Setting the top 10 priorities for obesity and weight-related research (POWeR): a stakeholder priority setting process

Objectives To identify and prioritise the most impactful, unanswered questions for obesity and weight-related research. Design Prioritisation exercise of research questions using online surveys and an independently facilitated workshop. Setting Online/virtual. Participants We involved members of the public including people living with obesity, researchers, healthcare professionals and policy-makers in all stages of this study. Primary outcome measures Top 10 research questions to be prioritised in future obesity and weight-related research. Results Survey 1 produced 941 questions, from 278 respondents. Of these, 49 questions held satisfactory evidence in the scientific literature and 149 were out of scope. The remaining 743 questions were, where necessary, amalgamated and rephrased, into a list of 149 unique and unanswered questions. In the second survey, 405 respondents ranked the questions in order of importance. During the workshop, a subset of 38 survey respondents and stakeholders, agreed a final list of 10 priority research questions through small and large group consultation and consensus. The top 10 priority research questions covered: the role of the obesogenic environment; effective weight loss and maintenance strategies; prevention in children; effective prevention and treatment policies; the role of the food industry; access to and affordability of a healthy diet; sociocultural factors associated with weight; the biology of appetite and food intake; and long-term health modelling for obesity. Conclusions This systematic and transparent process identified 149 unique and unanswered questions in the field of obesity and weight-related research culminating in a consensus among relevant stakeholders on 10 research priorities. Targeted research funding in these areas of top priority would lead to needed and impactful knowledge generation for the field of obesity and weight regulation and thereby improve population health.

How can we combat the genetic component contributing to obesity-desire to eat/appetite, less ability to feel satisfied with food, preference for high calorie food? 23 Is obesity hereditary? 24 Is weight gain hereditary? 25 Is obesity hereditary? 26 I would like to know if genetics play a part. 27 Is obesity genetic? Can anything be done to prevent it?

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How true is the public belief that they are predisposed to be overweight -the broad sweep statement that genetic factors are to blame for a huge proportion of the weight issues observed 29 Do genetics play a big part in obesity? 30 Are there inherited factors to obesity? 31 Is obesity genetic 32 How big a role does genetics play in familial obesity? 33 Why can some people eat what they want yet others put on weight when they do the same 34 What are the direct effects / mechanisms of poverty in relation to obesity 35 What are the impacts of poverty and socioeconomic status on heal th; on body weight; and on health related stigma? What policy decisions could effectively address and reduce the health disparity and life expectancy disparity between richer and poorer communities in Britain? 36 What are the key drivers in SES disparities regarding overweight/obesity? 37 What is the relationship between poverty and obesity? 38 Why are people from a lower socio-economic background more likely to have overweight or to be obese? 39 Is there a link with peoples income and them being overweight 40 Why is it that some people can eat what they like n not put on weight yet I only have to look at food and the scales go up.

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How true is the public belief that they are predisposed to be overweight -the broad sweep statement that genetic factors are to blame for a huge proportion of the weight issues observed 29 Do genetics play a big part in obesity? 30 30. Are there inherited factors to obesity? 31 Is obesity genetic 32 How big a role does genetics play in familial obesity? 33 Why can some people eat what they want yet others put on weight when they do the same 34 What are the direct effects / mechanisms of poverty in relation to obesity 35 What are the impacts of poverty and socioeconomic status on health; on body weight; and on health related stigma? What policy decisions could effectively address and reduce the health disparity and life expectancy disparity between richer and poorer communities in Britain?

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Is it not what you do but how many different things you do? I.e. the impact of whole systems... 94 What has worked for you in the past and why you could not maintain your progression? 95 What are your long term goals? Where would you like to be in 5 years' time?

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Have you ever tried to lose weight before? How many times? And what was the outcome? -past experiences will help to find better solutions/option for a particular person 97 How can we maintain healthy behaviour patterns in relation to eating and exercising? 98 How can I maintain a healthy weight and lifestyle? 99 What characteristics of weight loss interventions are likely to lead to LONG-TERM MAINTENANCE of weight loss? 100 What are the evidence based interventions to maintain weight loss. 101 What's the best strategy to keep the weight off, once lost? 102 What is the most successful strategy to prevent weight regain? 103 Is there any method of weight loss that is reliable in the long term? 104 Once I lost some weight how avoid putting on again? 105 How to sustain weight loss or avoid increasing weight gain when obese if? 106 What are some of the most successful interventions in getting people to lose weight, and keep it off? 107 How to maintain the weight loss? 108 How can we ensure weight loss is sustained in the long term? 109 What is the best way to maintain weight loss 110 What is the best/most effective way of losing weight and keeping it off long-term? 111 How to achieve sustained weight loss 112 23. maintaining weight lost 113 What are the best regimes for long term weight management 114 How to prevent weight gain 115do es Having lost weight do you find it creeps back on and maybe even goes up?
116 Why do so many people who lose weight regain the weight they lost? 117 Research into keeping the weight off, once it has been lost as lots of people manage to lose weight and then put it on again. 118 Why do we slip back into destructive eating patterns so quickly? 119 What is the optimal dose of treatment contact required to prevent weight regain?
120 How can we maintain the modest weight loss achieved by lifestyle intervention or moderate weight loss achieved by VLED on the long run? 121 How can we apply a whole systems approach to weight loss maintenance? 122 Is there enough focus on transitioning from weight reduction to the maintenance of healthy weight? 123 Is weight maintenance feasible for any or many pts in weight loss programmes, and is this vital for health improvements 124 What is the best way to keep weight off in middle age? 125 What impact does it have on long term weight loss if the whole family is considered and not just the obese person in isolatio n 126 Identifying how much support is needed for weight maintenance 127 What creates success in weight loss? The dietary change/ choice or the long term support? 128 Research on services and messaging that focuses on behaviour change rather than weight loss 129 Which dietary strategies produce the most sustainable weight loss? 130 Why are weight loss programmes (weight watchers and slimming world) not effective in the long term? 131 Do we know which approaches to weight loss actually work? 132 Effective weight loss 133 What effective interventions could we deliver in primary care to help people with overweight and obesity 134 What Public Health programmes or interventions actually influence people to eat a healthy diet? 135 How do people lose weight easily? 136 How can I shift weight easily? 137 What works to reduce weight? 138 How to lose weight 139 Aside from restriction of calories and using more energy what else can I do to reduce my weight 140 For those who are already living with overweight/obesity, what are the most efficacious, cost -effective strategies and how can these be implemented? 141 How I can make changes in my diet so I can lose some weight?

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Which weight loss methods are the most effective and long lasting? E.g. calorie counting, exercise, group support, portion control, food group's exclusion etc.

