Posts Tagged ‘children’

FDA Approves Once Weekly Drug for Diabetes; Shows Weight Loss

January 28th, 2012

The Food and Drug Administration has approved Amylin Pharmaceutical’s Bydureon for thetreatment of type 2 diabetes. This is the first once-weekly treatment for type 2 diabetes. It is hoped that this feature will lead to higher adherence to the treatment regimen, although as with Byetta, it is injectable. The drug is exenatide, a GLP-1 receptor agonist. Study results showed an improvement in glycemic control.  A1C levels, a measure of blood sugar, decreased an average of 1.6 points.

Many patients with Type 2 diabetes are also overweight or obese. Many drugs for type 2 diabetes actually cause weight gain. The advantage of Bydureon (and its daily administered counterpart, Byetta) is that patients taking Bydureon can achieve weight loss, in addition to improvements in glycemia, blood pressure, and cholesterol in both overweight and obesity subjects with and without type 2 diabetes. Effects of glucagon-like peptide-1 receptor agonists on … [BMJ. 2012] – PubMed – NCBI

A very small study of 12 children and adolescents with extreme obesity also showed significant improvements, suggesting the need for a larger study. Exenatide as a weight-loss therapy i… [Obesity (Silver Spring). 2012] – PubMed – NCBI

More information is available at www.BYDUREON.com.

Nation’s Obesity Strategy a Failure

October 7th, 2011

The Department of Health and Human Services has issued its 10 year review of the nation’s health care goals, set in 2000. For obesity the picture is not pretty. By direct measurement between 1988-94 and 2005-8, adults over 20 with obesity increased by nearly 47.8%. The target for 2010 was 15%. Children and adolescent rates increased by 63.5% from 11% to 18%. The 2010 target was 5%.  The report also not little to no progress on increasing the proportion of adults or adolescents engaged in regular vigorous physical activity.  Finally, the proportion of adults 20 and over at a healthy weight, directly measured, decreased by 26%; in 2008 only 31% of American adults were at a health weight, the Healthy People goal was 60%. The proportion of persons with healthy eating habits showed no change, still below targets.

CDC – National Center for Health Statistics Homepage

It has to be recognized that during this period millions of dollars have been spent in the public and private sector on educating the public on obesity and the message to ‘eat less and exercise more’ (ELEM).  One would think that this dismal outcome would encourage a critical reappraisal of the nation’s anti-obesity strategy. Alas, I wish it were so. I suspect that we will see merely a call to shout ELEM louder.

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

Is obesity leveling off and what does it matter?

January 23rd, 2010

Ten days ago, the media was touting new reports from the CDC that the obesity epidemic was ‘leveling off’ or  ‘reaching a plateau.’ The news was taken in some quarters with a sense of relief:”Whew, I’m glad that’s over.” Well, don’t get too comfortable. The reports have a lot more to say and overall, this is not a time for complacency.

What the reports actually say.

First, regarding adults, (Prevalence and trends in obesity among US adults, … [JAMA. 2010] – PubMed result), the authors note that the prevalence of obesity is high, exceeding 30% in most age and sex groups except for men 20-39 years old. Strong racial and ethnic differences persist with very high rates among African-American and Hispanic Americans compared to white Americans. Prevalence of severe or morbid obesity, called class 3, (a BMI of 40 or more) was 5.7% overall, with 4.2% for mean and 7.2% for women, including a rate of 14.2% among non-Hispanic black women. What their analyses found was that the earlier rates of increase were on the order of 6 to 7 percentage points. In the this analysis, over the past ten years, the rate of increase is 4.7 percent. Bottom line: rates are still going up.

Second, regarding children, (Prevalence of high body mass index in US children … [JAMA. 2010] – PubMed result) the authors found no statistically significant increases over the last 10 years among girls. Among boys, there is a different picture. Heavy boys between 6 and 19 years of age are getting heavier. Bottom line: the prevalence of obesity has tripled among school-age children and adolescents if you go back to the 1980s. It is high – 17%- and remains high.

So, is the epidemic leveling off? Answer: we don’t know yet. These analyses look at the last ten year trends and they are less than the peak periods of increase. Is this a pause on an upward track or the start of a decline?

