By Dr. Richard Koletsky

Editor’s Note: The Dr. Paul Ernsberger research scholarship fund was established through the generous gift of one of Dr. Ernsberger’s colleagues. Here, Dr. Richard Koletsky, who was Dr. Ernsberger’s research partner for many years at Case Western Reserve University, gives us more insight into their work and why it’s essential that Paul’s approach be carried on by the next generation of researchers. 

Paul Ernsberger was a brilliant scientist, teacher and humanitarian. NAAFA has decided to create an award to honor his memory and promote work in his field. Paul fought against our society’s prejudices against obesity and argued for honest reviews of data regarding the effects of obesity and the need for evidence-based treatments. He fought against incorrect information, social taboos and psychological pressures. He espoused studying, explaining, teaching and promoting information to fight misinformation regarding weight issues.

His scientific studies centered around metabolic syndrome: a constellation of medical conditions that includes insulin resistance, often leading to diabetes mellitus, high blood pressure and hyperlipidemia. Metabolic syndrome is associated with increased morbidity and mortality.

By studying the effects of various diets and drugs on metabolic syndrome, Paul sought to understand how metabolic syndrome developed and how it could be prevented and treated. He sought to understand all the complicated interactions of exercise, diet, drugs and surgery. He used his training in neuropharmacology to explain how the nervous system played a role in promoting and promulgating metabolic syndrome, and used similar approaches in developing and testing treatments.

He was always concerned about the efficacy and safety of diets, pharmacologic interventions, and surgery for metabolic syndrome. Paul’s work pointed out that treating one aspect of metabolic syndrome with a particular diet or drug could, at the same time, adversely affect another aspect. He showed that weight cycling (yo-yo syndrome), often seen in weight loss programs, promoted more weight gain in the long run and increased metabolic syndrome morbidities and mortalities as well.

He understood all the uncertainties and shortcomings in approaches to behavior and lifestyle modifications that are used to treat metabolic syndrome. He was a fierce advocate for honest reviews of treatments for metabolic syndrome and spoke at government hearings when diets, drugs, or surgery used to treat metabolic syndrome were being evaluated for approval.

Paul was always deeply interested in making sure that his work was understood by his students, patiently spending time explaining, demonstrating and supervising their work. His students were motivated by his enthusiasm. He gave them a lot of explanation and attention. We had students  who ranged from high school students, to undergrads, to medical to pre-med, as well as masters and doctoral candidates

. We ran the whole gamut of students, and we had technicians who were not getting degrees but who worked in our lab. Anyone who worked in the lab was openly encouraged to ask questions, make suggestions, and participate. Our lab was friendly, helpful, and supportive. Nobody was too good to help someone else no matter what level they were. We never considered people as working for us; we always considered people as working with us.

Paul felt strongly about bias in medical care and the use of body mass index (BMI) as a measure of health especially rankled him. Paul knew that the social war on the overweight was based in part on oversimplified ideas about body measurements, like weight and BMI, contributing to misunderstanding of the health of fat people. 

Everyone is aware of the ways that structural inequality impacts access to food, information, and healthcare. Paul was aware of those aspects and his aim was to apply  the research we’d done to databases of information for thousands of people. He understood that physical, mental, and social health are all part of wellness, and he wanted people to have access to information so they could make better choices in order to live their best lives.

There’s not one pathway that’s right for everyone when it comes to wellness, and Paul knew people would be better able to figure out their pathway with more information. Providing financial support for the next generation of researchers who understand this approach ensures that the progress Paul made continues to advance. Prioritizing funding for students who are underrepresented in the sciences also helps create more possibilities that other labs can be as inclusive as ours was, and Paul would’ve been delighted to help enable that to be so.

Dr. Richard J. Koletsky graduated from the School of Medicine at Case Western Reserve University and is an endocrinologist in Cleveland, Ohio. On the faculty of the CWRU medical school, he worked with Dr. Paul Ernsberger for thirty years, sharing interests unraveling and explaining the metabolic syndrome. They published numerous basic science articles and won awards presenting their work at scientific meetings. They also wrote in social journals regarding misinformation and pitfalls in public perceptions of weight related issues. 

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