TheAcademy of Royal Medical Collegescalled for action this week totackle the obesity epidemicin the UK, which remains a very serious problem despite various awareness campaigns and proposed interventions.A quarter of adults and a third of primary school childrenare now overweight, and this figure is expected to double by 2050 if urgent measures are not taken. An enquiry by the academy found that public health interventions to curb obesity are “piecemeal and disappointingly ineffective” in adults and children, and UK doctors recommend that new approaches should be taken to resolve the crisis.

In anopinion articlepublished this week inBMC Medicine, StephenR Zubrick and colleagues from theTelethon Institute for Child Health Researchexplored the basic science behind weight-loss interventions, and described how current approaches based on simple models of energy balance fail to achieve long-term results. The authors recommend that multiple factors affecting energy regulation should be considered in order to design effective strategies to tackle obesity.

Being overweight increases the risk of developing many chronic conditions, including type 2 diabetes, cardiovascular disease and cancer. Research published inBMC Medicinethis week has addressed some of these problems; Simonetta Bellone and colleagues from theUniversity of Eastern Piedmontexplored the hormones linked to cardiovascular risk factors in obese children, and showed that high levels of adrenocorticotropic hormone and cortisolare associated with distinct risk factors.The authors concluded that complex mechanisms underlie interactions between hormones and metabolic impairments in obesity, which could be targeted to reduce cardiovascular risk in obese children.

Type 2 diabetescan develop rapidly in those who are overweight, and can cause manycomplicationsif left untreated. In aresearch article, Bernardo Costa and colleagues from thePREDICE project for the prevention of type 2 diabetesshowed that the Finnish Diabetes Risk Score (FINDRISC) can predict diabetes effectively when using glucose-based diagnostic criteria, but the predictive ability is reduced whenthe new hemoglobin A1c-based criteria提出的American Diabetes Associationare applied. These results indicate that it is important to have reliable scores to predict the development of diabetes in at-risk populations in order to identify the most appropriate individuals for targeted prevention strategies.

Given the growing numbers of people suffering fromtype 2 diabetes, it is increasingly important to identify new combination therapies to treat these patients. In early February, NICEissued draft guidanceto announce that it did not recommend dapagliflozin in combination with other diabetes treatments due to insufficient long-term data, and highlighted that more good quality trials are required. In arandomized controlled trialcarried out over 102 weeks by Clifford J Bailey and colleagues fromAston University, addition of dapagliflozin to metformin therapy was shown to be effective for glycemic control in patients with type 2 diabetes who are inadequately responsive to metformin alone. These results add strong evidence for the long-term efficacy of dapagliflozin combination therapy and should be incorporated into the final NICE guidance, which is expected to be released in June 2013.

Research inBMC Medicinethis week has also explored other lifestyle choices and the impact they can have on health and disease. Fernando Rodríguez-Artalejo and colleagues from theAutonomous University of Madridfound that adherence to generally accepted healthy behaviors, including not smoking, being active and eating a healthy diet, as well as other behaviors such as interacting with friends and not sitting for too long, could substantiallyreduce the risk of mortalityin older adults.

A study led by theNorwegian Institute of Public Healthinvestigatedthe impact of a mother’s lifestyle choices on her baby, showing that maternal caffeine intake is associated with increased risk of the baby being small for gestational age and having decreased birth weight. Verena Sengpiel and colleagues argue that these results could haveimplicationsfor the recommended consumption of caffeine during pregnancy, and suggest that pregnant women should consider giving up caffeine altogether.

The importance of living a healthy lifestyle in order to prevent the development of disease is well known, but these studies show that new interventions are still urgently required to prevent the obesity crisis and the subsequent onset of co-morbid diseases.