biology
Overcoming
+
medicine
OBESITY Stanford Researchers Find
Ways to Trim the Fat
by David Sherman
I
f you are sitting in a room right now with two other adults,
statistically one of you should be overweight or obese.
Obesity is a serious and growing health threat, and it usually
leads to other health problems such as high blood pressure
and diabetes. There are many approaches to treating obesity:
some involve personal initiative such as exercise and diet, and
others involve medical intervention through weight-loss drugs or
surgery. The possible value and efficacy of these two approaches
are actively researched at the Stanford Medical Center, where
teams of doctors and scientists are attempting to figure out the
best educational programs to promote exercise and potential
candidate drugs for suppressing appetite.
One in three US adults is overweight or obese and 15 percent
of children between the ages of six and 19 are overweight.
Factors Contributing to Obesity
When approaching the topic of obesity, it is important to
recognize the difference between the terms “overweight” and
“obese”. These terms refer to different points on a continuum
ranging from underweight to morbidly obese, and the body mass
index (BMI)--a measure of one’s weight relative to height--is used
to differentiate people on this continuum. For the most part, BMI
is an effective way of measuring fat content, although there are
times when muscular people appear to be overweight based on
their BMIs even though they are not.
There are many factors that contribute to obesity, some of
which an individual can control. For example, lifestyle choices
such as diet and regular exercise have a strong connection with
weight. These are the most important controllable factors that
individuals can change. Thomas Robinson, M.D., M.P.H.,
Associate Professor of Pediatrics and Medicine and Director of the
Center for Healthy Weight at Lucile Packard Children’s Hospital,
investigates ways to prevent childhood obesity by targeting some
of these controllable factors.
“The potential impact of obesity on our nation’s health, as well as our economy and every
aspect of our society, is astounding. It is now a worldwide problem.” – Dr. Tom Robinson
10 stanford scientific
© SXC.hu/Elise Nobe
Robinson did not begin his career focusing on obesity. “My
primary focus has always been on prevention science more
generally, to understand how to more effectively help children and
families improve their health-related behaviors.” As a medical
student, he began working as a research assistant at the Stanford
Center for Research in Disease Prevention, now called the Stanford
Research Prevention Center, on “methods to prevent and reduce
smoking, increase physical activity and improve nutrition among
teens, with the ultimate goal of reducing cardiovascular disease
and cancer.” However, by the time he finished his residency, he
realized that obesity “was going to be the next major public health
problem, with the potential to reverse much of the progress that
had been made in cardiovascular disease and cancer prevention
over prior decades.”
Robinson investigated the efficacy in reducing the BMI of pre-
adolescent African American girls of lower socioeconomic status
through a dance program and family intervention to reduce
television and videogame use. In a twelve-week controlled,
school-based pilot study in which dance was done during physical
education classes, Robinson and his research team found
that dance is a feasible form of activity for low-income African
American girls and that dance intervention results in noticeable
reductions in BMI. In two pilot studies of reducing television
viewing in eight- to ten-year-olds, Robinson found that it is
possible to reduce children’s television, video, and videogame use
and that this kind of intervention also reduces their BMIs. Thus,
based on the pilot studies, it is possible to help reduce obesity
through school policy and family intervention programs, but there
remains the question of whether children will maintain healthy
eating and exercise habits when they are older.
 biology
While controllable factors such as lifestyle influence obesity, +
medicine
uncontrollable factors have also been found to have an effect on
BMI. Lucile Packard Children’s Hospital says that the chance of
giving birth to an obese child increases by 25% if both parents
are obese. Also, heredity influences the physical locations on
the body—such as the hips or waist—where body fat is carried.
Metabolic factors affect obesity as well: for example, hormones
influence how an individual expends energy, as well as hormones
that affect appetite and the feeling of fullness after eating.
Socioeconomic status is found to affect weight, especially among
women. Women of lower socioeconomic status are six times more
likely to be obese than women of higher social standing. Obesity
levels are also highest among minorities, as 77% percent of African
American women over the age of twenty are overweight.

“…we don’t really have the option to wait

until we have a magic pill to ‘cure’ this
epidemic. In the meantime, we must try to
make major changes in our physical and
social environments to make it easier for
everyone to be more physically active and
eat better.” – Dr. Tom Robinson
©SXC.hu/bretz

Discovery of an Appetite Suppressant Hormone Robinson says, “The potential impact of obesity on our nation’s
Thanks to the recent work of scientists at the Stanford Medical health, as well as our economy and every aspect of our society,
Center, it appears that these uncontrollable factors may be is astounding. It is now a worldwide problem.” What is the next
manipulated in the near future. Dr. Aaron Hsueh, endocrinologist step in fighting this epidemic? Scientists and policy makers will
and Professor of Obstetrics and Gynecology, and Dr. Jian V. continue to grapple with this question. S
Zhang, a postdoctoral scholar in Hsueh’s laboratory, discovered
a hormone called obestatin that suppresses appetite and could
potentially serve as a drug to help treat obesity. The discovery of David Sherman is a sophomore majoring in chemistry. In addition to
the appetite-suppressing hormone leptin in 1994 and the appetite- writing, he enjoys talking about the wonders of science, listening to
enhancing hormone ghrelin in 1999 also boosted hopes for the music, and spending time with friends and family.
development of new weight treatment drugs, although leptin fell
To Learn More:
short of expectations. The recent discovery of obestatin should
help scientists more clearly understand the big picture of how
http://www.lpch.org/index.html
appetite is created
More information about obesity amongst children and
and diminished with
adolescents
possible therapeutic
consequences.
Super Size Me
Clearly, obesity is
An entertaining documentary about a possible culprit to the
not an issue that will
United States’ obesity problem
disappear anytime
soon, and it must
http://www.nih.gov/news/pr/feb2002/hhs-06.htm
be addressed by this
A fascinating study about ways to delay or prevent diabetes, a
nation as well as
consequence of obesity
around the world.

The recent discovery of the appetite suppressant

obestatin should help scientists better understand the
big picture of how appetite is created and diminished
with possible therapeutic consequences.
©SXC.hu/Richard Styles

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