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Childhood Obesity and Diabetes
Breaking the link between obesity and diabetes

Three decades ago, pediatricians thought that childhood obesity and diabetes stemmed from an abnormality of the children's glands. Today, that misconception no longer hampers effective treatment of these children, thanks in part to the work of Dr. Rudolph L. Leibel at Columbia. As a young researcher, Dr. Leibel remembers seeing one such child in his pediatric endocrinology practice. Only 7 years old, the little boy was already well on his way to developing adult-onset (Type II) diabetes.

"I realized that no one really knew what was causing obesity and diabetes in children and I could do nothing for him," said Dr. Leibel, now a professor of pediatrics at Columbia and co-director of the Naomi Berrie Diabetes Center. "It was then that I vowed to try to understand obesity on a more molecular basis."

Dr. Leibel decided to leave his faculty position and return to school to become a postdoctoral researcher. After nine years studying the biological make-up of mice, he and his collaborators discovered the first molecule linked directly to the control of body weight and obesity: leptin, a hormone that tells the brain how much fat is in the body. Without leptin, mice think they are starving, eat as much as they can, and become obese and diabetic. The same inability to make leptin that Dr. Leibel's research team found in mice also occurs in a small number of children. Thanks to Dr. Leibel's work, these children are now being treated with injections of leptin.

Dr. Leibel's work is also relevant for adults struggling to lose weight and keep it off. Recently his lab found that people who have successfully lost weight have trouble keeping the weight off because the weight reduction is perceived by the brain as a leptin deficiency state.

"The brain then tells the body to conserve energy and increase food intake, causing a weight gain," Dr. Leibel says. "We're now finding that people can maintain a weight-loss when given low doses of leptin."

Unfortunately, nearly 25 percent of all children in the United States are overweight—a number that virtually guarantees an enormous population of diabetes sufferers in the future. Dr. Leibel's lab has returned to its original research involving mice to look for genes that cause some obese people to develop Type II diabetes, in hopes of finding a treatment.

"Mice make it possible to hope for such breakthroughs, because virtually everything we have found in a mouse, we have found in a human," said Dr. Leibel. "Although we're separated by about 80 million years of evolution, genetically we're very similar. The only major differences are that the genes have been shuffled in the genome. Without mice, we'd be out of business. At some point they will give us enough understanding to either prevent or stop this epidemic."
© 2005 Columbia University