Debunking ‘progress’ on childhood obesity

May 2nd, 2016 No comments »

Much has been made recently of a purported drop in childhood obesity, particularly among children age 2 to 5. (See my Oct. 2015 blog, Did the White House Spin CDC Study to show progress in childhood obesity?) Now, a new study finds “no evidence of a decline in obesity prevalence in any age group, despite substantial clinical and policy efforts targeting the issue.” The paper by Ashley C. Skinner, Eliana M. Perrin and Joseph A. Skelton in Obesity used NHANES data from 1999-2014 and found, “A clear, statistically significant increase in all classes of obesity continued from 1999 to 2014.” They also reported that severe obesity (classII and III) showed a significant increase in adolescents and non-Hispanic black children.  They state, “By including severe obesity, our results also highlight particular areas of concern. In 2013-2014, nearly 10% of adolescents met criteria for Class II obesity, and nearly 5% also met criteria for class III obesity…The 4.5 million children and adolescents with severe obesity will require novel and intensive efforts for long-term obesity improvement. With scarce resources, and increasing costs of comorbid conditions, there is an urgent need for targeted interventions to stem the rise in severe obesity among children, in addition to policies and clinical efforts designed to prevent obesity. Policy efforts are yet to yield substantive changes in obesity prevalence but few have specifically targeted severe obesity.” Amen

Persons with Obesity Excluded from Nursing Homes

December 15th, 2015 No comments »

The New York Times published yesterday a sobering view of the discrimination faced by persons with severe obesity to access nursing home care. It is a sobering picture and one that is not likely to get better anytime soon.

Employers Promote Fat-Shaming: New Post

December 11th, 2015 No comments »

Fellow blogger Al Lewis has an excellent post on Huff  Post Business on the promotion of fat-shaming in “employer wellness” programs. He points out that (a) these programs do not cause weight loss, (b) they are  often structured to embarrass and harass overweight employees by their colleagues, (c) the penalties for failure to reach an employer goal of a specific BMI or weight loss amount are outrageous. What he might add is that millions  of American workers are affected by these programs,   them the largest human experiments in history. No doubt  the numbers of affected employees dwarfs those in medical or surgical treatment programs. What he does not explain is the absence of outrage in the scientific and medical community over these  scams.

Is CDC Massaging the Obesity Stats?

November 22nd, 2015 No comments »

The world was positively giddy this week following the release of a new CDC Obesity prevalence report. There was so much self-congratulation going on in the childhood obesity world I was afraid of an outbreak of carpal tunnel syndrome.

The headlines shouted that the childhood obesity numbers had stabilized and many groups claimed credit for the success. The CDC reported that, “the prevalence of obesity among U.S. youth was 17% in 2011-2014. Overall, the prevalence of obesity among preschool-aged children (2-5 years) (8.9%) was lower than among school-aged children (6-11 years) (17.5%) and adolescents (12-19) (20.5%).” The report goes on to state, “Between 2003-2004 and 2013-14, however, no change in prevalence was seen among youth.”

Hey, great news, no?  Well, the 17% figured was derived from averaging three groups: 2-5YOA, 6-11 YOA and 12-19 YOA. I question of including 2-5 year olds. The prevalence for this group is about half for the other age groups. And, frankly, they are toddlers. Their prevalence figure probably represents parental panic at the prospects of raising an overweight child. This panic may lead to restrained eating strategies which often fail as the child grows up. As soon as the child starts to exercise more control over their own feeding and behavior, the prevalence rate doubles. Doubles! Taking the 2-5 years old out of the equation, the youth prevalence rate is 19%, not 17%. , 19% is not leveling off. (Truth be told I did not attempt to re-calculate the historical figures without the 2-5 age group.) Keep in mind that CDC views obesity as a binary switch. You are either obese or not. They do not take into account the growth of body weights within the obesity category, i.e. class III or severe obesity growth.

Finally, the CDC does note, “The prevalence of obesity among U.S. adults remains higher than the Healthy People 2020 goal of 30.5%. Although the overall prevalence of childhood obesity is higher than the Healthy People 2020 goal of 14.5%, the prevalence of obesity among children aged 2-5 is below the goal of 9.4%.”

Before popping the champagne, advocates and the media should consider that we are moving further and further away from the targets of Healthy People 2020, not to mention Healthy People 2010. Therefore, it is reasonable to ask if self-congratulation based on failure is an appropriate response.