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Has the person dieted, was this successful 144 Effective weight loss intervention development 145 How effective current treatments for obesity is m, are there any clinical treatments 146 How can people lose weight? 147 What is the most successful diet 148 What is an easy way to lose weight 149 How do I lose weight? 150 What is the best and correct advice to give to patients 151 Evidence based guidelines for weight loss 152 What actually is the best eating plan to follow it's a minefield out there so much advice on tv books etc. is there research that could prove the best eating plan to reduce weight then maintain it healthily 153 A holistic approach to weight loss 154 How can we help people change their lifestyles to maintain weight lost with very low energy diets?  How effective is schema-focused therapy in weight management? 156 How can we better engage people with weight loss services? 157 What could services do to encourage you to help yourself? 158 What can be done to help people stick to new healthy eating behaviours? 159 Why is weight loss maintenance so hard? 160 Why is it so hard to keep weight off after you lose it? 161 What are the best tools/technologies to help people adhere to long-term dietary and physical activity goals? 162 How do we get people to eat healthily and reduce obesity? 163 How to make lifestyle changes 164 What is a healthy lifestyle? 165 How to engage people (children and adults) who are overweight in weight management programmes 166 What are the barriers that prevent people from losing weight? 167 What stops you from losing weight? 168 What do people with obesity think is their biggest barrier to losing weight and keeping it off? 169 What are the real barriers in engaging the population in healthy eating for their children? What specific strategies help to avoid temptation in an environment filled with food cues? 217 How does the obesogenic environment directly affect obesity rates? 218 Why, despite public awareness are there so many fast food outlets? 219 How can we change the behaviour of policy makers / town planners to restructure the obesogenic environment? 220 What is the impact of policies looking to change the built environment? 221 Implementation of healthy planning/ obesogenic environment 222 How can we change the environment to help prevent obesity? Should we implement more taxes, reduce advertising or do more? 223 How can we make environments less obesogenic? 224 Governance of food environment-thinking in systems 225 How can we adapt our environment to encourage less sedentary behaviour (through town planning/workplace policies/nudges etc.)?

226
Whether is it possible to navigate the obesogenic environment without gaining weight or whether the obesogenic environment is has to change? 227 What do we need to change in the environment to support people to have a health weight?

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Which health policies that target the obesogenic environment (e.g. town planning, advertising restrictions, taxation) are most effective at reaching low socio-economic groups? 229 The obesogenic environment is a fairly new development, so why can't it be designed away again? 230 The impact on neighbourhoods built to promote active lifestyles on obesity and prevention of obesity. 231 How can better urban planning actually be implemented? 232 Modification of food environment 233 What makes people remain a healthy weight in an obesogenic environment? 234 How do we best prevent obesity in the first place; and how do we best lose weight over time if we have a few extra pounds? 235 How obesity can be *prevented*, rather than cured. 236 How to take sufficient,& sustainable preventative measures soon enough in a life to combat obesity 237 How to treat obesity and prevent it 238 What is best way to prevent, is it to never be obese or to fight it later? 239 Have any governments taken effective steps to tackle obesity, and could we learn from this? 240 What kind of public health promotion programmes and campaigns should governments be promoting/investing in? 241 More research into how other countries are managing to avoid having the same proportions of their population as overweight or obese. 242 What policy interventions can influence either obesity or other health outcomes related to obesity? 243 What kind of public policy changes are effective at helping people lose weight (e.g., traffic light labelling, calorie counts)? 244 What societal changes could be implemented easily / cheaply / at a local level -that would help reduce obesity 245 What community intervention strategies are successful for promoting weight loss in obese populations? 246 Do we have good evidence for community-based weight loss and management interventions? 247 What are the effects of population level or systems level interventions? 248 Is a wider public health rather than a targeted approach better of best used at the same time 249 How can we apply obesity prevention strategies at the population level? 250 What has research shown about if it is easier / cheaper to prevent obesity related diseases? 251 Early screening and intervention. Let's get creative, appropriate, and effective -what works?

252
Why doesn't medical intervention via paid subscription to a club or group start at 15% overweight, when it's still possible t o see results and do exercise instead of waiting until 100%+ overweight, when exercise is impossible and loss so slow you ever see any end to dieting 253 What is the impact of the development and implementation of national food policies to support healthy weight in public settin gs such as schools and hospitals? 254 What influence does fast food advertising have on children obesity? 255 Should the government put heavy taxes on unhealthy processed food/drinks and heavily subsidise healthy organic whole food/drinks? 256 What is the impact of increasing sugar tax or other legislation to encourage healthier eating 257 How important are things like the sugar tax and food labelling in the prevention of obesity? 258 What is the widely held (including public) opinion on "fat taxing" or strict industry/commercial sanctions? 259 Should food and drinks manufacturers be given a "cap" for products (i.e. limited to so many calories, fat, sugar, etc?) 260 Any research connected to people living with obesity who are serving long term imprisonments? 261 How come side effects differ so much from person to person 262 We know that bariatric surgery is currently the most effective treatment for people with severe obesity (e.g. BMI > 40), yet most people with severe obesity don't choose this option even when it is available. Should dietetic and psychological resources be invested in preoperative setting or in post-operative settings? 269 Statistics to weight gain after so many years 270 What are the energy requirements with and without CVD and/or weight resistance exercise post bariatric surgery? 271 Although l don't eat much feel my metabolism lowered with band and gain weight very easy 272 What is the short and long term psychological impact of Bariatric Surgery? 273 How best to integrate exercise with commuting BMJ Publishing Group Limited (BMJ) disclaims all liability and responsibility arising from any reliance Is there enough emphasis on combining healthy eating and exercise and a way of combating obesity rather than purely dieting? 300 How important is exercise in weight loss? 301 Is calorie controlling best way to control weight? 302 What is the best combination of dietary and physical activity strategies to maximize weight outcomes and appetit e? 303 What is the best form of exercise to lose weight? 304 what is the most efficient exercise to lose weight 305 Most effective exercise 306 What types of sport contribute to a reduction in obesity for those that don't regularly play or do sports.

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What kind of exercise do I need to do and how often to lose weight? 308 Best forms of physical activity for weight loss/maintenance 309 What are the health risks of being overweight/obese but physically active? Does being physically active despite being overweight reduce disease risks of being overweight?

