A research group at Stanford recently reported a novel experiment. Three separate vaccines were made against the hormone ghrelin. Ghrelin helps tell you that you’re hungry; it’s time to eat. Two of the vaccines succeeded in making rats gain less weight than they would have through the course of their lives. The new “anti-obesity vaccine” was trumpeted across the world. Some day, readers were told, they might take a shot and eat less for the rest of their lives.

       It was another triumph of media hype, shortchanging hope.

       First, the hype. When leptin, which acts as the yin-yang opposition of ghrelin, was discovered about ten years ago, it was described as the key to the war on obesity. Injecting leptin in rats and mice caused them to stop eating. Human studies were eagerly awaited.

       The results? Nothing. Injecting humans did not cause them to lose their appetites, except temporarily. Weight loss did not occur.

       Though many experiments are performed with rats, mice, and rabbits, translating their success to humans is difficult. Though researchers like to point out the many similarities between rats and humans, we live a lot longer, have a very different environment, a rather different immune system, and noxious responses to many experimental drugs. As Harvard cancer researcher Judah Folkman said years ago, “We can cure most tumors — in the mouse.”

       Another problem is human energy metabolism. To say it’s complicated hardly qualifies. Media statements that insulin, ghrelin, and leptin determine weight are rather like saying temperature alone determines planetary weather. Energy metabolism in people involves many different pathways. Most researchers admit that some of those pathways are not yet discovered. How they work together is unknown. The effect of microorganisms and inflammation is yet more unknown. What does seem clear is that if you change one element of human energy metabolism, all the rest shift. The system has many checks and balances, back alleys and escape hatches. Many are scientific black boxes.

       What’s particularly unknown is what happens when you make a vaccine against a hormone, like gherlin, that people need. Will some people lose all ghrelin content? Will they stop eating altogether? Will others develop allergies to the vaccine? How many will develop serious illness or die? Recent experience with a human trial of anti-sense antibodies in London, where all the respondents became critically ill, does not bode well for a ghrelin vaccine. Assuming that no disaster occurs, how long would the vaccine’s effect last? Obesity surgery, where part of the GI tract is cut out and imaginatively patched back together, may work in part by lowering ghrelin production. That effect lasts for about a year. Soon after, a lot of people start gaining weight.

       The unfortunate result of vaccinating fat hype is twofold. First, it convinces a credulous public that “miraculous cures” are waiting at the end of the rainbow. If you live long enough, “science” will produce a major treatment that will whisk away your fat, clogged arteries and halfdead brain cells, and convert you into a healthy, young stripling.

       Problem two is that such hype keeps us away from public health measures that do work. People have a fair idea of what health authorities tell them to eat. They suspect they must somehow become physically active. A few are beginning to have a small idea of how sleep and rest affect their weight and overall function.

       But are they willing to do the work to change things? Why should one bother when miracle cures are around the corner?

       Americans remain remarkably optimistic. A full three quarters of obese people in this country recently told researchers they “eat healthy.” A majority also think they “exercise regularly.” These personal definitions generally have nothing in common with what researchers think is healthy behavior.

       The reality is sadly different. A recent study of “minimally” healthy behavior in American adults looked at four factors — keeping body mass index below 25; walking or moving four times a week for 30 minutes; not smoking; eating a bunch of plantstuffs occasionally. The level of compliance among male adults — 3%. Thus 97% did not reach minimal criteria for healthy behavior.

       Reality avoidance is now a national pastime, whether it involves, diet, exercise, the national sleep debt, the Federal debt crisis or foreign policy “successes.” Reality avoidance can be nearly complete and last a long time. When it breaks down, pushed aside by unwavering realities, its destruction can be devastating. Consider the Nasdaq stock market in 2000, or recent promises of suddenly remaking the Middle East.

       There are simple plans out there that should work for the US. Going FAR — Food-Activity-Rest — is one. Getting the population to walk a few minutes after every meal would save ten of thousands of lives and keep millions of people from dementia, while also helping the environment. Such public health prospects receive close to nothing from the Treasury. They are admittedly less glamorous than liposuction, $30,000 defibrillators, or million dollar shock wave machines. Wall Street is very well aware that high technology health care pays much better than keeping the population healthy. The yearly $100 billion in health care profits is not being plowed back into the public health.

       And the hope behind the ghrelin vaccine also remains unreported. This hope involves not its pie in the sky clinical potential but its real scientific worth. Using vaccines can decrease ghrelin hormone. That’s amazing. And cutting ghrelin production long term did effectively change weight in rats. How both processes work is important. They may be particularly important if the effect of bacteria and viruses on weight become understood. So finding out how these processes work deserves research dollars and interest. Not more “miracle cure” reports.

Dr. Matthew Edlund, M.D., M.O.H., director of The Center for Circadian Medicine, is an expert on applied public health, sleep medicine and psychiatry. A former professor at Brown and University of Texas medical schools, he can be reached
via email to DocME@DoctorEdlund.com. And CLICK HERE to subscribe to our new Fitcast, via the iTunes Store.