Obesity and Blood, Urothelial Cancers

May 17th, 2012 No comments »

Last week I provided my prepared statement on the relationship on obesity and cancer. Now comes a study of blood cancers among 578,000 adults showing body mass index (BMI) was associated with blood cancer risk, lymphoid neoplasms and Hodgkin’s lymphoma in women, and  B-cell lymphoma and chronic lymphatic leukemia in men. BMI was the most consistent risk factor compared to other metabolic factors, especially for women. PubMed: Metabolic factors and blood cancer

Another study, out of Israel, has found that overweight in adolescence is related to increased risk of future urothelial cancer. PubMed:Overweight in adolescence and Urothelial

 

The New Math of Obesity

May 15th, 2012 No comments »

The New York Times Science Section May 15, 2012 carries an interesting interview with NIDDK mathematician Carson C. Chow on the mathematical model he and colleagues developed. They found that the convention wisdom of 3,500 calories less intake is needed to lose a pound is wrong. Chow states, “The body changes as you lose. Interestingly, we also found that the fatter you get, the easier it is to gain weight. An extra 10 calories a day puts more weight on an obese person than on a thinner one. Also, there’s a time constraint that’s an important factor in weight loss. It actually takes about three years for a dieter to reach their “new” steady state. Our model predicts that if you eat 100 calories fewer a day, in three years you will lose, on average, 10 pounds – if you don’t cheat.”

Read the full interview at: NYT: The New  Math of Obesity

Read our original post on this research including a calculator and paper in The Lancet from February.

 

Testimony before FDA on lorcaserin

May 15th, 2012 No comments »

I testified last week before the FDA Advisory Committee on lorcaserin about obesity and cancer. Here are my prepared remarks. More

Improvements Seen in Obesity Reimbursement

May 13th, 2012 No comments »

A Washington Post article by Judith Graham points out the progress made in getting insurers and physicians to screen patients for obesity and reimburse for counseling and treatment. I can add that at one of the recent FDA Advisory Committee meetings, an FDA health officer presented data indicating that about half of prescription drugs for obesity were paid for by insurance plans now. WaPo: BMI as vital sign

In addition, conversations with health plan representatives indicate that they are getting more requests from employers for riders covering obesity interventions, including bariatric surgery. These are considerable improvements from a few years ago.

 

Obese Boy Returned to Family

May 12th, 2012 No comments »

The case of the 8 year-old boy from Cleveland who social workers took from his family because he was obese appears to have been resolved…for the moment. After an editorial by Harvard’s Dr. David Ludwig and lawyer Lindsey Murtagh which recommended state intervention in families with obese children (so that they could avoid having to have bariatric surgery as adults), state social workers took the boy away from his mother. A judge had sent him to a member of the family. He had weighed 200 pounds and evidently lost 50. He was returned to his family in March and supervision of the family has been lifted. The family’s lawyer noted that the boy was never in danger, the parents were never accused of neglect, there was no concern for the boy’s emotional stability.

I strongly disagreed with Ludwig’s arguments in an earlier post and see no reason to change. Stepping on the scale can be traumatic in the best of times but to think that this boy will watch to see whether the scale will tell him he will lose his family, again, is, totally unjustified. Think there could be weight regain, behavioral disorders and disordered eating behavior ahead? See the article. Chicago Tribune: N.Ohio boy

 

FDA Panel Approves Arena’s lorcaserin

May 10th, 2012 No comments »

After a long day of discussing the significance of tumor development in rats taking lorcaserin, the FDA Endocrinologic and Metabolic Advisory Committee reversed a negative vote 2 years ago and have recommended approval by a vote of 18-4. FDA does not have to follow their recommendation but the FDA reviewers are satisfied that the drug has low risks. I expect they will approve it in the near future.

 

Interview Today on WRKO

May 9th, 2012 No comments »

Here’s the link to my radio interview today on WRKO in Boston, the Barry Armstrong Show.

http://dlvr.it/1Xnw7p

USAToday Coverage of IOM Recommendations

May 8th, 2012 1 comment »

Multiple strategies needed to fight obesity, study suggests

By Nanci Hellmich, USA TODAY

Updated 1h 12m ago

WASHINGTON – Taming the obesity epidemic in this country needs an all-hands-on-deck strategy so that schools provide students 60 minutes of physical activity daily, fast-food restaurants offer healthier fare for kids, and communities build recreational spaces that encourage physical activity, says a new report out Tuesday. 

