When more than two-thirds of persons living in the U.S are overweight and obese, why would researchers pay people who are already fat – big bucks to pack on more pounds?
For the sake of medical science, of course, but it’s really not that simple. Specifically, researchers in Washington University in St. Louis are trying to determine why some people are resistant to developing obesity-related metabolic diseases and disorders (like diabetes and high cholesterol) while others are not. It’s meant to improve treatment of obesity and complications of obesity.
“There are some very large people who don’t get diabetes; they don’t get high blood pressure; they don’t have abnormal lipids; they’re metabolically completely normal,” said Samuel Klein, M.D., principal investigator of the study. “And some of them can be very, very obese – why is their body able to resist this excess weight when other people with a little bit of weight gain get all the complications of obesity?”
Researchers are hoping the results of the study could lead to better therapies to break the link between obesity and unhealthy metabolic function.
Fast food is on the study menu for several reasons.
“Fast foods are popular; we know what’s in them … one hamburger made in one place at one day is similar to another hamburger at another place,” he said.
Because fast foods are mass produced, there is certainty in the nutritional content of the items.
“We know the calorie content of these foods more than you would if you went into a restaurant, for example and ordered a pizza or a hamburger in a restaurant. These are very carefully regulated stuff,” Klein said.
Five fast food restaurants are selected for the study.
“It is McDonalds, Kentucky Fried Chicken, Taco Bell, Pizza Hut and Burger King,” Klein said.
Eating the fast food is in addition to other foods normally eaten. They want participants to gain at about 5 percent of their starting body weight – but there will be no whole hog pig outs.
“We actually supervise them by our dieticians because the increase in the calories that they eat is not just anything that they want – it has to be the same proportion of calories in a regular diet … a certain percentage of fat; a certain percentage of protein; a certain percentage of carbohydrate,” Klein explained. “It’s a very-regulated increase calorie intake in that we monitor and instruct them on what they should be eating so that the increased calories have the same distribution of protein, fat, carbohydrates that’s in a normal diet.”
Researchers are willing to pay 40 participants $3,500 each upon completion of the 18-week study.
“We are looking for 20 people who are obese but are metabolically healthy and 20 who are metabolically unhealthy,” Klein said.
“Metabolically unhealthy” in this case means the volunteers may have insulin resistance or evidence of pre-diabetes, not having diabetes, Klein explained.
“Having some evidence of abnormalities in their blood lipids – high triglycerides; low HDL cholesterol; people who also have increased fat in their liver, which is a marker for metabolic health,” he added.
“We have them eat excess calories every day,” Klein said. “Every week they come in for blood tests and medical monitoring, so if there is any evidence of medical harm, we would just stop the study, but this mild weight gain does not cause any medical harm.”
Volunteers must be between the ages of 18 and 65; who are already obese with a BMI between 30 -39.9; they must not smoke and they cannot have diabetes.
Klein said the study seeks a mixture of participants because they want to study the differences among races.
“Asians, for example, are much more prone to developing diabetes when they gain a little bit of weight.
“When Caucasians gain weight, it seems they have abnormal lipids, abnormal liver fat, high blood pressure and diabetes,” Klein said.
“When Hispanics gain weight, they get much higher abnormalities in their liver and blood lipids than do Caucasians.
“When African Americans gain weight, they have much less increase in liver fat and in blood lipids, but they have an increased risk of diabetes.”
In addition to tests and procedures related to the study, the University put participants in a free weight loss program after the study.
“We put them on a very-supervised weight loss program to make sure they’ve lost all the weight they’ve gained, plus more,” Klein said. “And it’s not hard to lose weight when you put it on this way – by forcing yourself to eat extra food. It’s easy to lose weight this way because you’ve gone beyond your normal lifestyle.”
The hard work, he says, is getting them below that weight afterwards.
Klein said they’ve received a huge number of phone calls from people wanting to participate in the study, but unfortunately, most have not qualified to enroll.
“If they have diabetes – they are excluded from the study; if they are on medications to control their blood lipids for example, we exclude them,” Klein explained. “We are taking people that have metabolic abnormalities but it’s very low risk because they don’t have severe metabolic abnormalities – no diabetes, no cholesterol medication.”
Klein says it will take about a year for results to be analyzed and released publicly.
For more information, contact Emily at 314-747-3758, email jenkersone@wusm.wustl.edu or visit vfh.wustl.edu/currentstudies.
