Focus areas
The Precision Medicine for Obesity Laboratory at Mayo Clinic focuses on understanding and characterizing the complex differences among people living with this disease and on identifying personalized interventions for each patient.
Physiological phenotyping of energy balance
Identifying unique characteristics in people with obesity may accelerate the translation of basic science research in this area. This could result in a better understanding of the disease and lead to innovative new treatments.
The lab's recent studies uncovered several subgroups among people with obesity. These groups are known as obesity-related energy balance and behavioral phenotypes. These phenotypes have distinctive pathophysiological abnormalities that are associated with different responses to obesity medicines.
These phenotypes are:
- Abnormal resting energy expenditure.
- Abnormal satiation.
- Abnormal satiety after meals, known as postprandial satiety.
- Emotional eating behavior.
Dr. Acosta's lab uses precision medicine tools as well as physiology, neuroscience and biomedical engineering techniques to evaluate the diversity of obesity. These tools include well-validated measurements of:
- Food intake by ad libitum meal and nutrient drink feeding paradigms.
- Gastric and intestinal physiology by gastric emptying, gastric volume and accommodation, gastrointestinal hormones, bile acid circulation, and microbiome.
- Brain imaging by pulse arterial spin labeling functional MRI.
- Energy expenditure by indirect calorimetry, nonexercise activity thermogenesis activity and exercise.
Multi-omics cores support this innovative approach to obesity physiological phenotyping, which involves studying genomics, transcriptomics, proteomics and metabolomics in plasma, tissue and stool samples from people with obesity.
Diet and lifestyle intervention
Informed by a deep understanding of the underlying biology of obesity, the lab is pairing diet and lifestyle interventions to each obesity phenotype. The team has demonstrated that its unique PhenoDiet approach is superior to a traditional lifestyle intervention. Now, the lab is focused on understanding the biological improvements seen with PhenoDiet and identifying how each phenotype responds to different nutrients and lifestyle interventions.
Additionally, the lab is developing the Digitally Enhanced Lifestyle Intervention (DELI) tool. DELI uses state-of-the-art digital wearables and sensors, trackers and artificial intelligence to deliver health content and change care management with an individualized and real-time approach.
Pharmacotherapy
Building on the uniqueness of obesity phenotypes, the Precision Medicine for Obesity Laboratory is identifying new, patentable pathways and compounds involved in the pathophysiology of obesity. The lab is developing these targets into new obesity therapeutics.
The lab's research uses a combination of techniques including:
- Advanced cell imaging.
- Brain imaging.
- Gastrointestinal imaging.
- Metabolomics.
- Molecular biology.
- New cell sorting methods.
- Next-generation sequencing.
- Pharmacology.
- Physiology.
- Proteomics.
The research team uses clinical research to identify meaningful targets to manage obesity.
Food intake regulation
Dr. Acosta's lab seeks to understand the regulation of satiation and satiety through the complex interactions among the gut, liver and brain in people with obesity. His research team uses a combination of approaches to understand food intake regulation and modulate these variables to treat obesity.
The lab has developed advanced cell sorting methods to undertake new investigations of human enteroendocrine cells. This population of hormone-secreting cells is found in the wall of the gut. The cells regulate glucose levels, food intake and appetite. Studies using this advanced cell sorting technology help researchers understand the pathophysiological role that enteroendocrine cells play in causing and maintaining human obesity.