Mapping solutions to obesity: lessons from the Human Genome Project

To discuss appropriate endpoints for research designed to prevent obesity. Research investigating practical solutions to the complex multi-factorial global obesity epidemic may be stalled by undue emphasis on reduced body weight as the only acceptable endpoint.

Considering prevention research in cardiovascular disease and tobacco control, we contend that investigations of intermediate endpoints make an important contribution to the multi-faceted approach needed to combat the complex problem of obesity.

Intermediate endpoints are respected in other public health areas: reductions in risk factors such as high blood cholesterol or smoking are acceptable study endpoints for research aimed at reducing heart disease or lung cancer. Likewise, practical endpoints can be valuable in studies investigating interventions to reduce identified and potential intermediate risk factors for obesity, such as soft drink consumption.

Reduced obesity is the global aim but obesity is not caused by one exposure and will not be solved by a single modality intervention. A wider debate about endpoint selection may assist research which identifies individual building blocks of obesity prevention in the same way as individual gene mapping contributed to the Human Genome Project.