  • A new report recommends kids have 60 minutes of active time per day.By Reed Saxon, APA new report recommends kids have 60 minutes of active time per day.

By Reed Saxon, AP

A new report recommends kids have 60 minutes of active time per day.

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It’s going to take “bold actions” like these and a full-scale effort across all segments of society to reduce the obesity epidemic, says the report from experts convened by theInstitute of Medicine, which provides independent advice on health issues to policy makers, foundations and others.

The goals and some of the strategies were presented here at the Centers for Disease Control and Prevention’s “Weight of the Nation” meeting, where experts are discussing ideas for the prevention and control of obesity.

Currently, two-thirds of adults and a third of children in the USA are overweight or obese, government statistics show. Another study out Monday predicted that as many as 42% of adults may be obese, roughly 30 or more pounds over a healthy weight, by 2030 if actions aren’t taken to reverse the trend.

Extra weight takes a huge toll on health increasing the risk of type 2 diabetes, heart disease, stroke, many types of cancer, sleep apnea and other debilitating and chronic illnesses, and it costs billions of dollars in extra medical expenditures.

The Institute of Medicine committee reviewed more than 800 obesity prevention recommendations to pinpoint the most effective ones.

The report says there is no one answer to this problem, but it’s going to require bringing all the pieces together — the schools, the workplace, health care providers, says Dan Glickman, chairman of the institute committee and former secretary of the U.S. Department of Agriculture. “There are no magic bullets in here, but this report puts it all together.”

The illnesses and costs associated with obesity are spiraling out of control, he says. “If we don’t address this comprehensively, it will basically take us down as a society.”

M. R. C. Greenwood, vice chairwoman of the committee and president of the University of Hawaiisystem, says, “Many people will probably say ‘what’s new’ and what’s new is the clear statement that we must begin to attack this problem collectively on all fronts. It’s a massive problem unlike anything we have ever tackled before.”

Here are the five goals and a some strategies suggested for achieving them:

Make it easier for people to work physical activity into their daily lives. For instance, people need to have safe places to be active including trails, parks, playgrounds and community recreation centers.

Create an environment where healthy food and beverage options are the routine, easy choice.

Fast-food and chain restaurants could revise menus to make sure at least half of their kids’ meals comply with government’s dietary guidelines for moderately active 4- to 8-year-olds, and that those meals are moderately priced.

Businesses, governments and others should adopt policies to reduce the consumption of sugar-sweetened beverages including making clean water available in public places, work sites and recreation areas.

Improve messages about physical activity and nutrition.

The food, beverage, restaurant and media industries should take voluntary action to adopt nutritionally based standards for marketing aimed at children and adolescents, ages 2-17. If those standards aren’t adopted within two years by the majority of companies, then local, state and federal policymakers should consider setting mandatory nutritional standards for marketing to this age group.

Expand the role of health care providers, insurers and employers in obesity prevention.

Employers should provide access to healthy foods at work and offer opportunities for physical activity as part of their wellness/health promotion programs.

All health care providers should adopt standards of practice for preventing, screening, diagnosing and treating people who are overweight or obese.

Make schools a national focal point for obesity prevention.

Students should have nutrition education throughout their school years, and kids in kindergarten through 12th grade should have the chance to engage in a total of 60 minutes of physical activity each school day. This should include participation in quality physical education.

“There’s so much to do, and the country is still doing so little,” says Margo Wootan, director of nutrition policy for the Center for Science in the Public Interest, a Washington-based consumer group. “It seems heartless that we’re abandoning two-thirds of the American population to obesity-related diseases.”

There are lots of ways for students to get an hour of physical activity during the school day including recess, PE, walking and biking to school, classroom activities and after-school sports, Wootan says. “Kids need a chance to run around in order to sit still and learn in the classroom.”

When it comes to food marketing to kids, “companies claim to be taking meaningful action, but still the overwhelming majority of food ads aimed at kids are for unhealthy foods,” she says.

“What industry says is healthy to market to kids is not what most parents and health professionals think is healthy.”

Not everyone is convinced that the actions outlined in the report will make a dent in the obesity problem. “The literature in evaluating interventions like these shows weak effectiveness at best,” says Morgan Downey, editor and publisher of the downeyobesityreport.com. “So rather than evaluate the strategies’ effectiveness, they (the committee members) are just shouting them even louder.”

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Posted 11h 11m ago | Updated 1h 12m ago