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Where Discovery Creates Hope

A novel approach to childhood obesity.

Families no longer have to try harder. Doctors do.

Losing 50 pounds made a world of difference for an engaging teenager named Jack.

He can bike. He can swim. He can even leave his wheelchair in the dust.

Best of all, Jack’s fingers are nimble enough to play with his beloved Legos.

Watch Jack's Story

This is biology. This is genetics.

A simple, but powerful new approach guides the University of Minnesota’s Center for Pediatric Obesity Medicine:

What Jack and patients like him battle isn’t a character flaw, as conventional wisdom would have us believe. It’s a disease.

The Center’s mission, as a result, is two fold: Help families with a problem that sidelines one in five kids and develop even more effective solutions.

The power of early intervention, like it is with all diseases, makes the work all the more urgent. The Center hopes to not only stave off physical problems, but equally damaging psychological ones.

Says Dr. Aaron Kelly, who co-directs the Center with Dr. Claudia Fox: “When obesity is considered a disease, the onus is on us, as researchers, as medical care providers, to provide you and your kids with the help you need.”

The body thinks it has less fat tissue than it does.

Obesity, the doctors say, is a complicated disorder, with multiple biologic and environmental factors at play.

Dr. Fox, a clinician who works with Jack, explains that our bodies seem to have a “set point.” For those of us who struggle with weight, it’s too high and no matter how much willpower we muster, our bodies fight to return to that setting.

Dr. Kelly, a researcher whose work with new drug therapies helped lead to the approval of a new appetite suppressant for teens, talks about differences in the make-up of our stomachs. Some of us, he says, have a mix that pulls more calories out of a meal than others.

Then there’s the organ that controls everything. “You wonder,” Dr. Fox says, “about the opportunity to intervene very, very young when the brain is still plastic.”

You can see the family relax

While Dr. Kelly and his team study even more promising medications, Dr. Fox focuses on making a difference now.

Her first step—addressing the stigma of obesity— is the biggest, especially because parents are blamed for their kids’ weight issues.

Plus, with obesity having a genetic component, some parents have dealt with the stigma for a long time.

“It takes a lot of guts to come see us,” Dr. Fox acknowledges.

As a parent, you’d do anything to help your child.

Medication to treat autism and cerebral palsy super-sized Jack’s appetite.

The family of five tried everything, including putting locks on the cabinets and refrigerator.

Everything changed three years ago when they were referred to Dr. Fox. Medication she prescribed helped curb Jack’s insatiable appetite. A dietician referral turned him into an evangelist for fruits, vegetables and lean meat.

And a $5 per work out incentive from mom and dad not only got him moving but provided cash for his growing Lego collection.

Says Natasha, Jack’s mom: “When Jack gets down, we remind him of all the things he’s overcome. We know there’s a big plan ahead for him.”

I’d like to get back on it.

When a teenager named Kelsey was invited to participate in a trial for an anti-obesity medication, she told her mom: “What do I have to lose? Weight.”

Looking back, the now college freshman has nothing but good to say about her experience in the year-long double blind study administered by the University of Minnesota’s Center for Pediatric Obesity.

“I’m pretty sure I was on the real thing because I went from being hungry absolutely all the time to not.” Even better, Kelsey’s involvement in the trial persuaded her to do one of her own. She applied and secured a job in a research lab to see what it’s like to work as a scientist like the Center’s Dr. Aaron Kelly.

Biology of obesity

Obesity is a complex disease, not a failure of willpower. There are many factors that lead to extra weight, especially in children. An individualized approach helps to identify the specific treatments needed for each person.

People’s brains react to food differently. For some people, their brains do not detect the signals from the body that are supposed to tell them they are full after eating. For others, foods rich in fat and sugar trigger the reward system and override the brain’s ability to detect hunger or fullness. Medications can help to dampen hunger or the reward response and “level the playing field” for some people who struggle to manage their weight.

Some microbes in your digestive system affect how many calories your body takes from food you eat. For example, if two people each eat a 1200-calorie burger, one person could extract 1100 calories, another only 800. Altering the composition of gut microbes could aid weight management. This is an active area of research.

Our bodies store energy in fat as a survival mechanism. What causes our body to create fat stores and how easy it is to transform fat into energy varies from person to person. Some medications can assist in weight management by making it harder for your body to absorb and store fat from food.

Our bodies adapt to increased weight and try to maintain it by slowing the metabolism and releasing hormones that increase appetite and decrease fullness. These changes in metabolism and hormones make it difficult to sustain weight loss. Medications and bariatric surgery can potentially work to alter the “set point.”

Losing weight and maintaining weight loss involves many more factors than just healthy eating and physical activity. Stress management and getting enough good quality sleep are also critically important.