Experts I talked with are not too optimistic. First, there is the perennial question of relying on the BMI. A recent paper indicates that more precise tools, like skinfold tests, would have predicted the obesity epidemic by 10-20 years. The timing of the rise in U.S. obesity varies with… [Econ Hum Biol. 2009] – PubMed result. Second, there isn’t a clear explanation of why the rates should be leveling off. We’d like to think people are changing their behavior but the evidence is there is less compliance with recommended dietary and physical activity standards than ever. Adherence to healthy lifestyle habits in US adults… [Am J Med. 2009] – PubMed result  Compliance with the DASH diet among persons with hypertension has slipped. Deteriorating dietary habits among adults with hyp… [Arch Intern Med. 2008] – PubMed result

The recession may be causing people to forgo buying more expensive but healthier foods Recession Weighs on Waistlines – chicagotribune.com. Many clinicians running medical weight management programs I have talked with report their volume is down 20-30%.

Hopefully, this is the beginning of a levelling or downard trend in obesity but we will not know for sure until more information comes in. In the meantime, we should consider that we don’t to be having phenomenal increases in obesity to justify more programs for treatment and prevention. An editorial  by J Michael Graziano on the two reports from CDC, states, “Even if these trends can be maintained, 68% of US adults are overweight or obese, and almost 32% of school-aged US children and adolescents are at or above the 85th percentile of BMI for age. Given the risk of obesity-related major health problems, a massive public health campaign to raise awareness about the effects of overweight and obese is necessary..Major research initiatives are needed to identify better management and treatment options. The longer the delay is taking aggressive action, the higher the likelihood that the significant progress achieved in decreasing chronic disease rates during the last 40 years will be negated, possibly even with a decrease in life expectancy.”  Amen.

Downey Fact Sheet 2 – Quick Facts

September 27th, 2009
The Downey Obesity Report

The Downey Obesity Report

Printable PDF

ADULT OBESITY

The adult obesity rates have risen dramatically from 1960 to today; rates of overweight (BMI >30) have doubled, rates of obesity (BMI 30-39.9) have nearly tripled and rates of extreme or morbid obesity (BMI >40) have nearly increased seven fold.

ADULT (age 20-74) Prevalence 1

Overweight (BMI 25-30) Percentage

1960-1962 31.5%

2005-2006 33%

Obese (BMI>30)

1960-1962 13.4%

2005-2006 35.1%

Extreme or Morbid Obese( BMI>40)

1960-1962 0.9%

2005-2006 6.2%

The rates of obesity only tell half the story. During this period, the total US population has also increased. Therefore, the raw numbers of Americans affected have also increased. Looking at the numbers of people affected, the overweight population has doubled, the obese population has increased 5 fold and the population with extreme or morbid obesity as increased by a factor of nearly 12!

Number of Americans Overweight in 1960: 56.5 million

Number of Americans Overweight in 2006: 94.5 million

Number of Americans Obese in 1960: 24 million

Number of Americans Obese in 2006:
40 million

Number of American with extreme or morbid obesity in 1960:
1.6 million

Number of Americans with extreme or morbid obesity in 2006: 18.6 million

Since 1960-61 to 2006, the number of American adults who became obese or extremely obese*: 61.1 million

Average number per year: 1.3 million

Average number per month: 110,779

Average number per day: 3,693

Average number per hour: 153

Average increase per minute: 2.5

Since 1960-61 to 2006, the number of American adults who became  extremely obese*: 11 million

Average number per year: 240,217 

Average number per month: 20,018

Average number per day: 667

Average number per hour: 27

Adolescents Obesity age 12-19 3

Percent overweight/obese 2005-2006 18%

Young adult Obesity
Ages 18-29

Percent obese 1971-1974 8%

Percent obese 2005 24%

Childhood 2

Ages 6-11 15%

Ages 2-5 11%

Year at which each group will reach 80% obesity 4

All 2072

Men 2077

Women
2058

African American Women 2035

African American Men 2079

Mexican American Women 2073

Mexican American Men 20 91

White Women 2082

White Men
2073

Adipose Tissue (Fat Cells) 5

Age at which typical body has acquired its full number of fat cells: 13

Number of fat cells in average American Adult: 23-65 billion

Number of fat cells in persons with morbid obesity: 37-237 billion

Number of fat cells lost in weight-loss efforts: 0

By Julie Snider for the Downey Obesity Report

By Julie Snider for the Downey Obesity Report

 

Daily Calories Needed and Available 6

Recommended calories per day by typical American adult:

Men 2,400 to 2,800

Women 2,000 to 2,200

Mean (meaning half were above and half below) adult daily calorie intake per day 7 :

Men

1971 2,450

2001-2004 2,593

Women

1971 1,542

2001-2004 1,886

Percent increase in food available for consumption per person from
1970 to 2003: 16%

Amount of food available for each person increase from
1.67 pounds in 1970 to 1.95 pounds in 2003

Daily caloric intake has grown by 523 calories from 1970 to 2003. Leading the way were fats, oils, grains, vegetables and sugars and sweeteners.

