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Editorial: Obesity Research—Can Discovery Outpace the Epidemic?

Associate Editors, Endocrine Reviews

Last year marked the start of a new tradition at Endocrine Reviews, one that maintained the more than 60-year-old thread begun in 1944 with the first volume of Recent Progress in Hormone Research (RPHR). RPHR published the proceedings of what was known as the Laurentian meeting, which was for decades an elite annual conference in which leaders in the endocrine field presented their discoveries. The oral presentation and written reviews gave these leaders a prestigious platform to elaborate on their work and its relationship to the field. Although the Laurentian meeting and RPHR are gone, this volume is now the second special issue of Endocrine Reviews that provides such a platform in a different way.

For the RPHR special issue, an important topic in endocrinology is chosen and reviews are solicited from leading researchers in that area. In contrast to the usual comprehensive and authoritative style of Endocrine Reviews, these RPHR reviews are meant to be more personalized, with a focus on the development of new ideas and concepts in the authors’ labs.

The readers of Endocrine Reviews do not need yet another recitation of alarming statistics to appreciate the importance of obesity in modern medicine. In this case, the often used metaphor of the blind men and the elephant is a particularly apt description of our current attempts to understand an enormous problem. However, we believe that the seven laboratories that have contributed to this issue have shown particularly clear vision in their efforts to grapple with this problem. Although there are certainly many other important topics that could have been included, we are pleased to have elicited a range of contributions from the very basic to the most applied: Christoph Handschin and Bruce Spiegelman describe the impact of the fascinating PGC-1 transcriptional coactivators on metabolic pathways and energy balance. Roger Cone discusses the role of his laboratory in the initial description of the melanocortin receptors and the characterization of their functions in energy homeostasis and other pathways. I. Sadaf Farooqi and Stephen O’Rahilly discuss the monogenic obesity syndromes and how they have informed our understanding of the regulation of body weight and neuroendocrine function in humans. Maria Trujillo and Philipp Scherer present their perspective on the systemic impact of adipocyte-derived factors on energy homeostasis. Similarly, the manuscript by Kevin Murphy, Waljit Dhillo, and Stephen Bloom focuses on the role of gut hormones in energy homeostasis and as potential targets for antiobesity therapeutics. A translational focus is continued with James Hill’s discussion of how behavioral and environmental factors interact to produce positive energy balance and weight gain in humans. Finally, Karen Foster-Schubert and David Cummings describe current and emerging therapeutic approaches to the treatment of obesity, with a particular focus on targets in the central nervous system.

Although many other groups have also made seminal contributions to the field of obesity research, the work described herein demonstrates some of the key advances that are taking place in understanding fundamental processes that underlie the regulation of energy balance. Clearly, the intricate web of neural circuits, neuroendocrine mediators, mitochondrial function, and secretory feedback from the adipose organ itself that evolved over millennia to promote survival in times of food shortage is maladaptive in modern society. Recent advances in molecular biology, neuroendocrinology, and clinical medicine have produced many new drug targets as well as surgical approaches for obesity treatment. It is early days in testing these in clinical trials. But the rate of discovery promises to challenge the odds that the current epidemic of obesity and type 2 diabetes may shorten average lifespan in the United States for the first time in more than a century.¹

Footnotes

¹ Diabetes Prevention: The Best Dollar Congress Will Ever Spend", American Diabetes Association, Advocacy.diabetes.org, http://www.diabetes.org/uedocuments/ddtfactsheet.pdf

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