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Research

Obesity and its complications are the greatest public health threat of the 21st Century and a key NHS priority, backed by the Foresight Report and the Healthy Weight, Healthy Lives Strategy.
I lead Nutrition and Metabolic Research at the University of Liverpool. My groups' research objectives focus on developing new treatments and strategies to reduce the burden of obesity-related disease. The team's expertise ranges from clinical research with patients to linked projects in adipocyte biology, functional neuroimaging of how appetite control is disturbed in obesity & endocrine disease, and studies of liver and muscle metabolism in obesity, diabetes and metabolic-associated fatty liver disease.

I established a clinical investigation laboratory in the Clinical Sciences Centre at Aintree; this was refurbished in 2017. Research activity includes clinical trial work, measurements of metabolic changes during meals and during hyperinsulinaemic euglycaemic clamps, quantification of autonomic nervous system activity using measurements of heart rate and blood pressure variability and non-invasive measurements of arterial stiffness using pulse-wave analysis and measurement of body composition, appetite and energy expenditure using indirect calorimetry. Themes include studies of appetite regulation (including gut hormones) in health and disease and investigation of abnormalities in autonomic regulation of blood pressure and heart rate control that occur in insulin-resistant states such as obesity, type 2 diabetes and obstructive sleep apnoea and relate these to the metabolic disturbances. I have been involved in the design and conduct of studies of novel treatments for obesity and diabetes such as orlistat, sibutramine, leptin, PPAR activators, GLP-1 and other incretin analogues and SGLT2 inhibitors, in collaboration with industrial sponsors. I have set up collaborative projects with several other groups across the NHS in Liverpool including neurology, cardiology, and respiratory medicine, with project grants and / or fellowships from the British Heart Foundation, Diabetes UK the NIHR and Asthma UK. I have developed links with the Department of Psychology, as part of a Liverpool-wide initiative to collaborate in obesity research. Recent projects include ECAL, a study using indirect calorimetry to support weight management in severe obesity and STRIVE, a collaborative study of liraglutide in UK obesity services. I am a co-applicant on two NIHR programme grants for applied research – PROGROUP – a trial of group treatment for people with severe obesity (PI Jonathan Pinkney, Plymouth), and a study of type 2 diabetes in young people (PI Prof Melanie Davies, Leicester) and a role as Chief International Investigator for several commercial trials in obesity management.

I successfully bid for funds to pilot and audit the development of a comprehensive NHS-funded obesity service (the first in the North West), which has now expanded to provide services across Liverpool and Ashton, Wigan and Leigh and a ‘one-stop’ service for patients in Cumbria and Lancashire. This has attracted national attention, and provides an important core resource for ongoing & future research.

Research Interest 1

My research interests concern the pathophysiology and treatment of obesity and type 2 diabetes. I have extensive experience in the design and conduct of clinical trials in these areas. My group has expertise in the hyperinsulinaemic euglycaemic clamp and other measurements of insulin sensitivity in vivo, non-invasive measurements of heart rate variability and baroreflex sensitivity, pulse wave analysis, measurement of body composition, metabolic rate and hormonal assessment (eg insulin, leptin, ghrelin, adiponectin). Preclinical expertise includes study of metabolism (assessment of insulin secretion and sensitivity) in animal models of obesity and type 2 diabetes, and molecular and in-vivo studies related to control of energy balance such as intracerebal administration of compounds and assessment of feeding, and measurement of expression of relevant hypothalamic neurotransmitters

Research grants

Type 2 Diabetes (T2D) in 16 – 40 year olds: A Multifactorial Management Intervention to Address Multimorbidity in Early-Onset T2D in Adults (The M3 Research Programme)

DEPARTMENT OF HEALTH & SOCIAL CARE (UK)

January 2021 - December 2025

Development and feasibility of a behavioural intervention to increase physical activity in people who have undergone bariatric surgery (PARIS)

DEPARTMENT OF HEALTH & SOCIAL CARE (UK)

September 2018 - August 2022

PROGROUP ImPROving GROUP treatment for people with severe obesity

DEPARTMENT OF HEALTH & SOCIAL CARE (UK)

May 2021 - October 2026

Characterising the metabolic disruption caused by brief periods of reduced physical activity in people with a family history of type 2 diabetes mellitus (T2DM).

DIABETES UK (UK)

March 2014 - December 2017

DECIDE study: Dapagliflozin Pragmatic Randomized Trial

MEDICINES & HEALTHCARE REGULATORY AGENCY (MHRA) (UK)

April 2018 - October 2024

MECNUT: Impact of dietary exposure to emulsifiers on the intestinal mucosa - implications for inflammatory bowel disease and metabolic syndrome

MEDICAL RESEARCH COUNCIL

November 2017 - September 2021

Research SPR

AINTREE UNIVERSITY HOSPITAL NHS FOUNDATION TRUST (UK)

January 2018 - March 2021

Randomised, single blind study to assess efficacy of combination therapy of dapagliflozin with exanitide LAR versus exanatide LAR monotherapy in obese (BMI>35 kg/m2) patients with type 2 diabetes mellitus (RESILIENT)

