University of Sydney
Associate Professor Amanda Salis (nee Sainsbury) leads basic research and multidisciplinary clinical trials at the University of Sydney’s Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders. Her research aims to help people who are overweight or obese to safely attain and maintain an optimum body weight and composition. Associate Professor Salis’ research focuses on understanding and circumventing the body’s adaptive responses to continued energy restriction, a phenomenon she terms the ‘famine reaction’ that among other effects, increases appetite and reduces energy expenditure. “For me research is personal,” she says. “I used to be severely obese and tried many diets that worked for a while, but found I would inevitably become really hungry and hit a weight loss plateau, despite continued adherence to the diet, and I would give up and regain all the weight, plus more. I wanted to understand why and what could be done about it”. Associate Professor Salis investigates the neuroendocrine pathways that mediate the body’s adaptive responses to energy restriction in obesity, and the subsequent effects on appetite, physical activity, energy expenditure, fat distribution, muscle function and bone mass. Importantly, she has successfully translated her basic research findings on hypothalamic control of these processes to randomised controlled trials in humans. Personally, her understanding has helped her to achieve and maintain significant weight loss. She engages extensively with the wider community to share her knowledge, and is a leading commentator on weight management on national radio, TV, print and digital media. In 2014 Associate Professor Salis was named in the Australian Financial Review and Westpac list of Australia’s Top 100 Women of Influence.
Non-surgical obesity treatments are often ineffective, in part due to adaptive responses to energy restriction that increase appetite and reduce metabolic rate. These adaptations oppose ongoing weight loss, and may also promote disordered eating and adversely affect body composition via hormonal changes that favor abdominal fat accumulation with loss of muscle mass and bone. Thus, current obesity treatments may inadvertently increase the risk of eating disorders, metabolic complications such as diabetes and cardiovascular disease, as well structural diseases such as sarcopenia and osteoporosis. The long-term objective of Associate Professor Salis’ research is to find ways to attenuate these adaptive responses so that more people can safely attain and maintain a healthy body weight and composition. Her prior work at the Garvan Institute focused on identifying brain pathways mediating these adaptive responses to energy restriction and resultant effects on feeding behavior, fat, muscle and bone, predominantly using transgenic mice. Building on the successful outcomes of this work, she is now working to apply this knowledge to clinical practice for more immediate benefit to human health. Her team is using state-of-the art techniques to determine the consequences of adaptive responses to energy restriction on eating behavior and body composition in obese research participants. Additionally, her team is testing novel ways of attenuating the adaptive responses in humans during weight loss, using ketogenic diets, intermittent energy restriction and intuitive eating plans. This transformative research offers the potential to aggressively improve human obesity treatments within the next 10 years.