DEAR MAYO CLINIC: It seems like no matter what I do, I can't lose weight. Most of my family members struggle with their weight too. Do our genetics play a part in this?

ANSWER: It's important to understand that we are all unique and gain weight for many different reasons. When trying to understand weight gain and why some of us have difficulty losing weight, there are factors such as gut and brain connections, how we control our sensation of hunger and fullness and how long we stay full. Over a decade of studies at Mayo Clinic have helped identify characteristics that can be associated with groups of people called obesity phenotypes. 

Each phenotype has a single genetic predisposition (an increased likelihood of developing obesity based on a person's genetic makeup) and interacts differently with their environment. In many environments we see today, there is an excess of food, and we're less active than before. Some people may feel hungry between meals, while others only have one big meal a day — our genetics drives this. Your genetic makeup determines which phenotype you're going to have. These phenotypes can help guide treatment for weight loss. Each of these genetic phenotypes, or genotypes, identifies the type of obesity and which medication would work best. 

The first phenotype is what we call "hungry brain." These patients start eating and don't feel full even after consuming large meals with second and third helpings. Usually, this runs in families. The other phenotype is what we call "hungry gut." These patients start eating and feel full after their usual portion, but the gut does not send those signals to the brain. Because of that, they feel hungry between meals. Signals from the gut to the brain are hormones, such as glucagon-like peptide-1 (GLP-1). Semaglutide medications such as Wegovy, Ozempic and Rybelsus work on behalf of the GLP-1 hormone. They connect between the gut and the brain, and they signal to the brain that you're full. 

Patients who have emotional hunger are another group. Whether having a good or bad day, these patients look to cope with life by eating food. The fourth group is patients with a "slow burn" or abnormal metabolism where the body does not burn all the calories they consume. 

Looking at these four phenotypes can help individualize obesity therapy. How genes correlate with an obesity phenotype can help determine which medications should be prescribed. Each of us also should have a unique diet approach based on our genotype and phenotype. Many diets have mainly focused on obesity-related complications, such as managing Type 2 diabetes or preventing heart risk, but none have been customized to phenotypes. The concept of the phenotype-tailored diet came from multiple studies that showed metabolic benefits during and after the diet plan began. These findings were then matched to each phenotype to define recommended diets.

At Mayo Clinic, we work closely with our colleagues in bariatric surgery through endoscopic procedures to find out, based on our genetics, how we can identify who will be the most responsive to each course of action. We want to bring precision medicine as we have for any other disease, and I think it's time we do the same for obesity. — Andres Acosta, M.D., Ph.D., Bariatrician, Gastroenterologist, Mayo Clinic, Rochester, Minnesota

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Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video (0:59) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

"What we need to know about taking any intervention for obesity, including these two new medications, is that they're not a quick fix. They're not a magic pill or, in this case, a magic injection," says Dr. Acosta, a Mayo Clinic expert in treating obesity and co-author of "The Mayo Clinic Diet Rx."

He says in order to achieve healthy, long-term weight loss, tools like weight-loss medications need to be part of a multidisciplinary program that includes diet and exercise routines.

"The diet is still key. What this medication is doing is suppressing our appetite, so I don't feel that hungry, so I can eat less. So, diet is important," says Dr. Acosta.

Dr. Acosta recommends sticking to a healthy, low-calorie, high-protein diet to ensure healthy weight loss.

"When the medications or effects are coming off, or we want to stop the medications, it's important that we consider what diet intervention I'm going to do — what changes I'm going to do to my lifestyle, to my diet, in my exercising, my physical activity — in order to keep that weight off for a longer period of time."

Related posts:

• Mayo Clinic Minute: What's the skinny on weight-loss drugs?

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In a pilot study of 165 people, Mayo Clinic researchers looked at the effectiveness of two different approaches to weight loss: a standard lifestyle intervention and individualized therapy. The standard lifestyle intervention included a reduced diet, exercise and behavior therapy. The individualized approach was based on phenotypes and included different interventions depending on the person's predominant underlying cause of obesity. A diet based on phenotypes considers a person's genetic and phenotypic characteristics to create a tailored eating plan meant to optimize health and well-being.