ASTRAZENECA LIMITED (UK)

July 2016 - December 2024

Genetics in diabetes

AINTREE UNIVERSITY HOSPITAL NHS FOUNDATION TRUST (UK)

February 2017 - December 2017

Indirect calorimetry for measurement of energy expenditure in humans

AINTREE UNIVERSITY HOSPITAL NHS FOUNDATION TRUST (UK)

January 2015 - June 2015

Clinical Sciences centre

AINTREE UNIVERSITY HOSPITAL NHS FOUNDATION TRUST (UK), LIVERPOOL UNIVERSITY HOSPITALS NHS FOUNDATION TRUST (UK)

January 2018 - December 2021

North West Diabetes Local Research Network

DEPARTMENT OF HEALTH & SOCIAL CARE (UK)

November 2006 - March 2014

Cardiac autonomic dysfunction in adult growth hormone deficiency?

CHILD GROWTH FOUNDATION (UK)

July 2000 - June 2002

Diabetes Endocrinology Research Fellow

ST HELENS & KNOWSLEY TEACHING HOSPITALS NHS TRUST (UK)

October 2007 - September 2010

Clinical Sciences Centre

AINTREE UNIVERSITY HOSPITAL NHS FOUNDATION TRUST (UK)

January 2015 - December 2018

Diabetes and Endocrinology Research.

LIVERPOOL DIABETES RESEARCH ACTION FUND

April 2006 - December 2007

Tackling Obesity-Related Restrictions in Activities of Daily Living Programmes (TORRNADO)

LIVERPOOL PRIMARY CARE TRUST (UK)

April 2012 - September 2012

Benefits of weightloss in obese patients with asthma: mechanical or immunological mechanisms?

ASTHMA UK (UK)

October 2004 - December 2008

MerseyBeat- Best Evidence, Application and Translation of Research. Obesity in pregnancy a prospective cohort study

LIVERPOOL PRIMARY CARE TRUST (UK)

April 2009 - December 2012

Urinary proteomics in Diabetes and cardiovascular disease

AINTREE UNIVERSITY HOSPITAL NHS FOUNDATION TRUST (UK), WHISTON HOSPITAL NHS TRUST (UK)

November 2011 - October 2014

Research Nurse Support

AINTREE UNIVERSITY HOSPITAL NHS FOUNDATION TRUST (UK)

July 2010 - December 2014

Pancreatic and extra-pancreatic effects of glucose-dependent insulinotropic polypeptide (GIP) in humans in health and type 2 diabetes mellitus

THE NOVO NORDISK UK RESEARCH FOUNDATION (UK)

May 2010 - April 2012

Pulse wave velocity measurement and arterial stiffness in elderly patients with insulin resitance and heart failure.

ROYAL LIVERPOOL AND BROADGREEN UNIVERSITY HOSPITALS NHS TRUST (UK)

April 2004 - December 2006

Does low vitamin D cause adipose tissue inflammation and insulin resistance?

DIABETES RESEARCH AND WELLNESS FOUNDATION (UK)

January 2014 - June 2016

Diabetes Research Support

LIVERPOOL DIABETES RESEARCH ACTION FUND

April 2011 - June 2012

Patients’ expectations, beliefs and attitudes towards glucose-lowering drugs and their effects on body weight in type 2 diabetes: a prospective study and pilot intervention.

AINTREE UNIVERSITY HOSPITAL NHS FOUNDATION TRUST (UK), DIABETES UK (UK)

September 2011 - May 2016

Baroreceptor function, sympathetic activity and insulin resistance in obstructive sleep apnoea.

BRITISH HEART FOUNDATION (UK)

October 1999 - September 2002

MerseyBeat - Best Evidence, Application and Translation of research

LIVERPOOL PRIMARY CARE TRUST (UK)

March 2008 - September 2019

PhD studentship Dr Bing / Prof Wilding

AINTREE UNIVERSITY HOSPITAL NHS FOUNDATION TRUST (UK)

February 2012 - January 2015

Research in diabetes and endocrinology.

AINTREE UNIVERSITY HOSPITAL NHS FOUNDATION TRUST (UK)

June 1999 - July 2012

Roles of peripheral and central cannabinoids in energy homeostasis.

LIVERPOOL DIABETES RESEARCH ACTION FUND

September 2004 - October 2007

The manipulation of ghrelin in the treatment of nutritional disorders.

LIVERPOOL DIABETES RESEARCH ACTION FUND

April 2003 - June 2005

Are the weight-sparing effects of metformin mediated through prolonged postprandial ghrelin suppression? A prospective study of patients with type 2 diabetes mellitus treated with metformin monotherapy.

DIABETES UK (UK)

May 2005 - December 2006

Role of ependyma in controlling feeding in the rat.

LIVERPOOL DIABETES RESEARCH ACTION FUND

January 2003 - December 2006

Obesity and Endocrinology study

AINTREE UNIVERSITY HOSPITAL NHS FOUNDATION TRUST (UK), LIVERPOOL UNIVERSITY HOSPITALS NHS FOUNDATION TRUST (UK)

February 2015 - February 2022