There is considerable individual and population based variation in the relationship between body fat, lifestyle and the risks of obesity-related morbidities. While at the simplest level, diabesity can be considered as a form of evolutionary mismatch, it is now clear that there are multiple important genetic, developmental (epigenetic and learned) components as well as environmental components. While most focus has gone on secondary prevention through life style interventions, the results in general have been disappointing. There is ongoing debate about population-based interventions both from a policy basis and from an effector basis. The developmental perspective suggests approaches to primary prevention. Studies of the gut microbiome may offer new insights into population differences and approaches to treatment. The implications of the various domains of science presented at the meeting will be put into the context of how translation of emerging knowledge both supports and confronts current policy settings relating to obesity and its morbities.