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To what degree is higher weight due to more muscle OK vs higher weight due to more fat? Basically is it alright be to slightly overweight if it's 'all muscle'? 311 How can we widen access to effective weight loss support services for people affected by obesity? 312 Does regional variation in provision of obesity services have a positive or negative correlate with regional prevalence of -and trajectories in -obesity 313 How can obesity strategies be applied in practice? 314 What are the best early interventions that can be administered in primary care 315 Why can I get a gastric bypass on the NHS, but not Slimming World? 316 Do integrated lifestyle services offer equivalent outcomes and/or better value than individual programmes? 317 Should patients have direct access to Tier 3 services? Esp. those of high BMI 318 What is the effect of tier 3 weight management services on people with obesity? 319 How effective and cost-effective are level/tier 3 and 2 weight management services. 320 Are Tier 3 treatments better than How confident are health professionals when raising the issue of weight, and what is their current skill level to have these conversations 334 How can health professionals be more effectively utilised to support behaviour change conversations during routine interactions 335 Consultation skills: confidence and capabilities of health care professionals in raising the issue in any points of contacts 336 … Training and education requirements of different healthcare professionals to advice on nutrition on diet the role of p harmacists in weight and obesity management… (Split -rest of question used in two other sections)

337
How can we support implementation of obesity guidelines such that very person with obesity is offered significant support to reduce their weight with an acceptable chance of it working? 338 Is weight loss through diet or surgery of benefit for patients with type 1 diabetes? 339 Is weight loss surgery a good option for the severely obese, or would lifestyle changes/diet effect a similar long-term result? 340 Should the threshold for consideration bariatric surgery be lowered? 341 Is there any medication than can control appetite and suppress urges that is safe 342 Is there an effective satiety-inducing drug or other intervention? 343 About the design of drugs for obesity, should it focus on drugs for weight loss or should it focus on drugs not to recover lost weight? 344 Where do medications fit in the treatment pathway? 345 Design of a new obesity measure apart from BMI.

346
A new 'BMI' i.e. we know that BMI is often not relevant. Would be great to come up with a new 'scoring' system related to risk with weight 347 Why is BMI still used as an indication of healthy weight? 348 Is the BMI a good guide to healthy weight? 349 Why is BMI still used to define obesity? 350 With BMI being the crux of determining whether a person is overweight or not -is this notion now somewhat outdated? 351 Is BMI a reliable indicator of obesity, or not? 352 Why obesity seems somehow to be related to height but not frame size 353 To produce a better version of a weight measure than BMI 354 What better ways are there to assess weight other than BMI? 355 Accurate diagnostic criteria for obesity 356 Is our definition of obesity accurate 357 How accurate is a BMI as a guide to health if you are not an average body type? 358 What is the best way to estimate someone's healthy weight?

359
When will a more appropriate classification of obesity be made, focusing on the origin of the disease, which is necessary for a better treatment? 360 Is the BMI an appropriate way to decide if you're overweight for everybody, e.g., for BAME people? 361 How do I tell if I am a TOFI -Thin on Outside, Fat on Inside (i.e. around vital organs). I might be thin looking but have hidden fat issues.

362
The role of visceral fat [We are becoming increasingly aware that you can be 'skinny' but still unhealthy with regards to general health with high amounts of visceral fat.] 363 Clothing size could be used as a measure of weight. 364 What are the body composition changes post-bariatric surgery with and without weight resistance exercise? 365 What is the best, simple measure of adiposity in children?

366
Why is poor quality (highly processed) food so much cheaper than fresh/healthy food and how to get consumers to appreciate th e health implications of each? 367 How can we make whole nutritious food more accessible and affordable than heavily processed foods? 368 What parts of the global food system are tending to increase the availability of unhealthy foods and what can be done to reverse these tendencies? 369 The effect on obesity if healthy food were cheaper and not healthy were very expensive 370 Decrease price of fresh food to enable people on low budget to stop eating processed foods.

371
Changing the environment in supermarkets and high streets -how can these organisations be motivated to improve quality of food choices 372 How can we make healthier food more accessible, attractive and convenient?

373
The effect of the availability of various foods on eating choices and how the current system encourages or discourages the production of "healthy foods"

374
How can we get nutritional advice/information to those most in need -e.g. low SES, obese 375 For people living with financial hardship, do they have access to information on how to eat more healthily for the same amount of money? This is often difficult to achieve. It would be interesting to see what difference education in this area made to outc omes for people and their families. Do people with unhealthy eating habits because of a lack of interest/time to cook, and a tendency to eat fast food, do better if they are educated in ways to make healthy changes that do not take much time and effort?

376
Health choices can sometimes be expensive can we do more to support cheaper locally sustainable options so that people can make healthy choices more partnerships with supermarket chains 377 Why is healthy food so expensive? 378 Pensioners and the widowed find it difficult to access cheap or food for one meals. How can this be addressed? 379 What can we do to make healthier food more affordable and appealing to young people?  The sale of baby foods high in sugars continues to be a factor in the obesity of children. How can produc ers be impacted to produce more healthy foods for children?

381
What research questions need to be addressed to support policy change which leads to stricter industry regulations on the size and composition of unhealthy foods available?

382
Research into whether government funded voluntary schemes for large retailers could help put better choices in front of consumers and change buying habits. 383 What impact does packaging have -for example the packaging of sugary yogurts vs plain yogurts in people's choices 384 Should products have a link to what exercise would be needed if you eat/drink a particular product (ie walking, running for 3 0 minutes)

385
What efforts are being made to identify sugar/corn syrup/harmful additives content in food? Why are harmful vegetable oils st ill being used, especially for take-outs? Can law be passed to embolden the content printing of harmful additives on containers? [How about advertisements/ doing further checks on school meals. Jamie Oliver did some great ground work. We need follow up.] Second part of question used in another section. 386 How is the degree of processing in the creation of pre-packaged foods best identified? 387 Should calories, fat and sugar in items be much more visible on labels and menus (traffic light) 388 How can we change social norms around the consumption of junk food / sugar? 389 The impact of reducing availability of energy dense foods on excess caloric intake 390 How can we encourage restaurants to serve smaller portions (or people to make smaller portions at home)? 391 How can restaurants help with portion control and calorie content of their meals / what impact does this have on ob esity levels? 392 Have you heard of aspartame? 393 How does artificial sweetener affect weight gain or loss? 394 Do we understand the biology of how zero or low calorie sweeteners, particularly diet drinks, effect obesity 395 What role does artificial sweetener intake have on appetite regulation?

396
Do the huge amount of chemicals that are now used in food and drink production methods affect how the body's metabolism/hormones work, are these unpronounceable chemicals contributing to obesity? 397 Do you eat organic foods? [Do you know the benefits of organic & the harm of pesticides?] 398 Are the nutrient and energy levels compromised in GMO crops resulting in malnutrition? 399 Do GMO's contribute to obesity?
400 Do vitamin and mineral deficiencies cause or contribute to weight gain?

401
Natural ways to lose weight without dieting -how to lose the stubborn weight e.g. I only have 1 stone to lose not 10 but it's tough trying to lose it 402 Which is more important on the long run, calorie deficit or macro nutrients composition? 403 Do you see any link with diet and weight loss or weight gain 404 Does the keto diet cause greater weight loss than a non keto diet if the same amount of calories are consumed?

