Not all obese patients are alike

Not all obese patients are alike

Zooming in on the individual

11-04-2022 · Background

Many people suffering from obesity receive an intensive lifestyle treatment, with a focus on healthy diet and exercising. Adhering to these, some lose lots of kilos, while others actually gain weight. Vici winner Anne Roefs is going to draw up individual profiles to determine who benefits from such a treatment.

Just how damaging excessive weight is for one’s health, became all too apparent during the Covid pandemic, when ICUs were full of obese patients. That confirmed for Anne Roefs that obesity increases the chances of having other conditions, in particular cardiovascular diseases and diabetes. According to the World Health Organisation, the number of deaths linked to extreme excessive weight is 2.8 million.

A lot of research has been carried out over the past 25 years in an attempt to find the reason why some people manage to keep their weight at a certain level and others don’t. Extensive trials have brought to light a lot of risk factors, including a disrupted balance of the leptin hormone. This results in people not reaching a satiety level when they eat and just continue to eat. Depression also appears to increase the chances of becoming overweight, as does being in the company of friends who have become obese.

Former smoker

A disadvantage of these so-called randomized controlled trials (RCTs), often with hundreds of participants, is that the results are averages and don’t necessarily apply to each individual in the group, and sometimes not even to the majority of the test subjects. So, people who are overweight have less in common with than is often assumed.

That is why Roefs is zooming in on the individual. For the six hundred test subjects (two hundred of whom had a healthy weight, as the control group), she draws up personal profiles. It is known that in Europe obesity is more prevalent in men than in women, often in people who have had little education, no job, former smokers and heavy drinkers. But in addition to these personal characteristics, the focus is also on biology (leptin), as well as psychology (depression, self-control, sensitivity to stress, eating disorder), environment (friends, neighbourhood, safety) and behaviour (eating patterns, exercise).

Not everyone is unique in everything, so the next step consists of clustering individual profiles that are very similar. “I have no idea which clusters will surface, but it is possible that we find a group of men who are from an area with people who have had little education, do not exercise much and are dejected. But what is also possible is that we find a group of women with disrupted hormonal regulation and friends who have developed obesity.”

Bar of chocolate

After that, Roefs zooms in to map out daily life in detail. Every day the participants receive questions on their smartphones to discover what they are doing at that time, what they are eating, whether they are experiencing stress, how they are feeling, et cetera. In addition, they wear activity trackers that register their exercise.

Eventually, she hopes to be able to predict who will benefit from which treatment. Or better: who will benefit from the intensive lifestyle treatment, prescribed by GPs. This consists of a personal diet and exercise plan, as well as behavioural therapeutic techniques such as ‘setting realistic objectives’, monitoring, and ‘detecting undermining thoughts’ – I’ve had a really awful day, so I am now allowed a bar of chocolate.

Roefs: “The treatment works well, but not for everyone. Some patients lose a quarter of their weight, which is an excellent result. But others actually gain weight. An obvious reason is that the treatment demands a lot from people. They have to adapt their eating patterns, exercise more, keep a diary. Not everyone can manage that.”

By keeping tabs on daily life, Roefs also hopes to be able to detect who is reverting back to old habits. “If people gain three kilos, I will look at what occurred prior to that. What happened in their daily lives?”

Photo: Pixabay

Categories: Science
Tags: obesity,lifestyle,treatment,vici,anne roefs,research,grant,instagram

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