Posts Tagged ‘Behavior’

Drug Therapy

September 27th, 2009

Long-term pharmacotherapy for obesity and overweig…[Cochrane Database Syst Rev. 2004] – PubMed Result

Long-term pharmacotherapy for overweight and obesi…[Int J Obes Relat Metab Disord. 2003] – PubMed Result

NIH: WIN – Publication – Prescription Medications for the Treatment of Obesity

Update on sibutramaine The use of sibutramine in the management of obesit…[Vasc Health Risk Manag. 2009] – PubMed Result

Update on orlistat Obesity management: update on orlistat. [Vasc Health Risk Manag. 2007] – PubMed Result

Drug therapy for weight loss in type 2 diabetes

Exenatide shows weight loss effect in patients with diabetes Effect of antiobesity medications in patients with…[Diabetes Obes Metab. 2009] – PubMed Result; Exenatide use in the management of metabolic syndr…[Endocr Pract. 2008] – PubMed Result; Metabolic effects of two years of exenatide treatm…[Clin Ther. 2007] – PubMed Result

Long term weight loss in patients with type 2 diabetes Long-term effectiveness of lifestyle and behaviora…[Am J Med. 2004] – PubMed Result

Pharmacotherapy for weight loss in adults with typ…[Cochrane Database Syst Rev. 2005] – PubMed Result

Efficacy of pharmacotherapy for weight loss in adu…[Arch Intern Med. 2004] – PubMed Result

Long term weight loss in pre-diabetes Long-term non-pharmacological weight loss interven…[Cochrane Database Syst Rev. 2005] – PubMed Result


September 27th, 2009

Using web-based approachWeb-based Weight Loss in Primary Care: A Randomize…[Obesity (Silver Spring). 2009] – PubMed Result

Preventing weight gain among new mothers Weight, physical activity and dietary behavior cha…[Nutr J. 2009] – PubMed Result . See also Preventing weight gain: the baseline weight relate…[BMC Public Health. 2009] – PubMed Result, and Health Hunters–an intervention to prevent overwei…[Int J Obes (Lond). 2006] – PubMed Result

Modest benefits of community cardiovascular prevention program in women Outcomes of National Community Organization Cardio…[J Cardiovasc Transl Res. 2009] – PubMed Result

Primary Care Treatment of obesity in primary care practice in t…[J Gen Intern Med. 2009] – PubMed Result

Weight loss advice U.S. obese adults receive from …[Prev Med. 2008] – PubMed Result

Are healthcare professionals advising obese patien…[MedGenMed. 2005] – PubMed Result

Psychological interventions for overweight or obes…[Cochrane Database Syst Rev. 2005] – PubMed Result

Genetic Basis of Obesity

September 26th, 2009

Often one hears it stated that obesity is not a genetic disease. If by that the speaker is saying that obesity is probably not due to a single genetic change they are not quite right. There are some rare forms of obesity which are due to a single gene change. Genetic obesity syndromes. [Front Horm Res. 2008] – PubMed Result; Genetic and hereditary aspects of childhood obesit…[Best Pract Res Clin Endocrinol Metab. 2005] – PubMed Result But if they mean a single genetic change cannot account for a worldwide epidemic of obesity occurring over the last 30 years they are probably right. If the speaker means it is unlikely that there will be a treatment for obesity based on gene therapy, they are probably correct. (Although who can predict the future?) However, they miss the point if they do not understand that for millions of years of evolution, the species we call humans have favored genes which maximize its chances for survival and reproduction. So our taste preferences, our physical activity preferences and the like are passed on in the genome and our part of our inheritance. The problem is that for centuries we humans lived in an environment which was totally different than the one we live in now. The disconnect is that our bodies have not yet adapted to this new world where tasty, nutritious food is readily available and where most of us do not have to expend anything other than a minimal effort to obtain it, survive and flourish. Anything policy-makers or parents want to do about obesity must be understood in the context of the powerful force evolution has been in designing how humans acquire, store and use energy from food.

According the CDC:

  1. Biological relatives tend to resemble each other in many ways, including body weight. Individuals with a family history of obesity may be predisposed to gain weight.
  2. Different responses to the food environment are largely due to genetic variation between individuals.
  3. Fat stores are regulated over long periods of time by complex systems that involve input and feedback from fat tissue, the brain and endocrine glands like the pancreas and the thyroid.,
  4. The tendencies to overeat and be sedentary, the diminished ability to use dietary fat as fuel and enlarged, easily stimulated capacity to store body fat are all genetically influenced. The variation in how individuals respond to the food rich environment and the differences in acquiring obesity related comorbid conditions are also genetically determined.

