Obesity
New tools and systems may help patients, primary care clinicians manage obesity
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Using combined and intensive treatments and restructuring care to treat obesity like other chronic diseases may help primary care clinicians and patients better address the condition, according to a commentary and three articles published in the January 25 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
Data suggest an extensive gap exists between recommended obesity care and current practice by primary care clinicians, notes Robert F. Kushner, M.D., of Northwestern University Feinberg School of Medicine, Chicago, in the commentary. “The reasons for the gap are complex owing to multiple physician, patient and medical system factors,” he writes. “Cited barriers include a lack of reimbursement, limited time during office visits, lack of training in counseling, competing demands, low confidence in the ability to treat and change patient behaviors, limited resources, the perception that patients are not motivated and a paucity of proven and effective interventions to treat obesity.”
“In this issue of the Archives, three articles on weight loss for overweight or obese patients have potential implications for primary care practice,” Dr. Kushner writes. The findings, outlined below, provide information on effective interventions for obesity and its complications in primary care settings.
Beijing fights obesity with tape measures
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Primary school students in China’s capital Beijing are being enlisted to help with the weighty issue of growing obesity.
The students have been given tape measures to size up the waistlines of their parents and themselves during the winter holiday, which starts Friday.
The move was initiated by Beijing educational and health authorities in an attempt to understand and combat obesity and encourage a healthier lifestyle.
The skinny on our obesity problem
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The Rowan County Health Department presented the 2009 Community Health Needs Assessment to the Rowan County Board of Health on Jan. 12. Leonard Wood, public health director, described how the department established a Community Health Assessment Committee (CHAC) in November 2008 to begin the process of evaluating citizen and agency responses to health related priorities for Rowan County. The CHAC was composed of 41 Rowan County citizens representing private and public agencies, public education, the medical community, the Board of Health, Cooperative Extension, Healthy Rowan, community foundations, Social Services, Piedmont Behavioral Healthcare, Catawba and Livingstone Colleges, the Hispanic Coalition and other agencies interested in participating in this assessment. In addition, 14 focus groups were held to collect primary health care data from citizens across the county. The themes that kept re-occurring from both the CHAC and the focus groups were in the following priority order: concerns about obesity, access to affordable health care/health insurance, diabetes and other chronic diseases, minority health disparities and individual responsibility for their own health care.
Obesity is not just a concern of how much you weigh; the problems of obesity lead to detrimental and life-threatening chronic diseases. These diseases include: heart disease, hypertension, stroke, Type II diabetes, infertility, gallbladder disease, cancer, osteoarthritis, sleep apnea and depression. Obese individuals have a 37.4 percent higher annual medical cost than their healthier peers, and according to the Health Affairs Web site, this will translate to an increase in the national cost of health care, both direct and indirect, of $75.64 billion for 2011 for adults 18 and over. For young people age 10-17, the cost of being overweight and obese is estimated to be $164.95 million for 2011. These cost figures are staggering.
Avalon | Hospitalization Program Offers Obesity Treatment In New YorkStanding as the first hospitali
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Standing as the first hospitalization program in New York for the treatment of eating disorders, Avalon Centers has been treating patients with programs since 1998. Avalon engages a group of highly skilled professions who are experts in treating patients diagnosed with Obesity, Binge Eating Disorders, Bulimia and Anorexia.
The facility offers a supportive, home like setting where patients work closely with Avalon clinicians, nutritionists, nurses, and psychiatrists to meet their unique mental health, emotional, nutritional, medical, and psychological needs. Avalon has become known for helping patients who suffer particularly from obesity. Obesity and Binging are considered eating disorders that effect how a person perceives and treats their body. Overweight and obesity are often interchangeable terms for describing weight that is greater than what is healthy for a given height, age, and gender. Obesity and being overweight identify ranges of weight that have been shown to increase the likelihood of other health problems, including heart disease, stress, depression, and so forth.