405
What is the right way to eat? High carbohydrate and low fat or High Fat and low carbohydrate? There is so much conflicting information. Why is the medical profession so conflicted? 406 What is more effective and healthy, low carbohydrate diets or low fat diets? 407 Does a low carb diet has long term side effects 408 Is a high fay, low carb diet a good way to stop putting weight on the stomach? 409 Is a well formulated LCHF diet healthy in the long term? 410 Is fat or sugar causing the obesity? 411 Is there a direct link between how much processed food is in a person diet to how many ailments may affect them later in life?

412
What is the impact on weight of eating processes foods? E.g. is there a correlation between eating processes food and increased calorie intake or weight gain. 413 Plant based eating for weight loss 414 Are plant based diets associated with obesity prevention, weight loss, and weight-loss management? 415 Is vegan a good way to reduce obesity? 416 How much meat should we eat? 417 Can being a vegetarian INCREASE weight? 418 Is it better to be vegetarian or eat meat fish etc.? 419 How to make all of us be more aware of the negative impact of high meat intake 420 Is protein from animal sources bad for our health 421 How much harm does a high protein diet do to your body? 422 Effectiveness of VLCD use in specific cohorts e.g. children/adolescents or pregnancy? Is there a way to turn on the "I'm full" switch earlier to avoid overeating 432 After my first diet I went on I got into a bad cycle of dieting or following a plan that doesn't work and end up binging or c oming off the diet. I wasn't that big in the first place but family members were telling me I was Bonny! 433 What is the rate of eating disordered behaviour in people with obesity, particularly those who repeatedly try to lose weight 434 What percentage of people are overweight because of disordered eating (I.e. mental health)? 435 The calorific values of food. how can we accurately assess the amount we eat BMJ Publishing Group Limited (BMJ) disclaims all liability and responsibility arising from any reliance What is lacking (physically, emotionally or psychologically) when someone overeats and can we be taught to obtain this from another source? 471 Why are some people unable to not or stop eating foods they know are bad for their health? 472 Best methods to suppress appetites 473 How is the "I'm full now -you can stop eating" response triggered? 474 Should we start our weight management by sleeping more? 475 What happens in the brain during weight regain? 476 What parts of the brain can we turn off to control the addiction?

477
Is there an answer in neuroscience that actually physically disable the part of the brain responsible for the addiction? We d o don't become addicted to alcohol / drugs etc. so young because we are not exposed to them, but we are exposed to food, and the pattern is set. 478 Impact of Autism on eating patterns 479 Does stomach muscles have a direct link to satiety? If you have loose stomach muscles due to pregnancy , will you not feel fu ll how much ever you eat 480 Energy Requirements for pre and post bariatric patients at various stages after surgery (e.g. 6mo, 12 mo, 18mo, 24mo)?

481
How do changes in body weight and composition influence the energy balance behaviours that may undermine weight management interventions 482 Diagnostic algorithm for cardiovascular risk stratification in patients with obesity 483 How much does the microbiome affect absorption and which foods (if any) can keep it at its optimal level 484 The mechanism behind the effect of the gut microbiome in obesity development.

485
To look at the microbiome of level 3 weight management services and see if they carry particular obesity genes and to see what the diversity of their gut microbes look like. 486 How does the microbiome influence body habitus -using metagenomics could contribute to this question 487 Can faecal transplant impact weight 488 Does healthy bacteria in the intestines affect /reduce weight gain? 489 Can improving gut bacterial alongside dietary/ exercise interventions help increase weight loss and maintain weight loss? 490 How can we change our gut microbiome to help maintain a healthy weight 491 The best forms of pre-and pro-biotics to improve health and facilitate weight loss. To explore the relationship between the over-consumption of antibiotics and the increase in obesity. 495 Can some antidepressant meds cause weight gain; 496 Which, and by how much, do prescribed medications adversely affect the patients weight? 497 Impact of medications on obesity 498 What is the best way to don't put weight while taking sertraline? 499 The effect of obesity on other health issues including dementia, arthritis etc. 500 Does losing weight reduce the risk of cancer and how much weight do you need to lose 501 Does weight loss reduce risk of heart failure in people with known heart failure? 502 Do patients with mild/moderate heart failure benefit from weight loss interventions? 503 Do obese people have more digestive problems than normal weight people? 504 Weight loss plan for those with IBS and Diverticulitis and gluten intolerance 505 Does one specific type of diet work for a single disease (e.g. a vegan diet for cvd)? 506 Relationship between obesity and osteoarthritis (if any) 507 How obesity affects bone health 508 Impact on joints 509 What impact does maintaining a healthy weight have on mobility (knee joints etc)? 510 Knee wear 511 Hip wear 512 In older adults exercise can be difficult due to rheumatic issues. How should diet accommodate this 513 Is it better to aim to be slightly underweight to reduce stress on the joints in old age? 514 The relation between long term illness and weight gain. 515 Pain and Obesity, eating as an avoidance strategy for pain? 516 Why do women with polycystic ovaries often put on a lot of weight 517 What effects do hormonal changes have on weight and how can one differentiate between gain due to hormones vs diet.

518
What level of BMI reduction is required to significantly increase the chance of ovulation for obese women with amenorrhoea as part of PCOS? 519 How effective is weight loss as a treatment for PCOS? What motivates and facilitates people with chronic illnesses who are overweight or obese to lose weight? Which biomedical and socioeconomic barriers do people face, that prevent them from being able to lose weight and what can be put in place to overcome these obstacles? 526 What effects does it have on the heart? 527 If my type 2 diabetes is in remission (blood-sugar levels 5.4 or lower), am I still diabetic? 528 Does the amount of sugar eaten worsen liver disease 529 Is red meat bad for liver disease 530 What is the impact of diagnosing non-alcohol related fatty liver disease as a motivator for people to lose weight 531 What evidence is there that children and teenagers post liver transplant will find it challenging to maintain a healthy weigh t? 532 Are obese people more likely to get colds 533 Why do some men have man breasts [People suffer mental health issues due to this] 534 How much does obesity limit and impact our life 535 What impacts does obesity have on health 536 The role in obesity in relation to prevention of ill health? [Because prevention at an early stage will help improve the quality of life for a vast number of people] 537 By how much does being obese affect your predicted life span 538 What is the life expectancy of obese people as compared to similar individuals who are not overweight? 539 What is the impact of obesity on peoples' lives including their life opportunities?

See 77
What are the benefits versus harms/risks of weight loss using different weight loss methods or specific types/groups of people? [If you are genetically pre-disposed to obesity, are you better to live at a higher weight, if trying to reduce your weight leads to repeated weight cycling] (First part of question used in another section) See 323 Do economic evaluations based on modelling of cohorts over-estimate the benefits of weight loss? [Does weight loss return people to the same risk of those who never gained weight in the first place?] (First part of question used in another section)

540
The physiological impact of early menopause and weight gain.

541
Understanding of why women put on weight before menopause when never previously struggled with weight 542 What is the effect of hormones during and after menopause on weight gain 543 Why is weight loss so hard post menopause? 544 I've now come through the menopause and it is even more difficult to maintain a steady weight.

