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the right patients with the right therapies, whether they be drugs, surgery, or lifestyle changes. As with cancer, obesity could have genetic factors that steer patients toward the right treatments and away from those that won’t work.
For example, Aetna is working with a diagnostics company that believes it has pinpointed three genetic markers that determine which diet and exercise plans will help obese people shed pounds. Aetna’s Pezalla declined to say more; a study will be published in the next couple months.
Farther out on the frontier is the microbiome, the trillions of bacteria and other microbes living in and on our bodies. The Mayo Clinic in Rochester, MN, is building a microbiome research program and is working with biotechs, including Second Genome of South San Francisco, CA, and Enterome of Paris, France, to understand the relationship of the gut microbiome to people’s weight. But like all emerging science, those explorations will likely take years to bear fruit.
UCSF’s Hecht, who admits that some of his views are controversial, wants to see a more holistic approach, testing “environmental interventions”—steering people away from junk food—and new ideas about behavior modification like mindful eating.
“Our level of obesity now is way higher than 30 or 40 years ago,” says UCSF’s Hecht. “It’s not like our genetics changed in that time. Reversing the epidemic means getting back to where we were in the 1970s.”
Meanwhile, Americans—and a growing number of people around the world—are dangerously overweight. Whether it’s 1970-levels of less junk food and more exercise, or the quest for effective drugs, or other goals that research might point toward, we need to get there as quickly as possible.
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