Category: Obesity

Misperceptions About Obesity Persist

misconceptions about obesityAccording to a recent survey of 1509 Americans conducted by the American Society for Metabolic and Bariatric Surgery (ASMBS) and NORC at the University of Chicago, 81% cited obesity (along with cancer) as the most serious health threat in our country. Diabetes (72%), heart disease (72%), mental illness (65%), and HIV/AIDS (46%) followed on the list.

The majority (94%) agreed that obesity increased the risk for early death, even without other health issues. Most also believed diet and exercise alone were the most effective methods for long-term weight loss, with 60% indicating they were more effective than bariatric surgery. One-third of those surveyed who were obese reported having never spoken to a physician about their weight, and only 12% of those for whom bariatric surgery may be an option said their physician made the suggestion. Read more

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Childhood Obesity: A Nationwide Epidemic

childhood-obesityOn Tuesday, the U.S. Preventive Services Task Force released proposed guidelines in an attempt to further combat childhood obesity—a nationwide epidemic that has progressively worsened in the past decade. Today, 17% of America’s children qualify for the official categorization and definition of obesity.

The publication is intended to help healthcare professionals and decision makers to make well-informed judgments and choices, thereby improving the quality of health services, and ultimately help curb the increase in childhood obesity. The report outlines the benefits and harms of screening and treatment for obesity in children and adolescents; obesity is not only commonplace in children and adolescents in the United States, but also produces a variety of negative, detrimental health effects—including, but not limited to, asthma, high blood pressure, insulin resistance, and a host of other physical and psychological problems. Read more

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Obesity Fat Distribution and Cardiovascular Risk

The ever-increasing obesity epidemic has placed that risk factor at the front of cardiovascular disease risk assessment and management. But specifically, how does body fat distribution impact cardiovascular risk? In the Keynote presentation, “Obesity Fat Distribution and Cardiovascular Risk,” Dr. Subodh Verma will evaluate the epidemiology and clinical course of visceral fat as it relates to cardiovascular event rates and explain the mechanistic basis of how visceral adiposity leads to cardiovascular disease. Additionally, Dr. Verma will shed light on the role of epicardial fat tissue as a source of inflammatory cytokines in cardiometabolic risk, critique the literature linking weight reduction to cardiometabolic risk reduction, and discuss the current guidelines for the management of cardiovascular risk in obesity.

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Will New AACE Guidelines Help Obesity to be Taken More Seriously?

Updated guidelines strive for obesity to be treated as a chronic condition

The obesity epidemic shows no signs of slowing, with an estimated 640 million people worldwide now considered obese. According to the CDC, every 2 of 3 adults are overweight or obese. Recently, the American Association of Clinical Endocrinologists (AACE), who declared obesity a disease in 2012, released evidence-based management guidelines that recommend obesity be approached as a chronic medical condition. Their rationale for the update? “Obesity medicine lacks comprehensive and evidence-based guidelines that are translatable to real-world clinical care of patients with obesity,” said AACE Obesity Scientific Committee Chair W. Timothy Garvey, MD.
Read more

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New “Fingerprint” of Inflammation Identified in Obesity-Associated T2DM

Researchers at Boston University School of Medicine have identified a new “fingerprint” of inflammation that may be able to predict which patients with obesity may also develop type 2 diabetes. Specifically, inflammatory proteins known as Th17 cells, which are associated with autoimmune conditions, were identified as major contributors to inflammation and hyperglycemia. Although research has already shown inflammation promotes obesity-related type 2 diabetes and related complications, anti-inflammatory drugs have had limited success in treatment. Thus, the findings may provide better insight into the relationship between inflammation and obesity-related type 2 diabetes.

Read more on the study published in the journal Obesity  here.

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Education of Youth Is Key to Promoting Wellness and Alleviating the Obesity Epidemic

Results of a recent study found that among children and young adults with a BMI at the 85th percentile or higher, cardiometabolic risk factors including low HDL-C, high systolic and diastolic blood pressures, and high triglyceride and glycated hemoglobin levels increased with the severity of obesity. Commenting on the study, CMHC faculty member Caroline Apovian, MD pointed out the prevalence of severe obesity in children between 2 and 19 years of age has increased at an alarming rate, from 4% to 6% for the block of years from 1999 to 2004 and 2011 to 2012. However, she said, educating the young, even those as young as preschool age, is key in combating obesity and promoting wellness, citing the Si! Program in Madrid, Spain as a successful example. Read more

