Obesity is a growing epidemic, but prevention efforts have not been successful. To a great extent, this is due to the challenging task of changing the way people eat, move, and live. Obesity is both a biological and a social problem and must be considered as a function of these larger contexts. Several NICHD organizational units conduct and support research on a broad range of areas related to excess weight gain, including the causes, effects, prevention, and treatment of obesity and related conditions.
Because environment and genetics play important roles in childhood obesity, the NICHD’s Section on Growth and Obesity works to increase understanding of the metabolic and behavioral factors involved in determining body weight regulation and body composition during childhood. The section also studies prevention and treatment interventions, and places a special emphasis on minority populations that are at an increased risk for obesity. For example, in one study on African American and Caucasian children and adolescents, researchers found that the gastrointestinal lipase inhibitor orlistat improved weight loss. Another study found that the medication metformin added to a behavioral program significantly improved weight loss and lowered insulin resistance in severely obese, insulin-resistant children.
The Pediatric Growth and Nutrition Branch (PGNB) also supports a wide range of childhood obesity research, including studies on psychosocial risks of obesity, the natural history and clinical pathophysiology of body composition, metabolic syndrome and diabetes, environmental and policy research in relation to obesity, and preventive and therapeutic interventions for childhood obesity. Funding from the PGNB has led to several noteworthy advances, including one of the first large genome-wide association studies (GWAS) on weight among U.S. children.
Obesity affects pregnancy in several significant ways. The Pregnancy and Perinatology Branch (PPB) conducts obesity-related research in many areas, including the short- and long-term effects of maternal obesity and weight gain during pregnancy on women’s and children’s health. In addition, the Branch supports studies of lifestyle interventions during pregnancy that aim to improve maternal and child health through healthy changes in diet and physical activity levels. The PPB also has explored the possible connection between obesity and postpartum depression.
Obesity also can affect fertility. The NICHD’s Fertility and Infertility (FI) Branch explores ways to prevent and treat infertility related to obesity. One recent scientific advance provided new insights into the relationship between obesity, androgen excess, and polycystic ovary syndrome in adolescents.
Other NICHD units, such as the Intellectual and Developmental Disabilities Branch (IDDB), explore issues related to obesity in specific populations, such as people with Down syndrome. The Child Development and Behavior Branch (CDBB) supports research on the behavioral factors that can lead to obesity and behavior-based prevention and treatment strategies for obesity. In addition, the Division of Intramural Population Health (DIPHR) works to fill critical data gaps to advance understanding of such factors as obesity that affect health. For example, DIPHR launched a 7-year assessment of U.S. adolescents and young adults to identify several health-related factors, including genetic, personal, family, school, and social factors that promote or sustain positive health behaviors.
To ensure that NICHD organizational units advance the most effective obesity-related science, the NICHD’s Obesity Research Strategic Core (ORSC) brings together research and translational activities from across the Institute. Some of the ORSC’s focus areas include:
- Interventions, such as pediatric obesity prevention or treatment studies in the primary care setting, at home, in schools, and in camps
- Behavioral and psychosocial observational research, including observational studies that examine social and psychological antecedents, consequences, or correlates of diet, physical activity, sedentary behavior, and/or obesity in children and adolescents
- Basic sciences research, including human in vitro or animal studies that focus primarily on the genetic, molecular, cellular, or organ-system factors related to diet, physical activity, development of adiposity, or other aspects of energy metabolism
- Clinical physiology, such as human studies that focus on clinical cohorts of either normal weight or overweight children and adolescents
The ORSC also is working to promote a systems-oriented approach to childhood obesity that includes the following key features:
- Framing obesity as a complex systems problem
- Emphasizing cross-level and cross-disciplinary hypotheses at the outset of research
- Increasing efforts in structural or upstream interventions
- Building capacity for multilevel research, in terms of training and collaborating with partner organizations
- Investing in complex systems research methodologies
- Maintaining a global perspective
The NICHD works to promote collaborative efforts to understand overweight and obesity and to promote healthy weight. For example:
- In 2003, the NIH director began addressing the problem of the obesity epidemic by forming the Obesity Research Task Force to promote obesity research efforts across the NIH.
- The NICHD is a member of the National Collaborative on Childhood Obesity Research (NCCOR) , which brings together leading research funders (including the NIH, the Centers for Disease Control and Prevention, the Robert Wood Johnson Foundation, and the U.S. Department of Agriculture) in a public-private collaboration to accelerate progress on reversing the epidemic of overweight and obesity among U.S. youth. The mission of NCCOR is to improve the efficiency, effectiveness, and application of childhood obesity research, and to halt—and reverse—childhood obesity through enhanced coordination and collaboration.
- The NICHD created the Maternal-Fetal Medicine Units Network to focus on clinical questions in maternal-fetal medicine and obstetrics. The Network is composed of 14 university-based clinical centers and a data coordinating center that have explored a number of issues, including weight gain and nutrition.
- The NICHD also works to encourage a healthy weight among young people. It joins several other NIH Institutes to support We Can! (Ways to Enhance Children’s Activity and Nutrition), which focuses its evidence-based education activities on parents and caregivers—the primary group for influencing youth. The NICHD’s Media-Smart Youth: Eat, Think, and Be Active! curriculum is one of four youth curricula offered through We Can! Media-Smart Youth is an afterschool program that helps participants become aware of, and think critically about, the media’s influence on their nutrition and physical activity choices.
- Research supported by NICHD and other NIH Institutes was featured in the HBO documentary The Weight of the Nation , which explored many topics related to the obesity epidemic in the United States, from causes to treatments. Leaders of the NIH Obesity Research Task Force provided guidance and materials to the filmmakers throughout the creation of the piece.