Partner Article

Clinical research to help reframe obesity debate

20% of the public in the North East and Cumbria don’t know the difference between being obese and overweight, according to a new survey conducted on behalf of the National Institute for Health Research (NIHR). Despite this confusion, the same survey shows more than 70% of people do have a clear understanding of the causes of obesity: over eating and lack of exercise.

With obesity levels in the UK having almost trebled in the last 30 years, public understanding is not solving the problem – many people are noticing that this health crisis is getting worse. (See graph 2 in Notes to Editors) Yitka Graham, Health Services Specialty Group Lead in the NIHR Clinical Research Network: North East and North Cumbria, believes clinical research can help to reframe the debate: “We’ve talked about diet and exercise for a long time. This survey tells us the message is getting through, but increasing levels of obesity show it is not having the positive impact society needs.

“People need more options. Clinical research will play a vital role in developing better and more cost effective treatments for people who are obese. Crucially, it also looks at the reasons for weight gain, which can help us address long-term solutions for the causes and development of the condition.”

The By-Band-Sleeve study, which is funded by the NIHR and coordinated from the Clinical Trials and Evaluation Unit at the University of Bristol, is underway in Sunderland and addressing some of these issues. Current national guidelines recommend that surgery is considered for people with severe and complex obesity. This surgery is known as bariatric surgery. Three of the most common types of bariatric surgery operations are: the adjustable gastric band (‘Band’), the Roux-en-Y gastric bypass (‘Bypass’), and the gastric sleeve (‘Sleeve’).

At the moment, health professionals do not know which of these three operations is the most effective for long-term weight loss and improvement of health problems and quality of life.

Choice of surgery is based on a combination of clinical opinion and patient choice. Yitka believes this way of working should change, and good evidence for which kind of surgery is best needs to be collected:

“We want to give advice to patients based on clinical evidence, not personal opinion. We need to know which operation is most effective and who it’s most effective for. Based on that information, we can make informed decisions about which type of surgery to recommend, safe in the knowledge it is the most cost effective choice for the NHS.”

Peter Wright, from Gateshead, was asked to take part in a research study about the effect of bariatric surgery on type 2 diabetes, a few months before his expected surgery. It was explained to him that taking part in the research would involve a lot of blood samples and MRI scans, but he was happy to agree as he supports research wholeheartedly. People can be offered bariatric surgery when their BMI goes over 50, but Peter was able to have a gastric by-pass with a BMI of 40 because he had so many other things wrong with him. He had type 2 diabetes, asthma, needed a knee replacement and had the start of diabetic retinopathy affecting his vision. After surgery, the improvement was staggering; Peter felt he had a clearer head within days because of stopping taking statins. Within weeks his diabetes had gone, the asthma was a lot better, and he no longer needed a knee replacement. His vision actually improved too. And they fixed his umbilical hernia while he had the op.

Peter said: “I was terrified before the surgery, but feel like a new person now. I was out of hospital in 3 days and within a few months I could climb mountains. I had lost my wife a few years before the surgery and was fairly solitary but since the surgery I enjoy my social life. And being part of the diabetes research with Professor Roy Taylor was an added interest and bonus.”

To find out more about the clinical research into obesity being supported by the National Institute for Health research, visit www.BIGchallenge.nihr.ac.uk

To find out more about the By-Band-Sleeve study, visit: http://www.by-band.bristol.ac.uk/home/

This was posted in Bdaily's Members' News section by HEALTH NEWS .