The researchers compared whether diet and lifestyle interventions tailored to obesity phenotypes would work better than standard lifestyle interventions on weight loss, cardiometabolic risk factors and physical variables contributing to obesity. Cardiometabolic health describes the connection between the heart and blood vessels and the body's energy and chemical processes. It covers a wide range of disorders and risk factors that contribute to heart disease and metabolic syndrome.

In adults with obesity, the phenotype-tailored lifestyle interventions resulted in more weight loss than the standard lifestyle interventions of a reduced-calorie diet, exercise and behavior therapy.

Findings after 12 weeks included:

• Patients who used phenotype-tailored lifestyle interventions did better in treating their obesity than those who used standard lifestyle interventions.
• The phenotype-focused group of patients had more significant weight loss, reduced waist circumference, reduced triglycerides, reduced daily caloric intake and less anxiety.
• They had a substantial increase in lean mass percentage.
• They also had a lesser decrease in the number of calories required by the body during resting conditions.

"The results stress the relevance of identifying the underlying cause of obesity as a complex disease with many factors," says Andre Acosta, M.D., Ph.D., a Mayo Clinic obesity researcher and the study's last author.

What is a phenotype-tailored intervention?

Obesity phenotypes are based on the cause of the disease and behavioral components and include three main areas:

• Homeostatic eating — eating in response to a perceived energy need by the brain.
• Hedonic eating behavior — consuming foods for pleasure, not for physical hunger or energy needs.
• Abnormal energy expenditure — the number of calories burned in 24 hours compared to an average person.

Four actionable phenotypes of these areas include abnormal fullness, measured by calories ingested to experiencing unpleasant fullness; abnormal duration of fullness; emotional eating behavior; and abnormal resting energy expenditure.

The researchers reported that people who used the phenotype-tailored lifestyle interventions showed significant improvement in some targeted areas, such as abnormal fullness and emotional eating.

"The results of this study support the need for an actionable, phenotype-based classification [of patients in obesity treatment] rather than relying only on the number on the scale, body measurements or [if they have] obesity-related diseases, such as heart disease, high blood pressure and certain cancers," says Dr. Acosta.

Opportunities for further research

Dr. Acosta says more research is needed to assess the long-term effect of a phenotype-based approach. In particular, further studies may need to look at other physical and metabolic variables to understand people with no identified phenotype.

Dr. Acosta also notes that the effects of therapy on the two approaches must be examined independently. People with an emotional eating component received a more intense intervention, with 24 behavior modification sessions, to address this underlying trait that may have a leading role in obesity development.

"More research will enhance the tailored approach proposed from the data," says Dr. Acosta. "We will continue to work on individualized obesity therapy directed at specific traits to identify the right therapy for the right patient."

Declaration of interests

Dr. Acosta is a stockholder in Gila Therapeutics and Phenomix Sciences; he was a consultant for Rhythm Pharmaceuticals, General Mills, Amgen, Bausch Health, and RareStone; has contracts with Vivus Inc, Satiogen Pharmaceutical, and Rhythm pharmaceutical; and has a patent submitted for biomarkers of a phenotype-tailored diet.

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Individualized medicine initiatives mainly focus on rare diseases or cancer. Little has been attempted to individualize treatment for noncommunicable chronic diseases such as obesity — a chronic, relapsing disease, and a primary cause of Type 2 diabetes, fatty liver disease, cardiovascular disease and cancer. There are many obesity interventions, such as diets, devices, surgery and medications. However, not much is known about the predictors of response to these obesity interventions.

"Sustained weight loss with current treatment options remains a challenge in the clinical practice," says Andres Acosta, M.D., Ph.D., a Mayo Clinic gastroenterologist and obesity expert.

To address this, Dr. Acosta and a team of Mayo Clinic researchers set out to study anti-obesity medications based on obesity phenotypes to enhance weight loss. A phenotype is a set of observable characteristics of a person resulting from the interaction of his or her genotype with the environment.

