The BIG challenge

A spotlight campaign on obesity research

With over 60 percent of the adult population either overweight or obese and more than 2.7 million people diagnosed with type 2 diabetes, the health burden and economic impact of obesity in the UK are increasing.

The National Institute for Health Research (NIHR) is currently supporting research into the condition across 43 obesity-related studies. We’ve selected four of these studies to give an insight into the experiences of patients and the work of researchers and health professionals across England.

This diverse set of studies will also help you better understand the range of ways the BIG challenge is being addressed by the research community. It’s also a sign of what’s to come.

The NIHR has just issued a national call for new research to address UK obesity levels. We’re asking the research community for innovative research for the prevention and treatment of obesity in adults and children. Find out more about the call.



The By-Band-Sleeve study

Around 6,000 operations take place each year in the UK that are designed to help people lose weight. This is known as bariatric surgery. There are three types of bariatric operations, but it is unknown which one is the most effective option for patients in the long term because of a lack of good evidence. As a result, the choice of surgery in most hospitals is based on a combination of the patient’s and surgeon’s preference. But which operation is really most beneficial to long-term health, and which offers the most cost effective option for the NHS? By-Band-Sleeve is the biggest study of its type in the world addressing these questions. By taking part in the study, over 300 patients across England approved for bariatric surgery are already helping the research team work out which is the best choice: the gastric bypass, the gastric band, or the gastric sleeve…


Get the participant’s perspective

Diane Chadband is a mother of three who has recently undergone a gastric band operation as part of this study. When her GP recommended she go on a weight management programme, surgery was the last thing on her mind…

  • Watch Diane’s interview




Get the chief investigator’s perspective

Professor Jane Blazeby is Professor of Surgery and Honorary Consultant Upper GI Surgeon at University Hospitals Bristol NHS Foundation Trust. She’s passionate about engaging the surgical community with the benefits of clinical research…



Get the surgeon’s perspective

Richard Welbourn is a consultant surgeon at Musgrove Park Hospital, Taunton. He’s keen to make choices based on robust clinical evidence, not just personal experience…



Get the Lead Nurse’s perspective

Nicola Salter is the Lead Nurse for the study, based at Musgrove Park hospital, Taunton. She feels there are clear benefits for all patients at her Trust undergoing weight-loss surgery, not just those taking part in the study…


More about the By-band-Sleeve study

Find out in more detail about the By-Band-Sleeve study

Sponsor - University of Bristol

Funding - By-Band-Sleeve is funded by the National Institute for Health Research Health Technology Assessment (NIHR HTA) Programme (project number 09/127/53). Any views or opinions expressed are those of the authors and do not necessarily reflect those of the HTA programme, NIHR, NHS or the Department of Health.



The ACUTE study

Over 2.7 million people are diagnosed with type 2 diabetes in the UK. It’s a condition that leads to a number of other health problems, for example if you’re affected you’re up to five times more likely to develop heart disease or have a stroke.

Currently, people at risk of developing type 2 diabetes are advised to take part in moderate-to-vigorous physical activity for at least 150 minutes a week. So that could be a brisk walk, or a fast bike ride. ACUTE is a study that explored a new way of addressing prevention of this condition amongst inactive, overweight or obese women.

The study found that breaking up prolonged bouts of sitting with just five minutes of standing or walking every 30 minutes significantly reduced blood sugar and insulin levels. Importantly, the effect of the activity lasted until the following day.


Get the participants’ perspective

Ann Grimes and Jan Cashmore took part in ACUTE, the results of which have changed the way they live aspects of their day-to-day lives…


Ann Grimes

Get the Lead Researcher’s perspective

Dr Joseph Henson is the study’s lead researcher and PhD student who is based at the NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit (BRU)



Get the Lead Nurse’s perspective

As the lead nurse for ACUTE, Stephen Hartshorn spent a considerable amount of time with participants, acting as their “advocate” during their involvement with the study…



More about the ACUTE STUDY

Find out more details about the ACUTE study

Sponsor University of Leicester Funding NIHR Biomedical Research Unit (BRU) NIHR Senior Investigator Award


Mental Health

The STEPWISE study

People with schizophrenia are two to three times more likely to be overweight or obese than the general public. Weight gain can affect their lives in a range of negative ways. For example, it can lead to long-term health conditions such as diabetes and heart disease and it is thought obesity may also play an important role in stopping people taking their antipsychotic medication. The aim of the STEPWISE study is to find out if a lifestyle education programme can help people with schizophrenia manage their weight more effectively. It is also designed for people who have recently experienced their first psychotic episode, so the study team can look at the prevention of obesity, not just its treatment.

The programme is based on a lifestyle intervention originally developed by the University of Leicester DESMOND team, to reduce the risk of type 2 diabetes. It includes four weekly sessions with clinicians and follow up sessions after three, six and nine months all focussing on diet and exercise.


Get the carer’s perspective

David Shiers is a retired GP who developed a keen interest in obesity and mental health when his daughter was diagnosed with schizophrenia aged 16. His experiences as a carer have played an important role in shaping the STEPWISE study… (David is also a topic expert for the current update of NICE guidance on psychosis and schizophrenia in children and young people: these are his personal views and not those of NICE)



Get the researcher’s perspective

Professor Richard Holt is the Chief Investigator for STEPWISE and Professor in Diabetes and Endocrinology within Medicine at the University of Southampton…



Get the community psychiatric nurse’s perspective

John Pendlebury is a community psychiatric nurse who has been working on weight prevention programmes in mental health for more than a decade. His work in his local community laid the foundations for the STEPWISE study…



More about the STEPWISE study

Find out more details about the STEPWISE study

Sponsor Sheffield Health and Social Care NHS Foundation Trust Funding STEPWISE is funded by the National Institute for Health Research Health Technology Assessment (NIHR HTA) Programme (project number 12/28/05). Any views or opinions expressed are those of the authors and do not necessarily reflect those of the HTA programme, NIHR, NHS or the Department of Health.


Brain Imaging

Brain imaging studies

People’s brains respond to food in different ways, and it is this relationship that provides the foundation for Dr Tony Goldstone’s brain imaging research. Dr.Goldstone uses magnetic resonance imaging (MRI) of the brain to see how it is affected by obesity, gut hormones and weight-loss treatments. Studies examine:

  • Effects of being hungry – for example when fasted compared to having eaten a meal;
  • Gut hormones – for example when given an injection of a hormone that alters appetite;
  • Different diets or surgical treatments for obesity (e.g. gastric bypass and gastric banding).


Get the participant’s perspective

Bozena Bajer feels that taking part in a clinical research study has given her a much better understanding of her operation and her condition… Read about Bozena’s experience



Get the researcher’s perspective

Dr Tony Goldstone’s mantra is behaviour, not Body Mass Index (BMI). In order to develop improved treatments and prevention programmes for obesity, he believes we need to better understand what creates and maintains the condition…


More about the brain imaging studies

Find out in more detail about this programme of brain imaging studies 

For information about brain scanning studies currently looking for volunteers visit these websites:

Location NIHR/Wellcome Trust Imperial Clinical Research Facility Funding Medical Research Council (MRC) Wellcome Trust


Get involved in clinical research

Explore the range of ways you can get involved in clinical research, as a participant, or as someone who helps to shape the studies themselves:

Visit the “How you can get more involved” section of our website

Visit the “Getting involved” section of the National Institute for Health Research website

Useful info