545
Heavy/abnormal periods and whether they are weight related or not 546 Hormones/hormonal process. How they affect? Are these changes real? How could we counteract effects? Hormone injection for weight loss?  The relationship between testosterone levels and visceral fat?

548
We know there is a relationship between high levels of visceral fat and low testosterone levels, and this is also associated with higher CVD risk. Is the converse true? Are higher levels of testosterone associated with lower levels of visceral fat and/or overall CVD risk 549 What impact do male/female hormones have on appetite/weight/metabolism? 550 Does a baby in utero have a higher risk of becoming obese if Mum is obese during pregnancy? 551 How targeting prenatal development can reduce obesity risk 552 How can we prevent young women gaining excessive weight, including during and between pregnancies.

553
What is the effectiveness of weight management programs in the postnatal period and does this lead to a reduced BMI in subsequent pregnancies? 554 Weight increase in pregnancy 555 What is the most effective method to reduce gestational weight gain in obese women?

556
We're you breastfed as a baby? [As a mother who has struggled with breastfeeding but has persevered due to the many health benefits, I would like to know more and to have better research on the impact of breastfeeding and weaning on obesity later in life.]

557
Does educating school children about how to make healthy eating choices, prepare nutritious food quickly, and shop for healthy food at a low cost make a difference to their overall health and weight in the long term? 558 Does educating children within schools on healthy eating help prevent obesity? 559 Do you think if prevention was started in primary school your outcomes would have been improved? 560 How to prevent obesity in young people and inform at schools? 561 What more can be done at a primary school level to tackle obesity? 562 Are children educated about this topic 563 How to avoid childhood obesity and help child stay a healthy weight 564 What are the most effective health promotion interventions to halt weight increases in children between the ages of 5 and 11? 565 Which specific factors within health promotion interventions to promote healthy weight on school aged children are effective? 566 Why/how/what has had an impact on the areas where we are seeing a reduction in childhood obesity? 567 How can we reduce childhood obesity and make sure children grow up with healthy diets? 568 What are the most effective interventions for the prevention of childhood obesity globally and are they implementable in the UK? 569 Weight in children 570 Policy to promote healthy lifestyle and physical exercise from early age 571 What age does healthy eating need to be established in order to prevent adult obesity?

572
What works in preventing childhood obesity? What works to help people maintain a heal thy weight? What works long term to help people lose weight? The influence of mind over body in obesity? 573 Childhood obesity prevention 574 How can childhood obesity be prevented? 575 How to prevent obesity in young people and inform at schools? 576 Should counselling be provided to school children who are overweight? 577 Maintenance of a healthy diet, with group counselling all the way through school. 578 Should schools place a higher priority on nutrition education and cooking skills? 579 Would increasing the provision of home economics e.g. cooking skills, budgeting skills, reduce the incidence of adult/childhood obesity 580 Would better nutrition/cookery courses throughout a child's WHOLE school life make a difference to their understanding of healthy eating? 581 What are the essential elements of school food education programs that help children learn positive food behaviours? 582 How can we educate/promote sensible choices from childhood when sugar is everywhere? Would this make more sensible adults? 583 How can effective school food education programs be leveraged to influence the home environment? 584 How do we encourage parents to establish healthy eating habits in their kids? 585 Are parents educated to the consequences of bad eating habits in their children?

586
There is a need for greater funding for personnel and locations for education of parents regarding healthy nutrition. How can this situation be reversed and made more of a priority? 587 How to help families with children under the age of 11 avoid their children putting on too much weight 588 How can we best support children and families to change long term behaviour for weight loss 589 How do we engage parents in meaningful conversations to raise the topic of overweight/healthy growth in an effective manner? 590 What is the best way to encourage children to eat healthily? 591 How can we most effectively engage with an adolescent population regarding diet & exercise? 592 Diet and weight in adolescents. 593 How best to engage teenagers in exercise programmes? 594 What can we do to keep children active into adolescence and adulthood? 595 Would 1 hour a day of physical activity / sport per day in state schools lead to improved health and obesity levels in children and adolescents and improved habits and health in to adulthood? (97% of school population in the state sector. Independent schools already spend more time doing sport than state schools.) 596 Strategies to prevent weight gain young adult 597 What support is best for obese teenagers? 598 How to prevent childhood obesity -particularly in UK ethnic minorities and deprived populations. 599 How do we iron out the social gradient in obesity prevalence, particularly in children?

600
Children between 1 year and 4 years are found to be overweight by health visitors. They do not qualify for a healthy weight and exercise programme until they are 4. What are the best ways of managing these children?

601
Practical education and will help confront the problem and bring resolution. Group therapy is effective amongst a group of people who experience great social difficulty. 602 How to encourage Healthy meals uptake in school settings 603 Is adult obesity related to parental attitudes to food and eating?  Can we improve coded weight/height/BMI data for children in the GP record? I have an interest in Childhood obesity and would be interested in considering process that would help to code weight related data in the primary care record. There are currently over 27,000 children aged 0-16yrs with registered GP practices in Oxford alone, of these only 19 children had recorded BMI >25, yet we know through NCMP data the prevalence of higher weight status far exceeds this, plus we know very few contacts with families through current programmes for tackling this (e.g. 2019 NCMP only generated 4 referrals in Oxfordshire)

605
What are the current effects of the National Childhood Measurement Programme in terms of weight trajectories, health care usage, and mental health? 606 Is NCMP fit for purpose if, as in many places, it is to become a screening programme/pathway into child weight management? 607 What are the repercussions of obesity in childhood, in later life? 608 Does obesity impact on children's long term educational outcomes? 609 Does obesity impact on children's long term life chances? 610 How does obesity impact on children's happiness, confidence and mental health? 611 To explore the relationship between adverse childhood events (ACES) and obesity at a population level. 612 The relationship between ACE and obesity (either childhood development or adult). 613 Did you have an easy/stress free childhood? 614 Do childhood or adolescent negative events have an impact on unhealthy eating? 615 Is there a connection with mental trauma in childhood to obesity? 616 We need more research into the role of childhood trauma in causing obesity and / or weight related issues in adulthood. 617 Childhood trauma and being morbidly obese 618 What treatments for obesity should be available to children/adolescents?