Their findings, published in the journal Obesity, show a phenotype-guided approach was associated with 1.75-fold greater weight loss after one year and the proportion of patients who lost more than 10% at one year was 79%, compared with 34% whose treatment was not phenotype-guided.

What are phenotypes, and why do they matter?

The team stratified obesity into four phenotypes:

• Hungry brain ― mainly controlled by the brain-gut axis, and abnormal calories are needed to reach fullness.
• Emotional hunger ― desire to eat to cope with positive or negative emotions.
• Hungry gut ― abnormal duration of fullness.
• Slow burn ― decreased metabolic rate.

With regard to energy balance ― intake versus expenditure ― these four phenotypes regulate body weight.

Key drivers for intake are fullness, duration of fullness and emotional eating. Key drivers for energy expenditure are resting energy expenditure, nonexercise physical activity, exercise and the thermogenic (increase in the metabolic rate that occurs after a meal) effect of food and exercise.

"It was essential to explain differences among patients in some of these measurable components of food intake and energy expenditure, and assess their potential for individualizing therapy for obesity," says Dr. Acosta.

The team theorized that classifying phenotypes would reveal obesity subgroups and enhance response to obesity medications.

"Our aim was to characterize the obesity phenotypes and to assess the effectiveness of phenotype-guided anti-obesity medications, compared with non-phenotype-guided medication."

The Mayo team conducted a yearlong clinical trial performed in a weight management center where 312 patients were randomly assigned to phenotype-guided treatment or treatment that was not phenotype guided and included anti-obesity medications.

In the era of individualized medicine, the proposed phenotype-guided stratification and treatment approach, in addition to the positive outcomes reported in previous randomized trials, represent a step toward a precision medicine approach to optimize obesity therapy.

"Biological and behavioral phenotypes clarify the complexities of human obesity and can be targeted with medications to enhance weight loss," says Dr. Acosta. "Our long-term goal is to develop a personalized approach to identify the right medication for the right patient, minimizing side effects to obesity management."

Dr. Acosta's research encompasses many key areas of individualized medicine. His team applies principles of pharmacogenomics ― how drugs interact with genes ― in obesity to better understand how the disease develops, reduce treatment inconsistencies and decrease the treatments' side effects. His goal is to stratify obesity to support the development of personalized drugs to treat obesity and generate safer and more effective medications.

Dr. Acosta received the Mayo Clinic Center for Individualized Medicine Gerstner Career Development Award. This award provided partial funding for this study.

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With obesity, good advice only goes so far. What’s good for one person hasn’t turned out to be good for all, and it’s left patients and physicians adrift.  Michael Jensen, M.D., a Mayo Clinic endocrinologist, began studying obesity 34 years ago when it seemed manageable.

“There was sort of a false sense of optimism,” says Dr. Jensen. “Now the problem is so prevalent and doctors are so pessimistic that they just tend to not address it at all.”

Dr. Jensen, who wears running shoes with his suit, stops his treadmill desk and heads to his office filled with binders covering the hundreds of studies he’s managed over the decades. His research is a fraction of the whole. The level of obesity research has doubled nearly four times since 1996. But the massive collection of data hasn’t stopped this epidemic. Andres Acosta, M.D., Ph.D., a Mayo basic-science-trained gastroenterologist who is board-certified in obesity medicine, describes the numbers. 

“Almost 600 million people suffer from obesity across the world. In the United States alone, 40% of people have obesity. And despite FDA-approved medications, devices and surgery, less than 1% of the patients ask for them,” he says. “We also have a new diet every week and a new weight loss program every week. All of them secure weight loss, none are effective in the long-term. So that's a reality of obesity.”

Dr. Acosta and Dr. Jensen are not alone. Across Mayo, hundreds of researchers from the bedside to the lab are delving into obesity starting at its very core: the very active and dynamic tissue we call fat. 

Fat goes from fuel to driver

“This is extremely controversial, but this is the way we’ve decided to tackle this problem,” says Dr. Acosta. “Obesity, despite whatever people say, is still a disease of energy balance: what we eat versus what we burn.”

