There are 24 million adults who are classed as overweight

There are 24 million adults who are classed as overweight.The cause of the growth is an imbalance between the calories people consume and the energy they expend.Although we are eating 750 fewer calories a day on average than 20 years ago, activity levels have fallen by 800 calories Out of this small imbalance has come the wave of obesity. “A better understanding of the roles of ghrelin and obestatin in the intricate balance of energy homoeostasis and body weight control may be essential for successful treatment of obesity,” the authors write The need is urgent. Even more unusual was for two hormones from the same gene to have such opposite effects. Obestatin behaves in some ways as “anti-ghrelin”.”That was the big surprise,” said Professor Hsueh. In fact, switching off the gene had almost no effect.The discovery of obestatin offers an explanation Deleting the gene for ghrelin also takes out obestatin.

So the rats lost their appetite-stimulating and appetite-suppressing hormones at the same time.Aaron Hsueh, an endocrinologist and professor of obstetrics and gynaecology at Stanford, who led the study, said it was rare for more than one hormone to come from a single gene sequence. Scientists hope the new finding may clear up confusion about how the appetite-regulation hormones work.As the ghrelin protein stimulates appetite, scientists expected experiments in animals in which the gene for ghrelin was switched off would depress appetite. Leptin was seen at the time as the Holy Grail that would yield the key to the control of obesity.Both hormones, while playing key roles in appetite regulation, failed to act as expected when used as treatments. But despite frequent claims of success, progress has been slow.Ghrelin was discovered in 1999 and for years scientists hoped it would yield a treatment that would help weight control It followed the discovery of leptin in 1994. This work is notable because it represents a completely new pathway.”The search for treatments for the global epidemic of obesity has engaged thousands of scientists around the world for decades.

The treatment also slowed the movement of digested food from the stomach to the intestine.Commenting on the finding, published in Science, Greg Barsh, professor of genetics at Stanford University, said: “There are several known pathways that regulate body weight. The discovery of a new hormone that suppresses appetite has been hailed by scientists who said it opened a new front in the search for a treatment for obesity. The hormone, obestatin, is a sibling to ghrelin, which increases appetite, leading researchers to call them the “duelling hunger hormones”.
The finding surprised scientists, who believed all the key hormones involved in appetite control had been identified. But the discovery of obestatin could explain why treatments based on existing hormones have failed.Researchers at Stanford University School of Medicine who injected rats with a synthetic version of obestatin found they ate half as much as rats given no injection. Patricia Hewitt said that some practices were already operating opening hours from 8am to 8pm to allow better access for working people.
Ms Hewitt said that the public were often pleased with the service they got from GPs once they actually saw them, but were not impressed by the problems they faced getting appointments at times to suit them.”What we are hearing loud and clear is that although people are very happy with the service they receive from their GP, they are less happy with access and convenience,” she said.The Health Secretary’s comments came as the Government continued work on its white paper dealing with community-based health services, including GPs.As part of the preparations, large public meetings have been held around England, culminating in a “citizens’ summit” in Birmingham last month.A survey of those who took part in the event found that extending opening hours in the evenings and weekends was believed to be the best way to give people more choice about when, where and how they get services.This was followed by providing more NHS walk-in centres in convenient locations, such as train stations and city centres.Ms Hewitt said that access and convenience were emerging as the biggest problems that needed to be solved in the White Paper.She said that a minority of GP surgeries were still operating restrictive booking policies, where patients have to ring between certain times on the morning of the day they want an appointment.This was causing frustration among patients, Ms Hewitt added.”With banks and supermarkets, they are open 24/7.”But patients are telling us with the health service you either see your GP or out of hours go to A&E, but they want something in between.”We have started putting something in between with NHS Direct and walk-in centres.”We also need to make sure that the GP surgeries become more accessible.”Some GP surgeries are now opening on an 8am to 8pm basis.”One of the things we are now discussing as part of our consultation is how can we make that the norm among GP surgeries where that is what local people want.”Where the local population want those longer opening hours we have to make sure that GPs can deliver it.”But this is not going back on the GP contract that relieved GPs of responsibility for supplying out of hours services, Ms Hewitt said.The White Paper could also include the possibility of patients being able to register with more than one GP, for example by also signing up with one near their workplace.Bringing in more private sector providers to help deliver primary care services is another idea being discussed.But the prospect of more organisations outside the NHS being allowed to set up local health centres was given a low priority among those questioned in Birmingham.Just 6% put this option in their top three priorities, compared with 76% who backed regular “health MOTs” for everybody and 63% who opted for a focus on mental well-being.But Ms Hewitt said: “Bringing in an outside provider to provide a particular service is a means of achieving a particular goal.”I would not expect the public to be excited about the means of achieving something.”If GPs don’t want to lead primary care services in these areas, then of course we need to go elsewhere.”We are not going to leave people in deprived areas without the services that they need.”She added: “This is not privatisation of the NHS.”I think it is highly unlikely that there will be a huge wave of private sector providers.”But where they can help to deliver the best services for the best value for money, we will use them.”Ms Hewitt said they needed to tackle inequalities, where some of the most deprived areas have the worst access to GPs and other health services.The DoH is also looking at how to best support patients with long-term conditions, like asthma, diabetes and heart disease.”What we have found is that 45% of adults with a chronic health condition tell us that they don’t get advice about exercise and diet from the NHS, even though that would be useful to them in managing their condition,” Ms Hewitt said.She said that if people were not given better support in the community, they were more likely to end up in hospital.Ms Hewitt said that consultation had shown that people want “choice and voice” when it came to their health care.She said they were still working on the contents of the white paper, due to be published at the turn of the year, and deciding what measures should be included.”We have a clear diagnosis of the problem but we are still working on what the prescription might be,” she added.. GP surgeries should extend their opening hours into the evening and weekends if that is what local people want, the Health Secretary said today.

