Archive for May, 2011

Another Mean Season?

May 13th, 2011

Previous years has brought the American Medical Association wanting to take away disability payments from persons with obesity and Dr. Toby Cosgrove of the Cleveland Clinic wishing he could refuse to hire any fat person. Now comes an Illinois state legislator,  Shane Cultra, who wants to take away the child deduction from parents if their child is obese, further devastating poor families. He is backtracking or, as they say, maybe just testing the water. What do you think? Check the video Illinois lawmaker getting international reaction to ‘fat tax’ suggestion

And, in South Florida, ob-gyns are refusing to treat obese women  whether they are pregnant or not. Overweight women: Some South Florida ob-gyns turn away overweight patients – latimes.com. Meanwhile, Arizona is proposing to fine poor Medicaid patients $50 if they don’t follow a strict physician regime for weight loss. BBC News – Is it fair to fine fat people for not dieting? And which regime would that be?

NIH Releases Ho-Hum Strategic Obesity Research Plan

May 13th, 2011

On March 30, 2011, NIH released a new version of its Strategic Plan for Obesity Research. There isn’t anything particularly new in the plan. It is more or less a signal to researchers what the NIH expects to fund in the next few years.  As with earlier plans, this one lacks any sense of urgency in addressing and views most issues as interesting from a research point of view rather than fitting into a comprehensive strategy for obesity prevention and treatment. There is weak attention to the challenges of developing medicines to treat obesity, to the value of engaging obesity prevention/interventions on an international scale and to attacking obesity in  lower socioeconomic groups  and ethnically diverse communities most in need. In other words, it is largely academics talking to other academics. Nevertheless, it does an insight into the complexity of obesity which the policy-makers who spout the diet-and-exercise line would do well to read. Strategic Plan for NIH Obesity Research

Discrimination DC Style: Mayor’s hiring under scrunity

May 13th, 2011

Discrimination D.C. Style:  Hiring Pattern Under Scrunity

New Washington DC Mayor Vincent Gray has gotten off to a poor start, especially when it has come to staffing his administration. Now, the Washington Post reports on emails among his staff, pointing out, at least in one case, an applicant’s weight. E-mails by Gray advisers included frank talk – The Washington Post

The Dukan Diet—Reality Check

May 12th, 2011

The Dukan Diet… Reality Check

The Dukan Diet is getting a lot of attention, well, a lot of marketing, as the latest diet secret from France. What’s the fact’s behind the diet?

For one, the book claims on its jacket that it is “The Real Reason the French Stay Thin.” Actually, the French aren’t doing all that well. True, they do not have as high rates of obesity as some other nations but their rates have been steadily increasing. From 1980 to 2006-7, rates of overweight in France have gone up from 33% to 57.2%,  and for obesity from 6.4% to 16/1%. Source: WHO :: Global Database on Body Mass Index  

According to OECD, rates of obesity in France are expected to continue to grow moderately but with larger growth in rates of overweight. http://www.oecd.org/officialdocuments/displaydocumentpdf?cote=delsa/hea/wd/hwp(2009)3&doclanguage=en) See also, Trends and Stabilization up to 2022 in Overweight and Obesity in Switzerland, Comparison to France, UK, US and Australia

About the Dukan Diet itself, many claims are made or implied. For example, “ 2 Steps to Lose the Weight, 2 Steps to Keep it off Forever,” and “Never Feel Hungry Again.” So, on the theory that extraordinary claims require extraordinary proof, let’s look at the scientific evidence behind the diet.

First, let’s go to the  published, peer reviewed, independent randomized controlled clinical trials on the Dukan Diet. Well, there don’t seem t to be any. How about published observational studies? Nope. Any published papers ?

Well, the doctor must have his own data from his own patients, like the number starting his diet. Seemingly not. Number  who dropped out? Nada Reasons for droping out? Age, gender,economic/occupational level?  Forgetaboutit.   Placebo controls? Is that French?

 In 12 years of attending obesity scientific and medical conferences, number of presentations, abstracts I’ve seen or heard about on the Dukan diet? Zip. Number of published articles in the National Library of Medicine’s  international  database of scientific articles , Pub Med, by Dr. Pierre Dukan: 0          

Weight loss?  How much: no information. Change in BMI status, WC? Beats me? How long and how much was the weight loss maintained? Now you are really becoming tedious! Was there no weight regain? When? How much?  Sacre Bleu!

What is the essential message you must know about the Dukan Diet? It is in the front pages and it reads:

“The material in this book is for informational purposes only and is not intended as a substitute for the advice and care of your physician. As with all new weight loss or weight maintenance regimes, the nutrition and fitness program described in this book should be followed only after first consulting with your physician to make sure it is appropriate for your individual circumstances. Keep in mind that nutritional needs vary from person to person, depending on age, sex, health status, and total diet. The author and publisher expressly disclaim any responsibility for any adverse effects that may result from the use or application of the information contained in this book. ( Emphasis Added)

The French food agency and the British Dietetic Association have both questioned its safety. Royal wedding: Middleton fuels speculation about Dukan diet – latimes.com

Asking for some studies is not a high hurdle. Consumer Reports recently released its evaluation of diet plans, giving first place to Jenny Craig, followed by Slim Fast and Weight Watchers . Jenny Craig got credit for a two-year study of participants. Consumer Reports names America’s top diets – Health – Salon.com

Dr. Sharma’s 4 Ms

May 6th, 2011

Dr. Arya Sharma has a wonderful way of expressing some complex ideas about obesity. This is his talk about the 4 Ms of obesity managment. It is for physicians and professionals but I think everyone can benefit from it.

FDA Proposes Restaurant, Vending Calorie Labeling

May 6th, 2011

The Food and Drug Administration released two  proposed regulations, part of the Obama Health Care Reform Act, to require disclosure of calories on restaurant menus and vending machines. See Labeling & Nutrition > Overview of FDA Proposed Labeling Requirements for Restaurants, Similar Retail Food Establishments and Vending Machines. Comments are due by June 6, 2011.

FTC Proposes Voluntary Food Marketing Guidelines

May 6th, 2011

The Federal Trade Commission released its long-awaited voluntary guidelines for industry regarding how they market foods to children. Interagency Working Group Seeks Input on Proposed Voluntary Principles for Marketing Food to Children  The agency is proposing that there be more good foods and fewer bad foods marketed to children. (ED: No doubt this will be very controversial.)

 A forum for stakeholders will take place on May 24, 2011.  Public comment is being sought. They must be submitted by June 13, 2011. But early reaction was largely negative Junk Food ‘Guidelines’ Won’t Help – NYTimes.com

Medicare Weighs Behavioral Counseling

May 6th, 2011

The Centers for Medicare and Medicaid Services (CMS) is considering adding intensive behavioral counseling of adults for obesity as a Medicare benefit as recommended by the United States Preventive Services Task Force.  See the public comments at National Coverage Analysis (NCA) for Intensive Behavioral Therapy for Obesity (CAG-00423N) If you scroll down to “ Jennifer Leonard” you will see the comments from the STOP Obesity Alliance.