The Gates Cambridge Annual Lecture 2023 - entitled BRAIN FOOD: HOW YOUR SUBCONSCIOUS BRAIN CONTROLS YOUR APPETITE, WEIGHT AND GROWTH - was given by Professor Sir Stephen O’Rahilly MD FRS FMedSci and Professor Sadaf Farooqi PhD, FRCP, FMedSci, FRS on 16 November 2023.
In this lecture, the speakers explain how the brain plays a crucial role in controlling our eating habits and body weight. They discuss how genes and the pathways they control have a significant impact on whether a person gains weight or not, especially in an environment where high-calorie and tasty foods are easily available, and physical inactivity is common.
The lecturers focus on the leptin-melanocortin pathway, which is a set of processes that regulate body weight in humans. By studying this pathway, researchers have gained insights into how our body weight is managed, how our energy levels are linked to reproduction and growth, and how problems in these brain mechanisms can lead to obesity.
They also touch upon how this research has influenced society's understanding of obesity and how it has led to the development of new treatments for severe obesity. With over 1 billion overweight or obese people worldwide, understanding the brain's role in this process is essential for finding effective solutions to tackle this global health issue.
Professor Sir Stephen O’Rahilly MD FRS FMedSci
Stephen O’Rahilly is an endocrinologist who has transformed our understanding of the control of human energy balance and metabolism and how these can be disturbed to cause severe obesity and/or subtypes of diabetes. Stephen showed that mutations in single genes can cause a catastrophic loss of control of appetite and feeding behaviour, leading to severe obesity. Some of these inherited disorders can now be treated very effectively.
Stephen studies patients with extreme and inherited metabolic conditions such as severe obesity and insulin resistance. His work first established that some very obese children have a mutation in the gene for leptin - an appetite-controlling hormone. His work has led to a better understanding of how the brain senses its state of nutrition and controls not only appetite but growth, the rate of pubertal development and the accrual of muscle mass. His work revealed the genetic basis for more than 20 human disorders and he works with industry to develop targeted treatments.
From modest beginnings, Stephen has built up and leads one of the world’s largest institutes for metabolic research at the University of Cambridge. His findings have been recognised internationally with many awards and prizes, and in 2013 he was knighted for services to medical research.
[Bio from The Royal Society]
Roles: Professor of Clinical Biochemistry and Medicine ; Director, Medical Research Council Metabolic Diseases Unit; Co-Director, Wellcome-MRC Institute of Metabolic Science; Head of Department of Clinical Biochemistry, University of Cambridge; Scientific Director, Cambridge NIHR Biomedical Research Centre; Hon Consultant Physician, Addenbrooke’s Hospital, Cambridge.
Professor Sadaf Farooqi PhD, FRCP, FMedSci, FRS
Sadaf Farooqi is a Clinician Scientist distinguished for her discoveries of the fundamental mechanisms that control human weight regulation and their disruption in obesity. She found that the hormone leptin and its target the melanocortin 4 receptor (MC4R) regulate the drive to eat and the preference for rewarding and high fat food, revealing the biological basis of innate behaviours previously thought to be under voluntary control.
By precisely connecting molecular mechanisms to clinical phenotypes, her research explained how changes in weight affect blood pressure by altering leptin-melanocortin signalling, thereby explaining the association between obesity and hypertension.
Her identification and characterisation of multiple obesity syndromes has led to genetic testing being adopted worldwide, transforming the lives of families suspected of causing severe obesity in children through neglect. Her research has directly enabled life-saving treatment for some people with severe obesity, therapies that are now licensed and widely available. Her research into MC4R mutations that protect against obesity and into the genetic basis of thinness has opened up possibilities for the design of new weight loss treatments.
[Bio from The Royal Society]
Roles: Professor of Metabolism and Medicine and Honorary Consultant Physician at Wellcome-MRC Institute of Metabolic Science.