ESPE Abstracts (2014) 82 PL5

Obesity: Novel Treatments and the Imperative for Prevention

Donal O’Shea


Dublin, Ireland


Obesity has doubled in the developed world in the last 10 years. In the last year both the EU and WHO have launched high level commissions to address childhood obesity. The increase in young onset type 2 diabetes is already with us and we are increasing our understanding of how childhood obesity increases the likelihood of developing cancer and more severe infection. Meanwhile the food and drinks industries continue to ignore their own voluntary codes of practice as well as legislation and are promoting high fat high sugar high salt food and drinks to the youngest possible audience. Aggressive prevention strategies are essential and must be driven by the medical profession.

Novel treatments will emerge from a better understanding of how weight is controlled. Experience with bariatric surgery is growing in the adolescent population. Temporary devices that mimic aspects of the gastric surgeries are being developed in adults with a view to being studied in children. Over the last few years, a number of effects of obesity on the immune system have been identified. These are likely to contribute to the increase seen in the incidence of a range of diseases in obesity along with their worse outcomes. The surprising observation was that the immune system defects were themselves contributing to weight gain and thus perpetuating a cycle further weight gain. In turn the immune system is being regulated by gut hormones including GLP1 and insulin. Furthering our understanding of this immune sytem-weight regulation axis is already leading to candidate novel weight loss treatments.

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