Previous studies have revealed
that single ‘letter’ variations in the genetic code of the FTO gene are linked
with an increased risk of obesity, and this behaviour is present even in
preschool children.

Using a unique study design, scientists
led by Dr Rachel Batterham (UCL Metabolism and Experimental Therapeutics) recruited 359 healthy male volunteers to examine the
‘real life’ effects of the FTO variation in humans.

They studied two groups of participants
– those with two copies of the high obesity-risk FTO variant (AA group) and
those with the low obesity-risk version (TT group). They matched the volunteers
perfectly for body weight, fat distribution and social factors such as
educational level to ensure that any differences they saw were linked to FTO,
and not to other physical or psychological characteristics.

A group of 20 participants
(10 AA and 10 TT) were asked to rate their hunger before and after a standard meal,
while blood samples were taken to test levels of ghrelin – a hormone released
by cells in the stomach that stimulates appetite.

Normally ghrelin levels rise before
meals and fall after eating, but in this study men with the AA variation had much
higher circulating ghrelin levels and felt hungrier after the meal than the TT
group. This suggests that the obesity-risk variant (AA) group do not suppress ghrelin
in a normal way after a meal.

The researchers then used functional
magnetic resonance imaging (fMRI) in a different group of 24 participants to
measure how the brain responds to pictures of high-calorie and low-calorie food
images, and non-food items, before and after a meal. Again they took blood
samples and asked the participants to rate on a scale how appealing the images
were.

Individuals with the obesity-risk
FTO variant rated pictures of high-calorie foods as more appealing after a meal
than the low-risk group. In addition, the fMRI study results revealed that the
brains of the two groups responded differently to food images (before and after
a meal) and to circulating levels of ghrelin. The differences were most
pronounced in the brain’s reward regions (known to respond to alcohol and
recreational drugs) and in the hypothalamus – a non-conscious part of the brain
that controls appetite.

Finally, the scientists
looked at mouse and human cells to uncover what causes increased ghrelin production
at a molecular level. They over-expressed the FTO gene and found that this altered
the chemical make-up of ghrelin mRNA (the template for the ghrelin protein) leading
to higher levels of ghrelin itself. Blood cells taken from the obesity-risk
group also had higher levels of FTO gene expression and more ghrelin mRNA than
the low-risk group.

Dr Rachel Batterham from UCL
and University College London Hospitals, who led the study, said: “We’ve known for a while that
variations in the FTO gene are strongly linked with obesity, but until now we
didn’t know why. What this study shows us is that individuals with two copies
of the obesity-risk FTO variant are biologically programmed to eat more. Not
only do these people have higher ghrelin levels and therefore feel hungrier,
their brains respond differently to ghrelin and to pictures of food – it’s a
double hit.

“At a therapeutic level this
arms us with some important new insights to help in the fight against the
obesity pandemic. For example, we know that ghrelin (and therefore hunger) can
be reduced by exercise like running and cycling, or by eating a high-protein
diet. There are also some drugs in the pipeline that suppress ghrelin, which might
be particularly effective if they are targeted to patients with the
obesity-risk variant of the FTO gene.”

Professor David Lomas, Chair
of the MRC’s Population and Systems Medicine Board, said: ““Large scale population
studies have done an excellent job at highlighting FTO as a key obesity gene.
Here scientists have used an innovative combination of human studies and more
basic biology to finally give us the ‘smoking gun’ linking FTO variations,
hunger and weight gain.

“The brain imaging adds a fascinating insight into the
role of the nervous system in obesity, which is becoming increasingly clear. This
work will contribute to more targeted treatments and better outcomes for obese
patients in the future.”

Richard Ross, Chairman of the
Rosetrees Trust, said: “Rosetrees is delighted to be
able to support cutting-edge research carried out by outstanding researchers
such as Dr Batterham, which has such a direct human impact. Rosetrees supports
over 200 projects, helping researchers to make breakthroughs across all the
major illnesses.”

The research was led by UCL, Professor
Dominic Withers in the MRC Clinical Sciences Centre at Imperial College London,
and Dr Fernando Zelaya at King’s College London Institute of Psychiatry in
collaboration with a host of international partners.

It was funded by the MRC,
Rosetrees Trust, the National Institute for Health Research University College
London Hospitals Biomedical Research Centre (NIHR BRC) and the Wellcome Trust.

-Ends-


Media contact: David Weston

Image caption: Key brain regions that
regulate eating, reward and motivation show altered response to the hunger
hormone ghrelin in subjects with the obesity-risk FTO variant. (Credit: UCL)


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