U.S. Government Biomedical Research 8

2008 Budget of National Institutes of Health $29.6 billion

NIH Spending 2008 on selected diseases:

Cancer
$5.6 billion

HIV/AIDS funding $2.9 billion

Cardiovascular Disease
$2.0 billion

Heart Disease $1.2 billion

Obesity
$664 million

U. S. Government Infrastructure on Combating Obesity

Name of coordinator of U.S. global anti-obesity efforts:

(Trick question: no such position exists)

Name of White House coordinator of federal anti-obesity efforts:

(Another trick question: no such position exists)

Name of coordinator of Department of Health and Human Services***anti-obesity efforts:

(No such position exists)

*Calculations were made by taking the CDC prevalence figures for 1960-1962 and 2005-2006and multiplying them against US census data for 1960 and census data for 2006,respectively. See Census Bureau Home Page

**Available in this context means the total US calories available for consumption, less spoilage and waste. See ERS/USDA Data – Food Availability (Per Capita) Data System)

*** Department of Health and Human Services includes the National Institutes of Health, the Centers for Disease Control and Prevention, the Centers for Medicare and Medicaid Services, the Food and Drug Administration, Office of the Surgeon General, the Agency for Healthcare Research and Quality among others.)

Notes

1. N C H S – Health E Stats – Prevalence of overweight, obesity and exreme obesity among adults: United States, trends 1960-62 through 2005-2006

2. FASTSTATS – Overweight Prevalence

3. http://www.cdc.gov/nchs/data/hus/hus08.pdf

4. Studies of human adipose tissue. Adipose cell size…[J Clin Invest. 1973] – PubMed Result

5. Will all Americans become overweight or obese? est…[Obesity (Silver Spring). 2008] – PubMed Result. In this estimate, by 2030, 86.3% of adults will be overweight or obese and 51% obese; black women at a level of 96.9% will be the most effected, followed by Mexican-American men (91.1%). By 2048, all American adults would be overweight or obese but black women would reach that milestone by 2034. In children, the authors estimate, rates will nearly double by 2030.

6. http://www.mypyramid.gov/downloads/MyPyramid_Food_Intake_Patterns.pdf

7. http://www.ers.usda.gov/AmberWaves/November05/pdf/FindingsDHNovember2005.pdf

8. NIH Research Portfolio Online Reporting Tool (RePORT) – Estimates of Funding for Various Research, Condition, and Disease Categories (RCDC)

By Julie Snider for the Downey Obesity Report

By Julie Snider for the Downey Obesity Report

Latest News

September 27th, 2009

October 21, 2009

FDA plans revision to nutrition label. FDA seeks to improve nutrition labeling on food products – washingtonpost.com

October 20, 2009

Women with obesity at risk for in vitro fertilization failure The Press Association: Obesity cuts IVF success – study

October 19,2009

Can anyone get insurance? Now an underweight girl is excluded. Underweight Girl Denied Insurance Coverage – Denver News Story – KMGH Denver

October 18, 2009

Washington Post columnist Robin Givhan address the Fashion industry and thinness in the culture.Robin Givhan on Fashion: Size of the Model vs. Size of the Customer – washingtonpost.com

Great Idea: solve obesity by making people taller. Idea Lab – Should a War on Shortness Be One of the Goals of Health Care Reform? – NYTimes.com

October 17, 2009

NYT reports on prospects for new drugs for obesity Arena, Orexigen and Vivus Are Chasing an Effective Diet Drug – NYTimes.com

Why can’t CDC find obese swine flu patients? Pneumonia, Susceptibility of Young Among Traits of Swine Flu – washingtonpost.com

October 15, 2009             

Family Physicians Ink deal with Coke Family Doctors Sign Educational Deal With Coca-Cola – NPR Health Blog : NPR

October 14, 2009

First Lady Michelle Obama tackles childhood obesity Michelle Obama’s Weight Loss Tips: Watch TV Standing Up — Politics Daily

North Carolina Plan criticized Obesity penalty isn’t fair or effective – Columnists/Blogs – News & Observer

Ralph Lauren model fired for being too fat Photoshopped Ralph Lauren Model Filippa Hamilton Fired For Being Fat – WPIX

Dr. Bernandine Healy hits punitive steps against the obese The Obesity Epidemic Isn’t Just About Willpower – US News and World Report

October 13, 2009

Candidate’s weight becomes important issue in NJ Governor Race Is Chris Christie Too Fat to Be the Next Governor of New Jersey? – The Gaggle Blog – Newsweek.com

October 12, 2009

Infant denied health care for  pre-existing conditions Why we need health-care reform: ‘Obese’ infant denied insurance!