For adults, overweight and obesity ranges are determined by using weight and height to calculate a number called the “body mass index” (BMI). BMI is used because it correlates with their amount of body fat. An adult who has a BMI between 25 and 29.9 is considered overweight. An adult who has a BMI of 30 or higher is considered obese. It is important to remember that although BMI correlates with the amount of body fat, BMI does not directly measure body fat.
Degree of obesity raises risk of stroke, regardless of gender, race
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The higher a person’s degree of obesity, the higher their risk of stroke — regardless of race, gender and how obesity is measured, according to a new study published in Stroke: Journal of the American Heart Association.
“It has not been clear whether overweight and obesity are risk factors for stroke, especially among blacks,” said Hiroshi Yatsuya, M.D., Ph.D., study lead author and visiting associate professor at the University of Minnesota in Minneapolis. “There are also questions about which measure of excess weight (body mass index [BMI], waist circumference or waist-to-hip ratio) is most closely associated with disease risk.”
Analyzing the ARIC Study database in which subjects’ BMI, waist circumference and waist-to-hip ratio were measured at the study’s start, Yatsuya and colleagues followed 13,549 middle-aged black and white men and women in four U.S. communities from 1987 through 2005. Participants started the study free of cancer and cardiovascular disease.
Obesity Rates Hit Plateau in U.S., Data Suggest
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Americans, at least as a group, may have reached their peak of obesity, according to data the Centers for Disease Control and Prevention released Wednesday.
The numbers indicate that obesity rates have remained constant for at least five years among men and for closer to 10 years among women and children — long enough for experts to say the percentage of very overweight people has leveled off.
But the percentages have topped out at very high numbers. Nearly 34 percent of adults are obese, more than double the percentage 30 years ago. The share of obese children tripled during that time, to 17 percent.
U.S. obesity rate appears to be slowing
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Americans are still too fat, but the obesity epidemic in the United States appears to be waning a bit, U.S. researchers said on Wednesday.
New government data show that 68 percent of U.S. adults are considered overweight, having a body mass index, or BMI, of 25 or higher. A third are obese, having a BMI of 30 or higher.
“Obesity continues to be a significant health concern,” Cynthia Ogden of the National Center for Health Statistics at the U.S. Centers for Disease Control and Prevention said in a telephone interview.
Race, obesity affect outcomes among diabetics following prostatectomy
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Obese white men who have both diabetes and prostate cancer have significantly worse outcomes following radical prostatectomy than do men without diabetes who undergo the same procedure, according to research from Duke University Medical Center appearing in Cancer Epidemiology, Biomarkers & Prevention.
Many studies have shown that diabetes is associated with a lower risk of developing prostate cancer—at least in white men—but the effect of diabetes on outcomes after prostate cancer surgery has not been as clear.
“We found that diabetes was significantly associated with more aggressive disease in obese white men and less aggressive disease for all other subsets of men in our study,” says Stephen Freedland, M.D., associate professor of urology and pathology at the Duke Prostate Center at Duke University and member of the Urology Section, Veterans Affairs Medical Center in Durham.
Arizona State and Mayo Clinic Partner to Combat Metabolic Syndrome
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Arizona State University and Mayo Clinic in Arizona are joining forces in a partnership to investigate metabolic syndrome – a cluster of high-risk medical factors that include increased blood pressure, elevated insulin levels, excess body fat and abnormal cholesterol levels, which can lead to heart disease, stroke and diabetes.
Physicians, scientists and clinicians at the new ASU/Mayo Center for Metabolic and Vascular Biology will work together on solutions for this medical disorder. Research to better understand how insulin resistance affects the body’s blood vessels and metabolism will be an important part of the work at the new center, with facilities at the ASU Tempe campus and Mayo Clinic in Arizona, on the Scottsdale campus.
Lawrence Mandarino, Ph.D., a professor and founding director of the Center for Metabolic Biology at ASU, will direct the new joint venture.
Nintendo Wii may provide actual exercise-study
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The new active Wii video games from Nintendo Co Ltd may be creating a healthier generation of couch potato, according to a new study presented on Monday.