619
What effective management options are there for paediatric obesity -who should people be referred to/supported by? And how widely available/accessible are these currently? see 748 … Is there any improvement in the figures for schools which provide lunches/boarding schools? (First part of question answered see

748)
See 385 [What efforts are being made to identify sugar/corn syrup/harmful additives content in food? Why are harmful vegetable oils still being used, especially for take-outs? Can law be passed to embolden the content printing of harmful additives on containers?] How about advertisements/ doing further checks on school meals. Jamie Oliver did some great ground work. We need follow up. (First part of question used in another section) 620 How to get the rest of your family on board with supporting in your efforts to transition to a more healthy routine 621 How do participatory approaches with families within the community setting influence implementation and influence on healthy weight behaviours?

622
Parents often do not engage with healthy weight programmes because they deny their children are overweight. How can parents be more active in recognition of overweight children? 623 How much is related to socially and family dysfunctional lives 624 How do we assess and monitor diet quality in infants, older children and adolescents in a valid, robust, consistent and pragmatic way? 625 How can I make quick and easy meals with minimal effort so that I lose weight? 626 Can you cook 627 Benefits of local communities teaching basic cookery skills 628 Encouraging people to grow healthy foods 629 Has the plethora of cookery related programmes on TV had any impact on the nations diet or are they pure entertainment, unrelated to what/how people eat 630 Are images of obese people in dieting information sheets motivating or demotivating. 631 Do food choices based on environmental and sustainability concerns influence weight status in young people?

632
If we change the words and conversations we have around weight and bodies and food, could this be the biggest difference we n eed in battling the emotional, mental and physical damage done to us by over or under eating, and society's obsession with the body perfect? 633 What are the consequences of weight stigma on physical health 634 How can we combat obesity stigmatisation and discrimination? 635 How can we reduce weight stigma and discrimination in the society? 636 What can be done to change society's attitude towards obese people? 637 What terms could be used instead of obesity to describe the policy area? 638 What are you doing to prevent people being/feeling shamed because of their weight? 639 How can we reduce obesity stigma? 640 How can we reduce the stigma of weight regain? 641 10. What communication is needed to change public perception of Obesity? 642 What are the effects of weight stigma? 643 How should stigma around obesity be dealt with? 644 How can we combat weight stigma? 645 Help to address the stigma around weight and weight loss 646 How can public health messaging about overweight/obesity be delivered to maximise effectiveness and minimise stigma?
647 Do GPs assume that obesity is the fault of the patient rather than something to do with food marketing and/or healthier food availability for poorer people?
648 What can we do to shift an entrenched view within our society (including among some healthcare professionals) that those living with overweight/obesity are entirely responsible for their condition? 649 Is there an institutional bias against people with obesity in NHS England, trusts, CCGs and the country in general? 650 Can we reduce weight bias in health professionals (GPs, nurses, dietitians)? 651 Do health staff treat obese people differently, and less favourably, than those of recommended weight? 652 How can we reduce health inequalities for obese people, wrt prejudice they may face from medics, whether conscious or unconscious? 653 Do GPs assume those with lower BMIs (20-25) are somehow healthier (or more likely to be healthy) than those with higher BMIs? Are overweight people less likely to receive appropriate health investigation as obesity is seen as causative first, rather t han following the same diagnostic route that you would immediately follow with a person whose weight is considered normal/acceptable?

656
Why are people who are obese not given the same access to healthcare? People who are obese are blocked from receiving NHS sur gery by virtue of their weigh. Why is the NHS discriminatory against obese people in the supply of surgical procedures? 657 Does obesity stigma influence healthcare professional referral practices 658 Is access to primary care compromised for people classified as overweight or obese because GPs tend to focus on that rath er than the concern/symptom the patient actually presented with?

659
Explore whether how all health care professionals are trained around obesity perpetuates weight stigma attitudes which are th en reflected in their delivery of care 660 What words used in a GP consultation influence a person's desire to change their eating habits? (Evidence based)

661
How can GPs tackle consultations regarding weight loss in the most sensitive manner? Should the emphasis be on diet as opposed to weight at all? 662 Are you happy with your weight? 663 I, as an individual, have been received as better thin than fat. 664 Do current BMI bands and definitions make sense to the public?

665
What forms our image of a healthy body and how can this be used to promote a healthy weight and how society be educated in what is a healthy body weight? 666 Why is obesity accepted as a norm and not treated as a serious problem? 667 Is society's acceptance of obesity creating a feeling in the obese that it is okay to neglect yourself i n the way? 668 Is the body positivity movement ok? Is it ok to celebrate morbidly obese body shapes? 669 What role does constant media talk of the obesity crisis or 'drain on NHS have on weight bias and perpetuating obesity? 670 How does the internet, and specifically social media, affect the drive to eat? 671 Does social media influence eating behaviours? 672 What role has the media played in causing obese people to have low self-esteem? 673 How much is obesity related to education and personal responsibility 674 Why don't people who are obese make an effort to lose weight? Is it a lack of dietary understanding; poor motivation: or acceptance of their body image? 675 Why do people continue to be obese, when we have plenty of evidence to tell people how not to be? 676 Is it a mind-set problem that causes people to be obese and not deal with it? 677 What role should personal responsibility play in obesity discussions? 678 Why is there not more emphasis on personal responsibility when it comes to weight control? 679 Why don't people take ownership of their own health practices 680 What is the link between depression and being overweight 681 How does being overweight make you feel? 682 Mental health and obesity 683 The psychological reasons that trigger obesity 684 What is the psychology behind obesity? 685 How would you relate your weight to you mental health? 686 Mental Health issues, probably also relates to question above 687 Correlation of mental health issues with obesity. 688 Totally life changing after being depressed about weight gain 689 How does obesity affect mental health? 690 What causal mechanisms link the social experience of obesity to poor mental health outcomes? 691 Have you considered obesity as a mental health issue, as well as a physical one? 692 Is there a non-physiological trigger for obesity (such as a psychological trigger like bullying which lead to comfort eating)? 693 Is there any correlation between mental health illness and obesity? 694 The physiological impact of stress and weight gain. 695 What are the effects of diet culture and a focus on weight loss on individuals' mental health? 696 What are the physical and mental health effects of repeated dieting 697 How have past diets impacted on my health? 698 What is the impact of repeated dieting on health? 699 Understanding the impact of repeated attempts to change lifestyle habits e.g. is there a parallel with quit attempts 700 How does others perspectives on a person's weight impacted their mental health? 701 Why are there so many physical, mental and emotional implications from being overweight? 702 Why is obesity detrimental for people? 703 What's the effect of obesity on self confidence 704 Over-giving to others as an defence against low self-esteem and driver of obesity 705 How do you feel as a fat person How do people view you as a fat person Do fat people smell Are thin people better than fat people 706 How does obesity affect social behaviour and self-esteem? 707 How does being obese impact social interactions, and how obese people feel they are perceived?