Replacements: T Polata-Nau (NSW), G Holmes (Queensland), M Chisholm (ACT), S Fava (WA), C Whitaker (NSW), M Giteau (ACT), L Johannson (Queensland).. “We talked about the roof during the week, so we’re quite surprised,” the Fiji coach Wayne Pivac said ruefully.Australia Test teamv England (Twickenham, tomorrow, 3.0pm):C Latham (Queensland); M Gerrard (ACT), L Tuqiri (NSW), M Turinui (NSW), D Mitchell (Queensland); M Rogers (NSW), G Gregan (ACT, capt); M Dunning (NSW), B Cannon (WA), A Baxter (NSW), N Sharpe (WA), H McMeniman (Queensland), J Roe (Queensland), P Waugh (NSW), G Smith (ACT). The islanders are not the most enthusiastic of travellers, but they do have one or two remarkable players, not least the New Zealand-based No 8 Sisa Koyamaibole, and if they get through the first half-hour they may just give the home XV a work-out worthy of the name.That would have been the case in dry conditions but the Welsh, having closed the Millennium Stadium roof against the All Blacks, opted to leave it open for this game. As Rogers said yesterday: “We just want to win a footy game.” The element of surprise being as valuable as it is, Jones may just have struck gold.

There again…Over in Wales, a rugby nation plunged back into widow’s weeds by the rampant All Blacks last weekend, the new generation of World Cup wannabes – the Llanelli Scarlets full-back Lee Byrne, the Cardiff Blues loose-head prop John Yapp and the ridiculously tall Newport-Gwent Dragons lock Luke Charteris among them – have a chance to make a point or two against Fiji at the Millennium Stadium this evening. He’s still coming to terms with the outside-half position and just at the moment, we see Rogers and Morgan Turinui as our best 10-12 combination.”With John Roe replacing the more substantial Rocky Elsom on the blind-side flank, this is not the Wallaby side England expected to meet Perhaps that is the point. “Wendell was disappointing in Marseilles last Saturday – he didn’t give us the go-forward we needed,” said the coach, who has also awarded a first Test start to the 22-year-old lock from Brisbane, Hugh McMeniman, who is seen as the new John Eales by some of his more expectant countrymen, heaven help him “As for Matt, it was a difficult decision. Mitchell played three Tri-Nations matches at full-back during August, caught the eye in each of them and even contrived to put a try past the All Blacks in Sydney. Gerrard also knows what it is to score against New Zealand, so it can be assumed that he is nobody’s fool either.All the same, Jones had some explaining to do yesterday.