Abstract
(English)
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The rapid increase in the prevalence of obesity, type 2 diabetes, and associated complications is a major global health problem. In Europe alone, 32.9 million adults will be suffering from diabetes by 2010. Around 90% of diabetes is type 2, and in depending on ethnic background, it accounts for up to 80% of diabetes in children. Obesity, which is a major recognised risk factor for type 2 diabetes, is itself rapidly increasing in prevalence resulting in a 'diabesity' epidemic. The current cost of type 2 diabetes in the EU is 15 b Euros per year, and medical complications arising from diabetes account for up to 8% of health costs in Europe. Neither dieting nor current pharmacological interventions are effective in achieving sustained weight reduction in more than a minority of subjects. Dieting is ineffective for reasons that have become clear in the last 5 years. Briefly, once a chronically overweight state has been maintained, our brains interpret energy restriction as a threat to survival. In response to reduced energy intake, the control systems in our hypothalamus reduce our metabolic rate and divert energy utilization into maintenance of body composition - our brains 'defend' our existing energy store. Thus to cure obesity, we must find a way to modulate the central set point controlling our body composition and metabolic homeostasis. To do this, we must exploit and extend the recent advances in the understanding of neural and endocrine networks that control energy balance and metabolism, and apply contemporary molecular genetics to identify targets for therapeutic intervention in these networks. This challenge must be addressed at all levels: the genes, their proteins and their functional significance in health and disease. This Integrated Project, representing 10 European countries, brings together clinical and basic key researchers from academia and biotech-industry encompassing genetics, genomics, functional neuroanatomy, endocrinology, neuroendocrinology.
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