Some of the Nintendo Wii sports games and activities included in the Wii fit series, both of which require video- game enthusiasts to get up off the couch, may increase energy expenditure as much as moderate intensity exercise without ever leaving the TV room, researchers said at the American Heart Association (AHA) scientific meeting in Orlando.
“It’s a very easy and fun way to start exercising,” said Motohiko Miyachi, head of a physical activity program at the National Institute of Health and Nutrition in Tokyo, who led the study.
Obesity causes 100,000 US cancer cases: report
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Obesity causes more than 100,000 cases of cancer in the United States each year—and the number will likely rise as Americans get fatter, researchers said on Thursday.
Having too much body fat causes nearly half the cases of endometrial cancer—a type of cancer of the uterus—and a third of esophageal cancer cases, the American Institute for Cancer Research said.
Cancer is the second-leading cause of death in the United States after heart disease. The American Cancer Society projects that 1.47 million people will be diagnosed with cancer this year and 562,000 will die of it.
Be overweight and live longer
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Contrary to what was previously assumed, overweight is not increasing the overall death rate in the German population. Matthias Lenz of the Faculty of Mathematics, Computer Science, and Natural Sciences of the University of Hamburg and his co-authors present these and other results in the current issue of Deutsches Ärtzeblatt International (Dtsch Artzebl Int 2009; 106[40]: 641ԃ).
Most Germans are overweight, with a body mass index (BMI) between 25 and 29.9 kg/m2. About 20% are obese (BMI of 30 or over), with age- and gender-related differences. The authors systematically evaluated 42 studies of the relationships between weight, life expectancy, and disease.
The Sƃddeutsche Zeitung published an advance notice of the report (http://www.sueddeutsche.de/gesundheit/140/489526/text/), which shows that overweight does not increase death rates, although obesity does increase them by 20%. As people grow older, obesity makes less and less difference.
Geisinger Physician to Chair Pediatric Obesity Symposium
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William Cochran, M.D., vice chairman of Geisinger Health System’s Janet Weis Children’s Hospital, will chair and speak at a symposium on pediatric obesity and prevention on Oct. 17 in Washington, D.C., during the annual meeting of the American Academy of Pediatrics.
“I am tremendously excited to represent Geisinger at this event,” Dr. Cochran said. “Childhood obesity is becoming an increasingly important topic to discuss, and this symposium will be a great opportunity for professionals to share findings and ideas on the issue.”
Childhood Cancer Survivors Exercise Less, Increasing Diabetes Risk
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In a study of adults who survived cancer as children, St. Jude Children’s Research Hospital investigators found that many survivors lead sedentary lifestyles and are more likely to be less physically active than their siblings. Childhood cancer survivors are at greater risk of diabetes, obesity and heart disease than the rest of the population.
Cancer treatments such as cranial radiation can damage the hypothalamus and pituitary; the result is an abnormal metabolism, which increases the risk of obesity and diabetes. Also, chemotherapy with the drug anthracycline increases the risk of heart disease; and radiation to the body can cause blood vessels to become less pliant.
“Physical activity is a key step that survivors can take to reduce the health risk of these effects,” said Kiri Ness, Ph.D., of the Epidemiology and Cancer Control department at St. Jude. “Medical center programs to encourage physical activity in adult survivors could help significantly. However, one problem is that researchers have not firmly established the factors that affect cancer survivors’ participation in physical activity.”
Obesity in middle age bodes ill for old age
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Women who are obese in middle age may live to be at least 70 but they are nowhere near as healthy as women who kept in good shape, U.S. researchers reported on Tuesday.
An ongoing giant study of American nurses showed that only about 10 percent who made it to age 70 could be considered in top shape. Women who steadily gained weight from age 18 on ended up in the worst shape, the researchers said.
Most had some kind of physical or mental limitation, and more than a third had both chronic diseases and also mental or physical limitations.