Get out of balance, he says, and we start to gain weight or store fat, and it’s that fat which causes the problems. Fat tissue used to be considered just fuel. It provided for the body in case of nutritional turbulence, and that’s true at the most basic level. “The average, normal weight woman probably can store the caloric equivalent of three months of ‘groceries’ in body fat and take it out when it’s needed,” says Dr. Jensen. Even looking at fat cells gives you that idea. Their most striking feature is a giant reservoir containing a triglyceride (similar to cooking oil) with the cell’s nucleus and organelles squished in where there’s room. The fat cell’s main job is to remove excess fat from the bloodstream, hold it safely and then release it back out when the body needs it. The process is highly controlled. Fat cells pay attention to their own internal status, their habitat, their neighbors and information coming in from around the body in order to do their job.

“Fat cells are about 95% fat and do just fine because they have mechanisms to control it,” says Dr. Jensen. “But the other places that fat can be stored, like in the liver, those other cells are much, much less able to store it safely.” In cases of fat overload or non-triglyceride forms, fat molecules can have a toxic effect on cells, interfere with insulin efficiency or actually generate signals that cause cells to die.

“Imagine a pool filled with thousands of gallons of water,” says Dr. Jensen. “A normal functioning fat cell would be like a pool filter set to release one teaspoon a minute. Now imagine that the filter accidentally releases 1.4 teaspoons a minute. That’s the difference, over time, between healthy and diabetes.”

Fat cells that are poorly regulated don't respond to the normal signals, says Dr. Jensen. For example, when a person doesn’t eat for a certain period of time, the stomach cranks up appetite using ghrelin, a molecule called the ‘hunger hormone’ because it causes your appetite to increase. Ghrelin is released from the stomach, enters the bloodstream and crosses the blood brain barrier to prod your grey matter into action. At that point you start thinking, wouldn’t sushi be good? Metabolic action complete.

Resetting Receptors

In addition to appetite, though, ghrelin is also involved in the physical processes associated with cravings and addiction. As part of his research into cocaine addiction, Stephen Brimijoin, Ph.D., a Mayo Clinic neurobiologist, began studying ways to offset the high of cocaine by altering the enzyme butyrylcholinesterase.

During those studies, Dr. Brimijoin and his colleague, Peng Chen, Ph.D., found that their altered enzyme also lowered levels of ghrelin. So the researchers are beginning to look at the altered enzyme’s effect on one obesity-related challenge: yo-yo dieting. After cycles of weight gain and loss, ghrelin receptors in the brain do not work correctly. The body needs gentle appetite nudges, but the ghrelin pathway is set to punch. That translates into an urge to eat more than the body needs. To reset the receptors, the revved-up enzymes deplete the excessive ghrelin, resensitizing the brain receptors to the amount of the hormone that remains. Their work, published in  Frontiers in Pharmacology, continues with help from many sources, including the group Regenerative Medicine Minnesota. 

Tuning the Antennae

Fat cells also react to their habitat. One way they do that is through antenna-like structures, called “cilia.” When cilia fail to work correctly, their dysfunction gives rise to a range of diseases. Those genetic disorders, such as Bardet-Biedl syndrome, sometimes include obesity as part of their presentation. A team led by researcher Jinghua Hu, Ph.D., is examining a specific protein associated with the function of cilia, called FBF1. In a paper published in Nature Communications in 2016, the team reported that FBF1 plays a key role in the gate that forms between the cell and cilia. In terms of obesity, their theory is that shutting that gate, or depleting FBF1, could prevent cells from directing fat into other cells, such as those in the liver or muscles. They expanded on these findings in 2018, suggesting a new target for investigation. While tangential to obesity that isn’t related to ciliopathies, the team hopes this approach could help those with ciliopathies or with certain metabolic disorders associated with obesity in general.

