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Approved Research

Modelling heterogeneity in the morbidity and mortality outcomes associated with obesity

Principal Investigator: Dr Will Johnson
Approved Research ID: 80843
Approval date: December 7th 2021

Lay summary

Most adults in the UK are overweight or obese, according to body mass index (BMI). This is a major public health concern because these individuals are more likely than normal weight individuals to develop diseases, like diabetes and cancer, and die prematurely. There is, however, considerable variability and people of the same age, sex, and BMI often have very different health prospects. The goal of this research is to help understand why some people develop an obesity-related disease or die while other comparable people with the same BMI do not. We will investigate the roles of fitness (e.g., muscle strength), body composition (e.g., amount of stomach fat), genetic makeup, lifestyle variables (e.g., physical activity), early life factors (e.g., body size during childhood), and socioeconomic position (e.g., income). For example, it might be that a hypothetical 50-year-old man with a BMI of 35 kg/m2 (in the obese range) is more likely to develop diabetes than a comparable person (i.e., male, 50 years, BMI 35 kg/m2) because they drink more sugar sweetened beverages. By better understanding which types of individuals with obesity have the greater disease and mortality risk, our results will provide policy and practice relevant evidence on who might benefit most from targeted health care provision or lifestyle modification support. The proposed research will also investigate the biological mechanisms that explain the greater disease and mortality risk observed in some people (compared to other people with the same BMI). Our hypothetical 50-year-old man with a BMI of 35 kg/m2 might, for example, have developed diabetes (when his counterpart did not) because of impaired liver functioning. Knowledge of such disease pathways may provide clinically actionable insights for therapeutic intervention. Taken together, this interdisciplinary work will move the field forward by revealing why, how, and in whom obesity is most likely to lead to more severe health conditions, adiposity-related disease, and premature mortality. This information will not only represent a gain in scientific knowledge but may stimulate other research and be used (e.g., by Public Health England and the Medical Royal Colleges) to guide public health policies that aim to reduce the health and societal burdens of obesity.