708
We need more research into how, if we help individuals identify and understand how they are feeling, that aids a reduction in emotional (non) eating. 709 Can interventions that address emotional or social overeating be effective? 710 Does therapy help to eliminate emotional eating l 711 How to break the habit of using food for comfort. 712 What mental health/emotional support best helps a person living with obesity? 713 Overcoming psychological barriers to weight management -can this lead to weight loss when the focus is not on weight? To look at the impact of trauma focused therapy upon weight loss 718 Research further: Eating is used as a psychological avoidance strategy to avoid contact with past trauma which causes beliefs /feelings of "I'm not ok or I'm empty" and as a way of avoiding experiencing present feelings and negative thoughts? 719 How to maintain good mental health when struggling with your physical health -in this case, obesity. 720 To ask when the client first started eating more food. 721 How do I get surgery on NHS my dr says lm depressed and my health suffering 722 How should weight management services and pathways be optimised for populations with serious mental illness?

723
The link between obesity and depression is well known. Yet why is it, in the absence of thorough investigatory medical care, antidepressants are prescribed to obese people without explanation that these drugs will contribute to weight gain? How to minimise late night comfort eating 739 Why do some people crave carbohydrates and do some people react differently to certain carbohydrates. 740 Do you eat when you aren't hungry? 741 Why do people eat when they're not hungry? What is the link between emotion and consumption? Is there a biological driver? 742 How unhealthy eating, mental health and alcohol misuse interplay. What is the most effective way in to tackling this? 743 Can overeating be seen as a type of self-harm?

Answered original questions (5.2% of all submitted questions)
744 Obesity vs waist circumference and waist to hip ration for a marker of CVD in adolescent men 745 Has the decline in teaching Food and Nutrition in senior schools had an impact on the diet of society?

746
Why aren't we teaching children about proper nutrition in school? Nutrition that is based on the latest research, not 30 -40 year old findings. 747 Is there a link between social deprivation and childhood obesity?

748
Which groups of kids are most likely to be obese in school (socio economic background, ethnicity, gender, etc.), how does this correlate with their mental health and performance…(second part of this question (not written here) is unanswered and has been taken forward) 749 Do weight loss initiatives and diets actually work? What are the associated risks?

750
Carbs, calories, low fat, high starch, syns, points, there must be one method that actually works, without vast expense, thinking of how many have to rely on cheap food, and leaves you not hungry all the time. 751 Will eating more fruit and veg make the energy last longer 752 Does drinking water help you lose weight? 753 What is being done to work with industry to reformulate recipes to be less calorific? 754 How obesity affects fertility 755 impact on fertility? 756 Why do men lose weight much quicker than females? Is this something that research may discover something that could help females? 757 What are the best (short -medium) outcomes to show the effectiveness of weight management in pregnant women? 758 How has pregnancy and have a child affected your weight? 759 The effect of rapid weight loss on your health 760 Is being underweight better than being overweight? 761 The rise in bowel cancer and obesity-is there a causal effect or just a correlation? 762 Is being over weight linked to cancers -which ones? 763 Need to emphasis the importance of rapid weight loss in ending diabetes. 764 Relationship between obesity and diabetes? 765 Diabetes 766 Diabetes and nutrition, and how to prevent or reverse type 2 767 How much weight loss is needed to prevent those at high risk developing T2DM? 768 Type 2 diabetes now gone 769 Does obesity cause, rather than is it associated with, adverse outcomes? 770 How does obesity affect your health?  What evidence is there for the ways in which weight affect various disease processes? 772 What is the best why to avoid obesity related disease? 773 How much weight gain is permissible before I am at a risk of diseases? 774 What are the five most common health complications that arise from obesity. 775 How does weight impact on chronic illness and function? 776 What is the link between obesity and illness/disability? 777 Related medical condition 778 relationship between obesity and longevity -and is there a genetic tendency to obesity 779 Genetically are we becoming inbred? 780 what are risks relating to gastric band 781 What single change would make the biggest difference to weight loss 782 What is the best second line treatment for late gastric dumping post surgery? 783 Failure of procedure 784 Complications of procedure 785 Are psychological interventions being offered routinely within weight management services in the UK? 786 How does stigma around weight and obesity contribute to difficulties initiating weight loss? 787 What impact does weight stigma have on those trying to lose weight? 788 How mental attitudes impact on people's ability to lose weight 789 Weight stigma and the experience of the overweight/obese 790 Weight-based stigma in healthcare professionals: how this impacts people's ability to lose weight 791 What is the correlation of certain amount of physical activity (run, walk, etc.) with the calories we burn? 792 Would psychological counselling regarding eating behaviours make people more likely to loose weight and maintain it?

out of scope submissions (15.8% of all submitted questions): out of scope / not a research question / too broad / not obesity related / opinion based / unclear/ unclear but similar question in included research question above.
793 What is your correct weight bearing in mind BMI 794 How do I find out what is normal and healthy for my age and gender?

795
How is obesity measured? 796 Why do you think you are overweight? 797 Should obesity be considered a disease? 798 Staging of obesity 799 What is Obesity? Specific definition and subtypes. 800 How to encourage Healthy meals uptake in school settings. 801 How much damage to our bodies and how they work do fad diets actually achieve? Are we not just chasing an expectation that do esn't exist? 802 How to navigate and choose the best diet type? 803 Do you know the three macronutrients? 804 How can I get past health information on food products to understand what is bad in them, not just what is good? 805 healthy diet promotion and education 806 Why is sugar so freely available? 807 Why, as consumers, are we sold unhealthy food to eat? If trans-fatty acids are as bad for our health as is now being said why is the medical profession, the government and the authorities not informing people? Why are they not preventing the sale and banning the production of processed foods containing theses fats? 808 What are the corporate determinants of obesity/body-weight?

809
How do we get government to implement more effective policies regarding selling and producing unhealthy food etc. 810 How does obesity policy fit into wider public health policy? 811 When was the latest guidance on nutrition in obesity published and who recommended/reviewed it.

812
What is the current and best guidelines to use 813 How much natural, non-processed food do you eat? 814 The only downfall is the excess saggy skin Is it possible to be 'overweight' but still in good health? 815 Does a 'healthy' BMI always reflect healthy physiology? Can you be overweight and healthy? 816 Can one be healthy at any weight? 817 My parents are both type 2 diabetic, lifestyle-induced. Does this mean I am certain to be as well? 818 Do you have any medical / physical conditions 819 Should obesity be recognised as a disease? 820 Is it calories in and then exercise means calories out ?

821
How can we bring more 'eating behaviours' interventions into standard practice? 822 Do we need to focus on body weight or risk factors/health? 823 Lap band had 12 years ago worked but broke last feb had removed had bypass in june in latvia at much expense dudnt work 824 will there be a miracle cure in the future? 825 Is there a "cure" for obesity?