Retraining Fat to Burn

The complexity of fat cells extends even further. Instead of just one type of fat cell, there are two. Fat cells, also called adipocytes, come in two varieties: white and brown. White adipocytes store fat in one large droplet and release fatty acids for other tissues to use, say for hormones. Brown adipocytes have many smaller droplets of fat and use it to generate heat. Researchers have found, however, that with long-term exposure to cold temperatures, some adipocytes look white but act brown. These beige or “brown in white” (brite) adipocytes are thought to shift due to a protein called “fat-specific protein,” or FSP27. By understanding how FSP27 manages to change the action of white adipocytes, researchers hope to identify pharmaceutical interventions to help people lose weight. A team led by Jun Liu, M.D., Ph.D., received a Mayo Clinic Center for Biomedical Discovery award to study FSP27, and their latest publication looks at the effect of bariatric surgery on FSP27 expression in an animal model. Since many people managing obesity opt for surgery, this type of research helps understand how that intervention works at a cellular level.

Ultimately, basic research into fat cells and how they communicate, respond to the body and do their job helps generate the next generation of drugs, devices and surgeries to treat obesity.

But new treatments are only part of the story. People are the other part.  

People and artificial intelligence for the win

Often, says Dr. Acosta, his patients don’t know their obesity can be treated. He says too often people focus on how severe their body mass index is, instead of why that person has obesity. To find the cause, Dr. Acosta and his team, in collaboration with his mentor Michael Camilleri, M.D., are taking a new approach.

They collected data on a variety of well-validated measures from animal and human trials, and gathered that information for 509 patients across the obesity spectrum.

“We then asked the computer, ‘How would you classify obesity if you have these variables in these patients?’” he explains. The computer told them:

• Hungry brain: Patients don’t feel full so they eat a lot of calories

• Hungry gut: Patients feel full at first but within an hour or two feel hungry again

• Emotional hunger: Patients eat for reward, either for a good day or for getting through a bad day

• Slow burn: Patients who burn fewer than expected calories

Dr. Acosta and his team think that patients are evenly distributed between the classifications with some overlap, and there are some people who don’t fit into any of the categories. But for those who have received a research protocol designed for their classification, the team has shown that weight loss is greater than when patients receive standard care.

“We are bringing precision medicine to the management of obesity,” says Dr. Acosta. But that precision comes with a cost. To identify a person’s classification, the volunteer spends two days in Mayo’s clinical research unit. They give blood, stool, saliva and DNA samples. They’re scanned to measure fat mass and tested to see how fast their stomach empties. After all that, four hours of questions.

Not practical for a primary care visit.

So, armed with the data from the study, the team is now validating its classifications and searching for a telltale fingerprint to make the process less intrusive.

“If we can simplify obesity with a blood test and offer a treatment algorithm based on phenotypes, we can move the dial on this disease,” says Dr. Acosta. That, he says, would have a cascade of effects.

“Most times physicians will treat the diabetes, the hyperlipidemia, the hypertension, joint pain, the sleep apnea, the stroke, the depression, anxiety, the cancer, liver disease, the gastric reflux, but they ignore the cause: obesity,” he says. “It’s one treatment instead of 14 pills. But they don’t have the tools.”

What Dr. Acosta’s team, supported by Mayo's Center for Individualized Medicine and the Center for Biomedical Discovery, is doing now is identifying new targets with single cell RNA sequencing, which examines the RNA instructions within a specific type of cell, and using multiomics — which combines information from our genome, microbiome and other “omes” — to dig deeper into the phenotypes and identify new treatment possibilities.

“We need the basic science information to understand how the target works and compounds that might be an option for the new protein, molecule or whatever so we can bring it back to the bedside,” says Dr. Acosta.

And not a moment too soon.

“People with obesity are more likely to die from obesity,” says Dr. Acosta. “And if we put that in years and we compare someone with obesity versus someone who does not have obesity, they will live 13 years less. So obesity matters, for many of us.”

The good news is that fat tissue is getting the attention it deserves. Discovery research in the lab and the clinical setting is contributing new information on both fat and obesity. And there’s a lot more to come.  Researchers are aiming for no less than the Big Bang Theory of obesity. “There's been a lot of great work done, but I wouldn't say there's that unifying theory,” says Dr. Jensen. “Yet.”

