Obesity research priorities
Within the MRC's broad remit, a significant amount of research relevant to obesity and obesity-related disease is funded.
In 2014/15, we spent £23.4 million on research relevant to obesity through research grants and our units, centres and fellowships. This included genetic, physiological (studying underlying mechanisms of obesity and related diseases) and population-level (including social, behavioural, environmental and dietary) research.
Obesity is a complex physiological and socioeconomic issue, spanning many disciplines of research and requiring research investment from a variety of funders. Our objectives in obesity research are to produce an understanding of the mechanisms of obesity and of its links to disease, and to use these insights to develop effective interventions to prevent and treat these conditions.
Our activities in obesity research are centred on the causes of obesity and the processes by which it causes disease, and use a variety of approaches from molecular physiology to epidemiology.
Research into the prevention of obesity and related diseases is an area of growing interest, in which activity has increased as new translational opportunities have arisen. We have made substantial additional contributions to the National Prevention Research Initiative, a collaborative funding programme.
Underpinning research examining normal biological development and functioning is also important and well supported. Across these areas, a life course approach is taken, examining variation across different stages of life and the long term effects of early experiences. Thus we support a wide range of research activities related to obesity including mechanistic, epidemiological and proof of concept research.
In terms of our remit, obesity’s consequences for health are the dominant cause for concern. For example, obesity results in a substantial increase in risk of type 2 diabetes. This means that a balance between approaches – reducing or preventing obesity and breaking the link between obesity and related diseases – is required. An intermediate approach, targeting common points in the link (such as insulin resistance) is also possible.
Obesity is a complex problem that may seem intractable due to its complexity and the likely functional redundancy in systems controlling energy intake. It cannot be managed in the same way as single risk factor changes (such as smoking, where there is a clear and straightforward message).
It may therefore be useful to learn from examples of multifaceted research strategies that have been successful in improving health outcomes in other complex disease areas, such as cardiovascular disease.
Rather than focusing on a single causal pathway, multiple angles of attack are used in combination to address both socioeconomic and physiological factors: for example, public health policies to reduce salt intake, multiple drug therapies and active screening. For obesity, a similar combination of factors could be used:
- Population-level measures to reduce obesity through diet and activity.
- Therapies to produce and maintain negative energy balance: reducing energy intake (targeting the brain directly or through peripheral signals, from neuroendocrine or adipose tissues, for example) and increasing energy expenditure.
- Therapies designed to uncouple obesity from its adverse consequences.
The research priorities we have identified provide a scientific basis for these approaches to be designed and tested.
Given the substantial investment in obesity research worldwide, priority is given to those areas where the MRC or the UK has particular strengths and/or opportunities that can be exploited – for example, through our strength in cohort studies.