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Last Updated: Thursday, 4 September, 2003, 14:06 GMT 15:06 UK
Obesity: Ask a scientist
The number of obese people in Britain has been rising steadily since the 1970s
Dr Rachel Batterham answered your questions.



British scientists believe they may have discovered what could become the first effective treatment for obesity.

Research has shown that obese people have lower than average levels of a hormone that regulates appetite.

When volunteers were given injections of the hormone their appetites shrank dramatically.

How important are the findings? Should obesity be taken more seriously as a medical condition?

Dr Rachel Batterham worked on the study. She answered your questions in an interactive forum.


Transcript


Newshost:

Hello and welcome to this BBC news interactive forum. I'm Jon Brain. British scientists believe they may have discovered what could become the first effective treatment for obesity. Research has shown that obese people have a lower than average level of a hormone that regulates appetite. Volunteers given a dose of the hormone ate significantly less over the next 24 hours. The findings could be hugely significant. The number of obese people in Britain has been rising steadily since the 1970s. Dr Rachel Batterham was one of those who carried out the study and I'm pleased to say she joins me now to answer your questions. Dr Batterham welcome. Just how significant is this research in your view?


Dr Rachel Batterham:

Well basically we've shown for the first time that in overweight subjects there's a low level of a hormone that regulates appetite which may explain why they feel more hungry which could lead to difficulties in losing weight when they go on a diet. So it could be a very significant finding. But this was a very small study so we need to do more work to actually establish the significance.


Newshost:

So we could actually come to the point where people could have an injection to lose weight?


Dr Rachel Batterham:

Yes, that's a little way off at the moment and an alternative approach is to try and find out what releases this hormone. It's a naturally occurring hormone that comes from the gut when we eat and it signals what you've just eaten to your brain. If we could find what foodstuffs were better at releasing it then that might be a slightly better alternative to an injection because obviously people don't necessarily want to be giving themselves an injection every day.


Newshost:

But that is an option?


Dr Rachel Batterham:

Yes.


Newshost:

Let's move on to some of the questions. Stephen MacDonald, UK asks: What happens when the injections stop? Given that current attempts to reduce obesity are failing to have an impact, do you think there is a danger that obese people will rely on injections?


Dr Rachel Batterham:

As people lose weight we would hope that the levels of this hormone come back up because if we look at people with different weights, the level of the hormone depends on your weight. So hopefully if they took the injections as they lost weight, then they'd have normal levels of the hormone restored naturally in their body so they should have a normal - you've eaten food therefore you don't feel hungry response - but again we don't know that at the moment. We'd need to do a longer term study to see that effect.


Newshost:

Staying on this aspect of injections. Simon Weston, UK asks: Instead of injecting obese people with hormones why do we not just spend the money on educating people to eat less and live a more active lifestyle?

That's been the theme of quite a few questions we've received. That's fair comment isn't it?


Dr Rachel Batterham:

Absolutely. We need both approaches. We need to educate people, especially about diet, exercise, lifestyle changes. But for the hundreds of thousands of people who are already obese who are at risk because of their obesity then we need to give them something to help them to lose weight if these lifestyle measures haven't been effective.


Newshost:

Well people are sending e-mails even as we speak. Let's look at one that's come in from Glasgow: Would you say the best advice is that you can eat whatever you want as long as you exercise accordingly?


Dr Rachel Batterham:

It depends how much you eat - it comes down to quantities. I think it's very difficult to stick to a very strict diet that's not compatible with lifestyle, you have to have a diet that's compatible with your life otherwise you won't be able to stick to it. So both food and exercise are important but some people can't do exercise, so it really does depend on the individual - it's very difficult to give a broad answer to that.


Newshost:

But how much of it is individual responsibility as a number of these callers are saying? Isn't it up to people to take responsibility for their own health rather than relying on you doctors to do it?


Dr Rachel Batterham:

It's very difficult when you are overweight to lose weight. Anybody who's ever been on a diet will realise how difficult it is to lose weight. And it's very easy to be thin and say, I'm sure it's just self-control. But it's clearly not that otherwise the incidence of obesity wouldn't be increasing as it is in the UK despite all the people being on various diets and trying to lose weight by going to gyms and other dietary measures. So I think people are trying to lose weight but they're just stuck.


Newshost:

We've got some specific questions as well about how this whole research relates to obesity. One from Angie Harrison, UK who asks: How would this affect people with hypothyroidism? My weight gain is directly related to that. Would I be able to take this hormone?


Dr Rachel Batterham:

Well hypothyroidism is due to a deficiency of another hormone that comes from the thyroid gland in your neck and that also affects your metabolism - so how quickly you use up calories. There's no reason why this hormone wouldn't be effective in people with hypothyroidism because it just decreases appetite. But the best treatment for hypothyroidism is to replace the thyroid hormone, which I suspect this lady is actually taking thyroxin as a treatment, but there's no reason why it wouldn't help her.


Newshost:

We've had another e-mail that's just come in, this one from Gill who asks: If it is ok for people to be given pills to control illnesses caused by their obesity, why isn't it alright to give them a pill to stop them becoming obese in the first place? Could such a pill be possible?


Dr Rachel Batterham:

I'd say if we could go with a lifestyle dietary change in the diet then that's a much safer option than giving people tablets because sometimes tablets can have side- effects. But because this is a natural hormone then hopefully it won't actually have any side-effects because in you or I, every time we eat a meal this hormone goes up. So no I agree that people who are obese you have illnesses associated with that then there is no reason why they shouldn't be given a tablet.


Newshost:

Alison Healey, UK asks: I do not understand how obesity can be related to a hormone as this does not explain how obesity was not a factor 10 - 20 years ago. Surely these hormone levels existed in those days too?


