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a growing problem

The Life Sciences sector has been identified as one of the four pillars of the North-east’s future economy, and scientists and academics are at the cutting edge of research into some of the world’s most challenging health issues. Bulletin finds out about new research into one of the world’s biggest epidemics – obesity.

Less than 30 years ago one person in 14 in the UK was clinically obese. Today we are in the middle of an epidemic of obesity with one in four falling into the category and all the health threats it brings.

We are also following the US towards an epidemic of Type II diabetes – once called “maturity onset diabetes” because it seldom appeared before the age of 40 - but which is now being seen in children.

Now a new course at The Robert Gordon University will help take a leading role in the fight against the condition.

It has just launched a new MSc in Obesity Science and Management and is the lead university in the Counterweight Programme, launched in 2000 because of the recognition of the need to tackle obesity management in primary care by a national group of consultant physicians.

Now in the development phase, Counterweight continues to have research arms, and has been rolled out across Scotland as part of the Keep Well health watch programme aimed at improving the health of 45-64 year olds in areas of greatest need.

Professor Iain Broom, who is world renowned for his research into obesity and leads the Centre for Obesity Research and Epidemiology (CORE) at RGU, is chairman of the Counterweight Board.

Counterweight also involves the universities of Glasgow, Bath, Warwick and UCH and Imperial College in London.

When Professor Broom joined the university six years ago his team comprised himself and a PA. Now there is a staff of 27, all externally funded and drawing in around £7 million a year in research grants.

Professor Broom explained that work is underway to identify ways of delivering Counterweight to help more and more people.

“For example we are working in Fife looking at the delivery of weight management by a group of community pharmacies which is exactly what government would like to see.

“Counterweight is designed to provide the information and education to primary care staff to allow them to deal with their obese and overweight patients. We are now redesigning it to work in community pharmacists and work in industry. We are in discussion with a major firm to put Counterweight into their commerce.

“We would train people within this industry and they would deliver the programme to customers in the UK and their huge market in the United States.

“The tools we use have been developed for primary care staff and for obese or overweight patients.”

The financial viability of Counterweight has been demonstrated in an analysis by the York Health Economics Consortium which has shown it is cheaper to put Counterweight in place than to do nothing at all because of the inevitable future costs which would occur as a result of ill health.

Counterweight involves managing food intake, exercise and cognitive behavioural therapy to allow patients to effectively take charge of their own situations.

“It doesn’t get huge drops in weight,” he said. “What it achieves is a clinically effective weight loss – between 5% and 10% of body weight in 40% of patients who join the programme. That has a major clinical benefit which will reduce the likelihood of developing Type II Diabetes by almost 60% over the subsequent five years.

“We are now seeing Type II diabetes increasing not only in terms of prevalence but it is also affecting much younger patients. The age of the onset is dropping quite dramatically as the weight of the population is increasing which means people are going to have Type II Diabetes for a much longer period and therefore the likelihood of complications is going to increase.

“Clearly something has happened over the last 30 years. There has always been obesity but it is only in the last 20-30 years we have had this huge increase. Our environment has actually changed - both the micro environment within the home and the macro environment outside. We are in an era of automation. The way we deal with our lives is completely different to the 1950s and 1960s. Transport is different, our leisure time is different and we are in some ways genetically geared to put weight on when there is plenty of food around and take it off when there isn’t.”

As well as researching the epidemiological aspects of obesity Professor Broom and his team are looking at the molecular side. Two key areas of focus are the control of appetite and satiety and the effect of obesity on the likelihood of developing breast cancer.

They are also examining different dietary approaches to obesity including the use of very low calorie diets and low carbohydrate for those with the most serious weight problems.

“We do research here from molecules to man and to populations,” said Professor Broom.