...treat obesity

The cure for obesity is to eat less and move more.  All of us know this, yet it is much easier said than done.  Our problem is that after years of natural selection ensuring that we eat as much as possible to stay alive, we now have to try to adapt to an environment of too much food.  And given the obesity problem we see around us, we’re clearly not doing a very good job!  There are a number of strategies that are being explored.  Firstly, significant efforts are being made to try and target the signalling pathways in the brain directly. This however suffers from the problem of getting drugs across the ‘blood brain barrier’, which is a natural barrier which separates our brain from the rest of the body, and once it gets there, being able to specifically target the appropriate molecule.  Secondly, there is the use of gastric surgery, which typically involves some level of ‘re-plumbing’ of the small intestines, coupled with a reduction in stomach size.  This approach is actually very successful in very obese individuals, but it is simply impractical, not to mention the cost and risk to life, to roll out a major surgical procedure across a significant proportion of the population.  Thirdly, there is the use of the gut peptides themselves.  When surgery was first conceived as a method of getting an obese patient to lose weight, it was thought that the primary mechanism would be a reduction in food intake because of the smaller stomach, and a reduced absorption of nutrients because of the shortened small intestine.  This however, turned out not to be the case.  The real effect of gastric surgery arises from a change in the milieu of gut peptides that are released after the surgery, which then plays a role in altering feeding behaviour.  There are now efforts to try and mimic this change in gut peptide profile in patients, without the trauma of undergoing major surgery, as a weight loss strategy.