Dr Rachel Batterham:

That's a very interesting question. As she correctly states, obesity has massively increased in the last 30 years and our diet has changed an awful lot in that same period. We've changed to highly processed food, a lot of carbohydrate-rich food and this comes from gut and depends on what you eat. So at the moment one thought is that it's our change in diet over the last 30 years that's affected how we release this hormone from the gut. So if you have a high fibre diet it releases more of the hormone than if you have a high carbohydrate diet. So it's actually in keeping with the fact that it's changed over the last 30 years and as is due to the environment interacting with our normal hormonal mechanisms.


Newshost:

So people weren't just eating more healthily in those days because of that their hormones were in a completely different make up?


Dr Rachel Batterham:

Yes, it's basically depending what you eat, you release different amounts of this hormone. So something like a highly processed carbohydrate food doesn't really release it very much whereas if you have a high fibre food or protein then it tends to release more of it and you are getting more of a signal to say, hey you've just eaten a large meal. So it's actually very much in keeping with the change in what we're eating over the last 30 years.


Newshost:

Let's take another specific question. This one is from Roger, UK who asks: I am 52, active, fit and otherwise healthy. Six months ago at 16st 7lb I was diagnosed with mild type 2 diabetes. I have now changed my diet: no added sugar, no sweets, no snacks, sugar-free versions of whatever I can get - increased fresh vegetables, decreased red meat. I weighed myself this morning - 16st 11lb. Would the hormone help? Does weight really matter as much as other lifestyle factors?


Dr Rachel Batterham:

Again it really depends on the individual. Type 2 diabetes, which is the type of medical problem he has, is very common in overweight people. But reducing sugar intake is also a very good measure. But if you could lose weight as well, then that would be very helpful. So again this treatment would be very beneficial for him in helping him to probably decrease the actual amount of calories that he's eating. So even though he's cut out high sugar, he's probably eating the same amount of calories in a day and so he actually needs to decrease the actual total amount of calories that he's eating. So this hormone could help in that situation.


Newshost:

We have a fairly controversial question here from MK, UK who asks: Obesity is an absolute blight, but the notion that it is a "medical condition" rather than a problem of gluttony is erroneous. If obesity was medical, it would have been evident and widespread throughout human history instead of just in the past couple of decades. The solution to obesity is simple: eat less and exercise more.


Dr Rachel Batterham:

That's a very contentious issue. Even within the medical community, there's a big split as to whether obesity should be described as a disease or not. Regardless of that fact, it's responsible for thousands of deaths a year in the UK and a huge amount of the NHS budget. So we can't just say, well it's just self will.

Going back to his point about gluttony and it's a recent thing. We've actually evolved - your ability to evolve has been dependent on your ability to store fat, so when we only had infrequent meals thousands of years ago, if you could store fat then you'd survive. So we've actually been genetically hardwired to store fat and it's only in the 200 years that we've had excess of food that it's become such a problem. So different people have different levels of self will and you can't say, well you just have to be stronger because there are millions of people out there trying to be stronger and they just can't manage to lose the weight.


Newshost:

It's curious you say that the medical community itself is divided. Why is that?


Dr Rachel Batterham:

Again because there are people within the medical community who have the same views as the general population. People think it's just self will. Then there's the other camp that think well it's not just self will. It is a problem to do with how we've evolved and how we've changed. Those of us who are thin, you could say well you're lucky you've got thin genes. There is a pre-disposition to put on weight - often if you look at families, you'll find whole families who are overweight and then whole families who are thin.


Newshost:

We've got another email that's just come in, this one is from Dan who asks: I believe that these findings are important but I don't necessarily agree with them. Wouldn't an injection just be an easy way out?


Dr Rachel Batterham:

Giving yourself a daily injection is not an easy way out. All of the people who've got type 1 diabetes or give themselves insulin - a daily injection that you're giving yourself into your body is not an easy option. It actually takes a lot to give yourself that injection. If we can find other measures, by changing the diet, then that's a better option. But we still are faced with the fact that obesity is causing such a problem in the UK, we can't just turn a blind eye to it. It's actually going to overtake smoking as the primary preventable cause of death. So we can't just say, leave it alone.


Newshost:

Are you happy that people are being informed in terms of what they should doing to avoid obesity? Is there enough public education?


Dr Rachel Batterham:

No I think there should be a lot more public education especially aimed at teenagers and children because that's one group of the population that's really increasing in numbers of people who are obese. Nearly 20% of all British children are classified as being obese or overweight and that's obviously going to have a huge impact on their health in the future.


Newshost:

We've just got time for one more question from Gerry in Scotland: There are several reasons for habitual overeating, some are psychological, and now we find out some are medical. This is excellent research, do you believe it will lead to additional benefits for the NHS with reduced levels of heart disease?


Dr Rachel Batterham:

Again heart disease is directly related to obesity. So if we could even decrease the percentage of obesity in the population by 5%, that would cause huge savings for the NHS. So it could decrease the incidence of heart disease.


Newshost:

Just very briefly, how much more research is needed?


Dr Rachel Batterham:

The study just looked at a one-off injection and then the effect. We need to do a long-term study looking at several weeks of the treatment and seeing whether that results in weight loss. So there is still a long way to go. These are the beginnings of a treatment rather than we're at the end of the process.


Newshost:

But exciting times ahead. I'm afraid that's all we have time for. My thanks to our guest Dr Rachel Batterham and to you for your many questions, from me Jon Brain goodbye.




WATCH AND LISTEN
The BBC's Fergus Walsh
"No one knows what will happen if you're given the hormone everyday"



SEE ALSO:
Hope for drug to tackle obesity
03 Sep 03  |  Health


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