Criminal Crackdown on Supplement Makers

November 21st, 2015 No comments »

This week the federal Department of Justice announced major criminal and civil actions against 100 makers of dietary supplements, including those for weight loss. According to DOJ, the actions resulted from a year-long effort, beginning in November 2014, to focus enforcement resources in an area of the dietary supplement market that is causing increasing concern among health officials nationwide.  In each case, the department or one of its federal partners allege the sale of supplements that contain ingredients other than those listed on the product label or the sale of products that make health or disease treatment claims that are unsupported by adequate scientific evidence.

 

Why Conservatives Seem to Favor Dietary Supplements

November 8th, 2015 No comments »

Do conservatives favor dietary supplements? That’s pretty much the point of David Weigel’s article in the Washington Post. He picks up on Republican Presidential candidate Ben Carson’s relationship with the dietary supplement maker, Mannatech Inc. (Mannatech’s products including those promising weight loss.) His article points to a deep relationship of conservatives and dietary supplement manufacturers, based on common rejection of expertise in favor of personal liberty and antipathy to big government, in this case the Food and Drug Administration.

Readers may remember that it was a relationship with a supplement manufacturer which led to the criminal convictions of former Virginia Governor Robert McDonnell and his wife. But liberals, like former British Prime Minister Tony Blair, are not immune.

 

EEOC Issues Proposed Rule on Employer Wellness Programs Under Genetic Nondiscrimination La2

November 2nd, 2015 No comments »

The EEOC has (at last) issued proposed regulations on employer wellness regulations under the Genetic Information Nondiscrimination Act (GINA). The EEOC issued proposed regulations in April for employer wellness programs under the Americans with Disabilities Act.

In this proposal, the EEOC requests comments on seven specific issues. They are:

  1. “Whether employers that offer inducements to encourage the spouses of employees to disclose information about current or past health information must also offer similar inducements to persons who choose not to disclose such information, but who instead provide certification from a medical professional stating that the spouse is under the care of a physician and that any medical risks identified by that physician are under active treatment.

  2. Should the proposed authorization requirement apply only to wellness programs that offer more than de minimis rewards or penalties to employees whose spouses provide information about current or past health status as part of a (sic) HRA (ED: health risk assessment)? If so, how should the Commission define “de minimis”?

  3. Which best practices or procedural safeguards ensure that employer-sponsored wellness programs are designed to promote health or prevent disease and do not operate to shift costs to employees with spouses who have health impairments or stigmatized conditions?

  4. Given that, in contrast to the status quo when the ADA (Americans with Disabilities Act) was enacted, most employers today store personnel information electronically, and in light of increasingly frequent breaches to electronically stored employment records, should the rule include more specific guidance to employers regarding how to implement the requirements of 29 CFR 1635.9(a) for electronically stored records? If so, what procedures are needed to achieve GINA’s goal of ensuring the confidentiality of genetic information with respect to electronic records stored by employers?

  5. In addition to any suggestions offered in response to the previous question, are there best practices or procedural safeguards to ensure that information about spouses’ current health status is protected from disclosure?

  6. Given concerns about

    privacy

    of genetic information, should the regulation restrict the collection of any genetic information by a workplace wellness program to only the minimum necessary to directly support the specific wellness activities, interventions and advice provided through the

    program-namely

    information collected through the program’s HRA (health risk assessment) and biometric screening? Should programs be prohibited from accessing genetic information from other sources, such as patient claims data and medical records data?

  7. Whether  employers offer (or are likely to offer in the future) wellness programs outside of a group health plan or group health insurance coverage that use inducements to encourage employee’s spouses to provide information about current or past health or past health status as part of a (sic) HRA (health risk assessment), and the extent to which the GINA regulations should  allow inducements provided as part of such programs.

The deadline for comments is December 29, 2015.

 

CDC Spins Breastfeeding-Obesity Link

October 27th, 2015 No comments »

CDC is continuing to perpetuate the old canard that breastfeeding is protective against childhood obesity. In the recently released publication, Vital Signs: Improvements in Maternity Care Policies and Practices that Support Breastfeeding-United States, 2007-2013,  the CDC states “In addition, evidence suggests that breastfeeding is associated with a reduction in the risk for obesity and diabetes in children (3).”

The reference is a 2007 evidence report on CDC’s sister agency, the Agency for Healthcare Research and  Quality website. However, unlike several other citations, there is no link to the paper. Why? Perhaps because AHRQ identifies the paper as “Archived” and states, “It (the paper) was current when produced and now may be out of date.” Here’s the link:  http://archive.ahrq.gov/clinic/tp/brfouttp.htm#Report.

Maybe out of date? No fooling! See here, here and here for updated research which CDC decided to overlook.