After 34 years, it’s just getting interesting.

-        Sara Tiner, November 2019

Mayo Clinic and Dr. Acosta have a financial interested related to a technology referenced in this article.

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ANSWER: Genetics play a role in determining your weight. But that’s not the whole story. Environment, lifestyle and healthy choices still contribute a great deal to how much you weigh. And your genes also make a difference in the type of weight-loss strategies that may work best for you. When deciding how to move forward with achieving weight loss, all of these factors must be considered.

Obesity is a significant concern in the U.S. According to the Centers for Disease Control and Prevention, or CDC, two-thirds of Americans are overweight, and one-third of people in this country are obese. That’s a problem, because obesity is associated with many serious health concerns, including diabetes, heart disease and stroke. The CDC also estimates that the annual medical cost of obesity in the U.S. is about $150 billion per year.

With two-thirds of the U.S. population overweight, it’s clear that a better way to manage weight is needed. Rather than approaching weight loss as if everyone has the same problem, a more individualized strategy is needed.

Genetic analysis can be useful for creating an individual approach to weight loss. For example, your genetics can make a difference in factors such as how full you feel as you eat, your appetite levels, and how your body uses energy and burns calories. All of those — energy expenditure, level of fullness, appetite, body composition and gastric emptying — can be measured and evaluated. Specific types of testing also can reveal how your body responds to certain medications.

That information can be very valuable in crafting a weight-loss program that fits your body’s needs and make it more likely that you will be able to lose weight and keep it off over the long term.

An example of how this type of careful evaluation can make a difference can be seen in the use of weight-loss medication. Currently, the U.S. Food and Drug Administration has approved five medications for weight loss in people who are obese. Usually, when these medications are used, about 30 percent of people will not respond, seeing little or no effect on weight loss due to the medication. About 30 percent will respond in a modest way. And about 30 percent will have a significant weight-loss response — equaling a loss of more than 10 percent of total body weight in a year.

Recent studies show that, depending in part on an individual’s makeup, health care providers may someday be able to use specific testing and genetic analysis to select the right medication for the right patient. In the future, genetics also may help to show how effective weight-loss procedures, such as gastric bypass surgery or placement of an intragastric balloon, might be for an individual.

It is important to note, however, that medical treatment for weight loss, such as medication and surgery, must be accompanied by lifestyle changes that include a healthy diet and regular exercise. Without dedicated attention and effort put into those areas, no weight-loss intervention can succeed over time. — Dr. Andres Acosta, Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota

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September is Ovarian Cancer Awareness Month. On the next Mayo Clinic Radio program, Dr. Carrie Langstraat, a gynecologic oncologist at Mayo Clinic, will discuss treatment options for ovarian cancer and the hopes for improving early detection.

Also on the program, Dr. Andres Acosta, a gastroenterologist at Mayo Clinic, will review a new, individualized approach to treating obesity through the Mayo Clinic Center for Individualized Medicine. And Dr. Justin Kreuter, medical director for the Mayo Clinic Blood Donor Program, shares the new eligibility guidelines for blood donors with previous cancer diagnoses.

Here's your Mayo Clinic Radio podcast.

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September is Ovarian Cancer Awareness Month. On the next Mayo Clinic Radio program, Dr. Carrie Langstraat, a gynecologic oncologist at Mayo Clinic, will discuss treatment options for ovarian cancer and the hopes for improving early detection.

Also on the program, Dr. Andres Acosta, a gastroenterologist at Mayo Clinic, will review a new, individualized approach to treating obesity through the Mayo Clinic Center for Individualized Medicine. And Dr. Justin Kreuter, medical director for the Mayo Clinic Blood Donor Program, shares the new eligibility guidelines for blood donors with previous cancer diagnoses.

To hear the program, find an affiliate in your area.

Follow #MayoClinicRadio, and tweet your questions.