826
What are the psychological contradictions for Bariatric Surgery?  Should there be more psychological assessment available for those with obesity other than those with diagnosed eaing disorders? 828 Post operative psychological advice is lacking. This is only open to specific individuals? Other than funding, why has th is not be identified as an integral part of the bariatric process 829 Would psychological counselling regarding eating behaviours make people more likely to loose weight and maintain it? I am about to start a program of counselling as a pre requisite for bariatric surgery. I have also had experience with Overeaters Anonymou s. I feel that half the battle when it comes to obesity is mental & emotional. 830 Can obesity now be labelled as an eating disorder as it is without a doubt disordered eating and results from many if the sam e complex psychological, emotional and behavioural issues as anorexia, bulimia etc and can have equally devastating results mentally and physically. 831 Psychologically informed services, training etc 832 Do fat people need to feel bad about themselves? 833 Do you enjoy food 834 To ask the client how they think they would feel if they were able to lose weight and what they miss doing the most. 835 Do you require and emotional or psychological help or guidance? 836 Do you think you would be happier if you were not obese? 837 Are you happy with your size 838 Can increased metabolism rate means you can eat more food 839 How do you speed up your metabolism? 840 On a scale of 1 to 10 (with 10 being the happiest), how happy are you with your weight? 841 What would make it a 10? 842 What could we do to help you make it a 10? 843 What could you do to help you make it a 10? 844 What do you already understand about obesity and weight management? 845 to change diets and attitudes to food 846 Does shaming obese people really work 847 Why are the aids via drugs which are available in the USA ignored in the uk 848 Are there safe drugs available to treat the condition? 849 Is there a magic pill that you can take to lose weight? 850 What level / amount of physical activity / exercise do you undertake in an average week 851 What is you weekly routine in terms of "movement": how often do you exercise, do you walk to work -if yes how far, do you walk up the stairs or use the escalator and so on, if you have a dog, do you take i t for a walk and how long are those, how busy is you after work life: do you have to manage the kids or do you come home and sit in front of the TV. 852 Does the person do regular exercise to manage weight 853 Do you do any exercise? 854 What can we learn from the epidemiology of obesity to help in terms of prevention? 855 Do you think it's possible to lose weight and would you like help to lose your excess weight. 856 Why if you ever manage to lose weight, having wasted your life in fat, does the nhs refuse to assist with skin removal, thereby giving you a body to be proud of instead of a grotesque thing to hide, which will inevitably be refilled 857 Do you know what services are available to support weight loss? 858 The type weight-loss programme that is suitable dependent upon size, age and physical health presentation. To reduce potential risk of injury, stroke or heart attack 859 Are researches into obesity funded by government? 860 Who should help patients lose weight? What is the evidence that things such as MECC actually works? Or should we leave it to professionals with obesity treatment experience? 861 The cost to the NHS for adapting specialist equipment 862 What kind of help do you feel that the NHS could provide? 863 How do you feel about your weight? 864 Does malnutrition (diet of poor nutritional value) increase the risk of obesity 865 What food combinations best help you to lose weight? 866 Crisps or not 867 Have you drunk any fruit juices? 868 What is the truth about milk? 869 Butter and full fat milk ? 870 Successful interventions for disorders which lead to weight loss 871 Xxxxxxx 872 Is there as much time/money spent on obesity-related diseases as those related to being severely underweight? 873 Re-formulate how weight with other factors is 'healthy' and 'unhealthy' 874 Can we identify at an individual level what rate of weight loss is optimal to avoid harmful complications such as excess skin, gallstones etc 875 How and best to support our most difficult patients 876 Success rate for each procedure 877 healthy lifestyle initiatives at Primary Care level 878 How strong/reproducible is that evidence? 879 How can guidelines best communicate uncertainty and variability to the public? 880 What is the impact on the offspring of mum having hyperglycaemia in pregnancy?   How do genetic factors, physiological and metabolic processes affect weight status, weight gain and regional fat distribution? What are the mechanisms involved? Do these factors affect the ability to lose and maintain body weight? Do weight loss programmes tailored to a person's genetic makeup or physiology produce greater weight loss than untailored programmes? 7.45 (2.20) 18 Do interventions that target the 'obesogenic environment', such as community interventions, urban planning, placement of fast food outlets or workplace policies, affect population mean weight and do these effects differ by baseline weight status (underweight, healthy weight, overweight, obesity)? Which of this type of interventions are most effective at reaching low socio-economic groups?

=53
Does eating a diet high in processed foods make losing weight, maintaining lost weight, or gaining weight more likely? Do diets high in processed foods lead to a higher incidence of weight-related illness, such as diabetes or heart disease, independent of body weight status?

=53
Does eating a diet high in processed foods make losing weight, maintaining lost weight, or gaining weight more likely? Do diets high in processed foods lead to a higher incidence of weight-related illness, such as diabetes or heart disease, independent of body weight status? 24. Does prolonged psychological stress affect bodyweight? Do interventions that aim to reduce stress increase weight loss in people living with overweight and obesity compared with interventions not addressing stress? 25. Do interventions that address emotional or social overeating lead to weight loss or weight loss maintenance? 26. What is the relationship between emotions and appetite or energy intake? 27. What changes in supermarkets or the wider food industry are effective in promoting healthier diets? Does changing labelling and/ or packaging on foods affect purchasing, consumption and body weight? 28. Do interventions in primary care prevent obesity? What are the effects of offering weight management referrals on the prevalence of obesity? 29. How accurate are existing models of the health consequences of excess weight and the impact of weight loss? Which assumptions are critical in determining the long-term effectiveness and cost-effectiveness of weight loss interventions? What is the impact of weight regain on the incidence of disease and cost-effectiveness of weight loss interventions in these models? 30. How does the brain control food intake and can we use knowledge of these mechanisms to aid weight loss? What are the brain responses to food during weight loss and following weight regain?
8. Is attempting to follow intermittent fasting (including 5:2, every other day diet, etc.) or time restricted eating (e.g. 16:8 or eating between specific hours of the day) effective for weight loss and weight maintenance? Is intermittent fasting or time restricted eating more effective than calorie restriction alone? Are the benefits from inte rmittent fasting or time restricted eating (e.g. metabolic health, general wellbeing) independent from weight loss? Are there any side effects or health risks from intermittent fasting or time restricted eating? 9. Do people crave or become addicted to certain foods and, if so does this cause obesity?
Can treatments reduce pica, food cravings or addiction? 10. Do interventions, including clinical follow-up, after bariatric surgery prevent weight regain? What are the adverse consequences of bariatric surgery and can these be predicted? Why do people living with severe obesity eligible for surgery decide not to proceed with the surgery and do they take up other interventions? What are the psychosocial consequences of bariatric surgery for example, on intimate relationships and eating disorders, and do these vary by social and cultural group?