Study to research causes, treatments for obesity

Published 12:00 am Wednesday, December 2, 2009

By Emily Ford
KANNAPOLIS √≥ Dr. Laura Svetkey knows what it’s like to struggle with weight.
Now lean, Svetkey can empathize with patients who come to her for help with obesity and dangerous complications like diabetes, high blood pressure and high cholesterol.
“Like most Americans, it’s been an issue I’ve struggled with my adult life,” said Svetkey, who leads a research team studying obesity for Duke University’s MURDOCK Study at the N.C. Research Campus.
When her daughter turned three years old, Svetkey said she realized she couldn’t use “baby weight” as an excuse anymore. She lost 25 pounds in six months by counting calories, eating pre-packaged meals for portion control and skipping dessert.
“It was a lot of hard work,” she said. “Losing the weight is step one. The harder thing is keeping it off.”
While Svetkey, the clinical research director for the Sarah W. Stedman Nutrition and Metabolism Center at Duke, found a weight-loss strategy that worked for her, the same plan might not work for someone else.
In a country where obesity has become an epidemic, many people quit trying to lose weight out of frustration.
Scientists working for the MURDOCK Study, named for Research Campus founder David Murdock, hope to find a way for doctors to determine which of their patients will respond to which weight-loss interventions.
Murdock gave Duke $35 million last year to jumpstart the ambitious study that aims to reclassify disease and “rewrite the textbook of medicine.” It could run for decades.
By researching the genetic causes of obesity, Svetkey’s team could discover why some people lose weight easily while others struggle, as well as finding better treatments and new medications.
While obesity dramatically increases the risk of hypertension, diabetes and other conditions that can lead to heart attack and stroke, some overweight people apparently suffer few ill effects.
On the other hand, some obese people who lose weight still have ailments that usually improve with weight loss.
“It’s not just about weight,” Svetkey said. “There’s something else we need to understand.”
Researchers will start by trying to better understand metabolism, or how food is broken down and used in the body.
In the study’s first phase, they will generate metabolic profiles of patients by testing old blood samples stored at Duke. They will apply new genomic technologies to identify predictors of weight loss and weight control, as well as which patients’ health will improve when they lose weight.
In the study’s next phase, researchers will test their theories using some of the new blood samples taken from 50,000 Kannapolis and Cabarrus County citizens. Enrollment in the MURDOCK Study registry begins next month.
Much of this research will occur at the Core Laboratory in Kannapolis.
“We form a question, come up with a preliminary answer, then test it against another population,” Svetkey said.
It’s the same process that the MURDOCK Study will use to better understand heart disease, arthritis and hepatitis C.
“We all know people who can eat all they want and stay skinny,” Svetkey said at a seminar in Kannapolis last month. “We hate these people a little bit, but it’s not their fault. It’s their genetics.”
Ultimately, the MURDOCK Study should help physicians look at their patients’ biological profiles and predict whether they will lose weight and how best to do it.
But Svetkey cautioned that the fundamental key to weight loss always will be to burn more calories than are consumed.
“The majority of what influences weight loss and regain is not about biology,” she said. “It’s about behavior√≥calories and exercise.”
Losing even a small amount of weight can significantly decrease the risk of diabetes and high blood pressure.
Dropping just one pound cuts the risk of developing diabetes by eight percent and takes one point off of high blood pressure.
“You don’t have to lose a lot of weight to see remarkable benefits,” Svetkey said.
Results from the MURDOCK Study could have a resounding impact on public health.
“I personally feel very grateful for this opportunity,” she said. “But we should never get the idea that a pill is going to solve everything.”