Mayo Clinic Radio is on iHeartRadio.

Mayo Clinic Radio produces a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

Access archived shows.

The post Mayo Clinic Radio: Ovarian Cancer Awareness Month appeared first on Mayo Clinic News Network.

September is Ovarian Cancer Awareness Month. On the next Mayo Clinic Radio program, Dr. Carrie Langstraat, a gynecologic oncologist at Mayo Clinic, will discuss treatment options for ovarian cancer and the hopes for improving early detection.

Also on the program, Dr. Andres Acosta, a gastroenterologist at Mayo Clinic, will review a new, individualized approach to treating obesity through the Mayo Clinic Center for Individualized Medicine. And Dr. Justin Kreuter, medical director for the Mayo Clinic Blood Donor Program, shares the new eligibility guidelines for blood donors with previous cancer diagnoses.

To hear the program, find an affiliate in your area/

Miss the program this week?  Here's the Mayo Clinic Radio podcast.

Follow #MayoClinicRadio, and tweet your questions.

Mayo Clinic Radio is on iHeartRadio.

Mayo Clinic Radio produces a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

Access archived shows.

The post Mayo Clinic Radio: Ovarian cancer / individualized obesity treatment / blood donor guidelines appeared first on Mayo Clinic News Network.

Precision medicine research has shown that one size does not fit all when it comes to medical care. Early career investigators can bring new ideas and perspectives to the search for treatments tailored to a patient’s unique needs. These are the goals of Andres Acosta, M.D., Ph.D., and Mrinal Patnaik, M.B.B.S. – this year’s recipients of the Gerstner Family Career Development Awards in Individualized Medicine.

Each year, Mayo Clinic Center for Individualized Medicine selects Gerstner Award recipients to promote a specialized workforce capable of moving individualized medicine from discovery into patient care. This initiative provides important seed money for early-stage investigators to conduct research to predict, prevent, treat and even cure disease through individualized therapies.

An individualized approach to fighting obesity  

Dr. Acosta has identified different types of obesity, based on a person’s gut-brain function, genetics and lifestyle. The Gerstner Award will allow Dr. Acosta to advance his research to:

• Identify factors that can predict how patients within the different types of obesity respond to weight loss therapies.
• Uncover genetic differences among obese patients that can be used to develop targeted treatments.

“Thanks to the Gerstner Award, we hope to move from a one-treatment-fits-all approach to the right treatment for each patient. We want to develop individualized strategies that lead to successful weight loss and long term weight control, allowing patients to live a healthier life. ” says Dr. Acosta.

Searching for treatment for a rare, aggressive blood cancer  

Chronic myelomonocytic leukemia is a rare, aggressive blood cancer that affects patients who are in their 70s. With no effective treatment to date, most patients die within two years of being diagnosed.

With the Gerstner Award, Dr. Patnaik aims to:

• Define how the NRAS gene, a gene known to affect the disease, actually causes this fatal condition.
• Use patient tumor samples grown in both mouse models and petri dishes to evaluate the effectiveness of different therapies.

“While this rare, aggressive blood cancer only affects four out of 100,000 people, we see many of these patients at Mayo Clinic. With the support provided by the Gerstner Award, we will be able to address the urgent need to develop an effective treatment for this deadly disease,” says Dr. Patnaik.

Learn more about previous Gerstner Award recipients.

Register for the 2017 Individualizing Medicine Conference

Learn more about precision medicine and how that can be applied to improve diagnosis and treatment for many conditions at Individualizing Medicine 2017: Advancing Care Through Genomics.

The Mayo Clinic Center for Individualized Medicine, is hosting the sixth annual genomics conference, October 9–10, in Rochester, Minnesota.

• Register today via the conference website.
• See the schedule.
• Review the list of speakers.
• Follow the latest news related to the conference on the Center for Individualized Medicine blog, Facebook, LinkedIn or Twitter at @MayoClinicCIM and use the hashtag #CIMCon17.

Mayo Clinic Center for Individualized Medicine is hosting the conference with support from the Jackson Family Foundation.

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