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Bariatric Surgery Appears to Cure Half of Patients with T2DM for at Least 5 Years

In a study of obese patients with type 2 diabetes, bariatric surgery was found to be more effective than medical treatment in the long-term control of the disease (for at least 5 years). The study consisted of 60 patients randomized to either medical treatment or surgery (Roux-en-Y gastric bypass or biliopancreatic diversion). The primary endpoint was the rate of diabetes remission at 2 years (defined as HbA1c of 6.5% or less and a fasting glucose concentration of 5.6 mmol/L or less) without active pharmacologic treatment for 1 year. Patients were followed up for 5 years. Among 38 patients who underwent surgery, 19 (50%) maintained diabetes remission at 5 years compared with none of the 15 medically treated patients. The study authors advise continued monitoring of glycemic control because of a potential relapse for hyperglycemia.

Read the complete study here in The Lancet. To learn more from one of the study authors, Dr. Francesco Rubino, be sure to attend the 10th Annual CMHC where he will co-present “Long-Term and Metabolic Effects of Bariatric Surgery” on Friday, October 23, from 3:25 – 4:05 pm with Dr. Lee M. Kaplan.

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Two New Balloon Devices Approved for Obesity Treatment

Two new minimally invasive obesity devices have been granted FDA approval in the battle to achieve weight loss: ReShape™ and ORBERA™ balloon systems are temporarily implanted in the stomach and then filled with saline via endoscopic procedures that take less than 30 minutes and require only mild sedation. Both devices are designed to be left in place for 6 months and work by causing the patient to feel a sense of fullness without altering the natural anatomy of the stomach. ReShape consists of dual balloons that are filled and sealed separately and is indicated for obese adults having a BMI of 30 to 40 kg/m2 with one or more obesity-related conditions. ORBERA consists of a single balloon and is indicated for obese adults with a BMI of 30 to 40 kg/m2 who have been unable to lose weight through diet and exercise alone. Patients receiving either device should continue to participate in a diet and exercise program.

The balloon systems are the second and third devices to be approved in 2015 (Maestro [EnteroMedics], an electrical stimulator that works by blocking nerve activity between the brain and stomach, was approved in January), after a period of several years with no approvals.

For more on the latest developments in obesity management, the Lifestyle and Obesity Management session being held at #CMHC2015 on Friday, October 23, will include a comprehensive look at the “Long-Term and Metabolic Effects of Bariatric Surgery,” presented by faculty experts Lee M. Kaplan, MD, PhD, who was director of the recent FDA workshop on device development for obesity and metabolic diseases, and Francesco Rubino, MD, whose work helped transform bariatric surgery from a mere weight loss therapy to one intentionally aimed at treating diabetes and other metabolic illnesses.


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The Gut Microbiome in Obesity and New FDA Approvals

“Some exciting news in the obesity pharmacotherapy space has occurred, opening up new therapeutic options for an area of metabolic medicine where there remains a great need,” Robert H. Eckel, MD said, referring to last week’s decision by the FDA to approve the obesity drug extended release naltrexone/bupropion (Contrave) and the recommendation by an FDA advisory panel to approve the use of liraglutide, already well known for the treatment of diabetes, in chronically obese patients. In the wake of these announcements, the 2014 CMHC Saturday session and symposia devoted to Lifestyle and Obesity Management are bound to provide much thought-provoking discussion and practical applications for clinicians.

In addition to Dr. Eckel, Caroline M. Apovian, MD will discuss long-term use of obesity medications and sustaining weight loss; Thomas A. Wadden, PhD will present information on behavioral strategies in obesity management; and William E. Kraus, MD will discuss the role of exercise in the modulation of nontraditional CHD risk factors.

Groundbreaking Research
Peter J. Turnbaugh, PhD will discuss his novel research on the impact of gut microbiota on obesity and CVD risk. “Much of what makes us human-many important aspects of our health and predisposition to disease-depends on the metabolic activity of our associated microbes,” he said. Specifically, Dr. Turnbaugh will discuss recent studies implicating gut microbes in obesity, how these interactions are influenced by host and environmental factors, and the potential mechanisms responsible, as well as opportunities for clinical intervention in the coming years.

Rounding out the Obesity day will be Lee M. Kaplan, MD, PhD and Francesco Rubino, MD presenting the latest research and recommendations for bariatric surgery, and Virend K. Somers, PhD addressing the impact of sleep apnea and restricted sleep patterns on cardiometabolic health.

View CMHC highlights – visit CMHC Rewind for featured presentations from the 2014 CMHC.

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