Britain has 'lost the battle against obesity'
By Lorraine Fraser, Medical Correspondent
(Filed: 07/10/2001)

BRITONS have lost the battle to control their weight and the nation is facing a public health disaster, according to the country's first dedicated "professor of obesity".

Paul Trayhurn, the newly appointed professor of obesity biology at Liverpool University, told The Telegraph that he believes only new drugs will combat the problem. He is establishing a laboratory that he hopes will help to develop the world's first effective anti-fat pill.

Prof Trayhurn said the health education messages of "eat less and exercise" had failed to halt a worrying increase in the number of people in the country who are clinically obese.

According to the World Health Organisation a person is "obese" if his or her Body Mass Index - the patient's weight in kilograms divided by square of their height in metres - is 30 or more. Anyone with a score of 25 to 29.9 is overweight.

Twenty years ago, six per cent of men and eight per cent of women were clinically obese. Subsequent health campaigns have been so ineffective that today one in five British adults, or 20 per cent, are so fat that their health is seriously endangered.

Prof Trayhurn said the situation was so serious that there was an urgent need for anti-obesity drugs to protect overweight people from the consequences of their condition. He hopes that he and his team will be able to identify the perfect molecular target for an anti-fat pill and have it in everyday use by the end of the decade.

In his first important interview since taking up his post, the professor said: "Obesity is now a major public health problem in most Western countries and the size of the problem in the UK is rather worse than most.

"This matters greatly from a health point of view. The very obese have a decreased life expectancy, but even those who would only just be classified as obese show substantial increases in the incidence of diabetes, heart disease and certain cancers, such as breast cancer.

"Once you are clinically obese, for example, your chances of developing diabetes increase 20-30 fold. Although we can treat it, this is not a trivial disease and we are going to have hundreds of thousands more diabetics over the next two decades. Worldwide we are likely to go from 150 million to 300 million diabetics and that is largely due to the surge in obesity."

Effortlessly thin at 5ft 10in and 11 stone, the 53-year-old professor is fascinated by the hidden mechanism by which the body controls its weight - and how this might be manipulated artificially to help the heavy to become slim.

"There is nothing dramatic that has happened in terms of our biology and genes," the professor said. "It is what we eat, how we eat it and how we exercise. The culprits are high-fat foods - the 'hamburgerisation' of our diet - and the reduction in physical activity.

"Some people may go to the gym or jog; however, the bulk of the population does not. We use our cars more often; we drive our children to school by car because of fears for their safety. They sit at home in front of computers and video screens; we do the same in our offices.

"But those environmental pressures have overwhelmed our biological mechanisms for controlling body weight. I cannot imagine that we will end up with a fifth of the population permanently on weight-reducing drugs, but when the secondary illnesses become a problem and the obesity is extreme we will clearly need therapies."

The new chair in obesity biology is partly funded by a grant from AstraZeneca, the pharmaceutical company. The industry is making big investments in the field, the professor said, in anticipation of rich rewards.

The body's mechanism for controlling food intake is exceptionally complex. Work at Liverpool University and around the world had already identified protein messengers in the brain that appeared to regulate food intake. Molecules that appeared to be involved in burning off energy had also been found.

Scientists have also found, however, that fat is not just unwelcome blubber - it is as vital to health as the liver or kidneys. The fat is stored in the adipose cells of fatty tissue and can occupy 85 per cent of their volume, but the cellular machinery remains intact and produces molecules that appear to be enormously important.

They can influence the brain, the immune system and possibly even a woman's ability to have a baby. "Until a few years ago, white fat was regarded as the most boring tissue in the body," Prof Trayhurn said. "It was just the larder: extra food was deposited in your fat stores or released and that was it.

"In the past few years we have come to understand that fat is an active player in how we control our body weight. It is not sitting there as a bystander - it is sending out signals." His scientists would focus on finding these messengers and working out just what they do, he said.

"Adipose tissue produces proteins involved in blood clotting, in the control of blood pressure, that influence how we handle fats in the blood and it probably produces molecules that are involved in controlling sensitivity to insulin, part of the potential link with diabetes."

Each messenger was a potential target for a drug to minimise the effects of obesity or help to control appetite. "If we know more about the players in the process we can define targets for drugs that will interfere with the process," the professor said.

Patients would still have to "take some responsibility" by eating less, while taking the new drugs, he said. Anti-obesity medication would, however, become commonplace in the West over the next 10 years.

	31 August 2001: Wonder drug aspirin takes on diabetes
	4 May 2001: Obesity in children at record levels
	15 February 2001: Britain on course to match American levels of obesity
	18 January 2001: Fat children are more likely to be asthmatic
	13 December 2000: One man in three prefers beer and chips diet
	28 March 2000: 'Fat gene' could be slimming aid