Since 1997, published studies have found that variation in BMI is largely due to heritable genetic differences, with estimates ranging from 55% to 85%. A 2008 study found that 77% of the adiposity in preadolescent children born since the start of the obesity epidemic was due to genetic inheritance compared to 10% for the environment. Evidence for a strong genetic influence on childho…[Am J Clin Nutr. 2008] – PubMed Result

A fast rate of eating appears to be heritable. Eating rate is a heritable phenotype related to we…[Am J Clin Nutr. 2008] – PubMed Result Differences in responding to the obesogenic environment may also be heritable Genetic influence on appetite in children. [Int J Obes (Lond). 2008] – PubMed Result and Appetite is a Heritable Phenotype Associated with …[Ann Behav Med. 2009] – PubMed Result. The FTO gene may be involved. The FTO gene and measured food intake in children. [Int J Obes (Lond). 2009] – PubMed Result and Increasing heritability of BMI and stronger associ…[Obesity (Silver Spring). 2008] – PubMed Result Parental leanness appears to provide strong protection against the development of obesity in children. Development of overweight in children in relation …[Obesity (Silver Spring). 2009] – PubMed Result

There is an interesting scientific debate about what is called the “thrifty gene” hypothesis about how a genetic preference for storing extra energy on our bodies might have developed. Thrifty genes for obesity, an attractive but flawe…[Int J Obes (Lond). 2008] – PubMed Result and The clinical biochemistry of obesity. [Clin Biochem Rev. 2004] – PubMed Result. Some think that childhood obesity is increasing due to ‘associative mating’ by overweight parents who pass on their genetic disposition to obesity to their children. Childhood obesity: are genetic differences involve…[Am J Clin Nutr. 2009] – PubMed Result

The evidence for the genetic basis of obesity, in addition to environmental changes is quite strong. See Implications of gene-behavior interactions: preven…[Obesity (Silver Spring). 2008] – PubMed Result; Genome-wide association scan shows genetic variant…[PLoS Genet. 2007] – PubMed Result and The genetics of obesity. [Metabolism. 1995] – PubMed Result

The environment is thought to be responsible for variations between populations but genetics is responsible for the variations within a given population. Obesity – Missing Heritability and GWAS Utility and Genetic and environmental factors in relative body…[Behav Genet. 1997] – PubMed Result. Genetics may account for many cases of morbid obesityFamilial aggregation of morbid obesity. [Obes Res. 1993] – PubMed Result.

Genetics may play an important role in determining who can benefit from different types of intervention. Implications of gene-behavior interactions: preven…[Obesity (Silver Spring). 2008] – PubMed Result or who is more likely to be affected by obesity Ethnic variability in adiposity and cardiovascular…[Int J Epidemiol. 2009] – PubMed Result. Or experience a comorbid condition like Type 2 diabetes Mechanisms of disease: genetic insights into the e…[Nat Clin Pract Endocrinol Metab. 2008] – PubMed Result

The FTO gene is currently under active research interest for providing a link to how obesity related conditions might arise and how patients can benefit from this knowledge. FTO: the first gene contributing to common forms o…[Obes Rev. 2008] – PubMed Result Genome-wide association scan shows genetic variant…[PLoS Genet. 2007] – PubMed Result

The FTO gene may explain different responses to exercise. FTO Genotype Is Associated With Exercise Training-…[Obesity (Silver Spring). 2009] – PubMed Result .Physical activity and the association of common FT…[Arch Intern Med. 2008] – PubMed Result

A factor in the resistance to describe obesity as a genetic disease may be in the assumption that the human genome does not change rapidly whereas the increase globally in the rates of obesity have occurred in the last 40-50 years. However, evolutionary biologists are debating the speed of genetic change. In “Catching Fire, How Cooking Made us Human” (Basic Books, New York, 2009) Richard Wrangham, the Ruth Moore Professor of Biological Anthropology at Harvard University writes,

A long delay between the adoption of a major new diet and resulting changes in anatomy is also unlikely. Studies of Galapagos finches by Peter and Rosemary Grant showed that during a year when finches experiences an intense food shortage caused by an extended drought, the birds that were best able to eat large and hard seeds – those birds with the largest beaks- survived best. The selection pressure against small-beaked birds was so intense that only 15 percent of birds survived and the species as a whole developed measurably larger beaks within a year. Correlations in beak size between parents and offspring showed that the changes were inherited. Beak size fell again after the food supply returned to normal, but it took about fifteen years for the genetic changes the drought had imposed to reverse. The Grants’ finches show that anatomy can evolve very quickly in response to dietary changes…Other data show that if an ecological change is permanent, the species also changes permanently, and again the transition is fast…The adaptive changes brought on by the adoption of cooking would surely have been rapid. (p. 93-94, emphasis added.) (See Book Reviews)


September 26th, 2009

Understanding the gene-environment-behavior connections Implications of gene-behavior interactions: preven…[Obesity (Silver Spring). 2008] – PubMed Result

Some see eating as an automatic behavior over which individuals have less control than they think Eating as an automatic behavior. [Prev Chronic Dis. 2008] – PubMed Result

While controversial, the view of eating or hunger as an addiction has many interesting parallels with studies of addictive behavior The neurobiology of appetite: hunger as addiction. [Int J Obes (Lond). 2009] – PubMed Result

It is generally accepted that humans have a genetic predisposition to obesity which is fueled by our modern environments. However, not everyone is becoming obese. Why? Individual differences in the neurophysiology of r…[Int J Obes (Lond). 2009] – PubMed Result Obese-resistant individuals may sense changes in their energy intake more quickly than persons who are obese. The effects of overfeeding and propensity to weigh…[Physiol Behav. 2009] – PubMed Result

Obese individuals may have evolved weak mechanism which favor overeating. Control of food intake in the obese. [Obes Res. 2001] – PubMed Result High concern over food intake may, paradoxically, lead to higher intake Determinants of food choice: relationships with ob…[Obes Res. 2001] – PubMed Result

Stringent parental controls may also disrupt a child’s development of internal cues for controlling eating. Development of eating behaviors among children and…[Pediatrics. 1998] – PubMed Result