Colorado Insurer caves The Associated Press: Colo. insurer changes course on fat infants

Baby denied health insurance for obesity as pre-existing condition 17-Pound, 4-Month-Old Baby Denied Health Insurance for Being Too Fat – Children’s Health – FOXNews.com

October 9, 2009

Groups push back on premium increases in Senate Finance Bill If Your Waistline Grows, Should Your Premiums, Too? – Prescriptions Blog – NYTimes.com

October 8, 2009

Corzine attacked as bigot Is Corzine A Bigot? | The New Republic

October 7, 2009

Physicians lead the way in treating obesity Doctors join fight against obesity – USATODAY.com

NJ Governor Corzine accused of attacking opponents weight Corzine Points Spotlight at Christie’s Weight – NYTimes.com

North Carolina to punish overweight state workers North Carolina state health plan to penalize smokers, obese

October 6, 2009

Study showing restaurant calorie labeling doesn’t change habits sure to add fuel to labeling debate Calorie Postings Don’t Change Habits, Study Finds – NYTimes.com

October 2, 2009,

New York Board of Education bans bake sales Bake Sales Are Banned in New York Schools – NYTimes.com

October 1, 2009

After 20 years USDA program for Women Infants and Children adds fruits and vegetables to its voucher program WIC nutrition program expands to cover fruits, vegetables — latimes.com

September 17, 2009 NEJM publishes study on taxing sugar-sweetened beverages NEJM — The Public Health and Economic Benefits of Taxing Sugar-Sweetened Beverages

September 11, 2009

Indiana Court allows workers comp coverage of bariatric surgery Indiana Appeals Court Affirms Work Comp Coverage for Obesity Surgery

September 9, 2009

STOP Obesity Alliance presents health care reform proposals Curbing Obesity Epidemic Key to Health Care Reform: Experts – US News and World Report See 16th and 17th U.S. Surgeons General, STOP Obesity Alliance Announce America has Reached Tipping Point on Obesity, Call for Direct Action – STOP Obesity Alliance

September 1, 2009

Institute of Medicine issues recommendations for combating childhood obesity Report maps out solutions to child obesity – USATODAY.com

USDA announces child nutrition grants Release No. 0416.09

More employers trying financial incentives As Federal Healthcare Reform Debate Continues, New Survey Reveals More Companies Turn to Financial Rewards to Tackle Soaring Employee Healthcare Costs

August 31, 2009

New target for therapies identified Study may lead to new obesity therapies – UPI.com

New York City targets sugar-sweetened drinks New Salvo in City’s War on Sugary Drinks – City Room Blog – NYTimes.com

Risk of infant mortality rises with mother’s weight Mom’s obesity tied to higher infant mortality

August 30, 2009

Obesity linked to swine flu deaths Obesity linked to swine flu deaths | World news | The Observer

August 27, 2009

Extreme obesity shortens lives by 12 years Extreme obesity can shorten people’s lives by 12 years – USATODAY.com

New drug claims ability to fight obesity and diabetes New fat-fighting drug has anti-diabetes action too | Health | Reuters

Obesity deniers come out http://www.newsweek.com/id/213807

August 24, 2009

American Heart Association raises alarm about sugar Heart Association recommends limits on added sugars – White Coat Notes – Boston.com

Interesting graph plots out contribution of obesity, age and health status on costs. A Concentration of Health Expenses – Prescriptions Blog – NYTimes.com

GE introduces new MRI geared for larger patients GE Healthcare shows off latest MRI – The Business Review (Albany):

Obesity a risk for swine flu deaths Half of swine flu deaths in high-risk people -study | Reuters

August 18, 2009

Sleep apnea on increase Sleep Apnea Rises With Obesity, Boosts Deaths in Middle-Aged – Bloomberg.com; PLoS Medicine: Sleep-Disordered Breathing and Mortality: A Prospective Cohort Study

Push back on doctor’s campaign against obesity Anti-Obesity Dr. Jason Newsom Chomps Down on Dunkin’ Donuts « Vitals Spotlight – We Give the Doctor an Exam

August 11, 2009

President Obama calls for health insurance reform to cover obesity treatments, stating, “All I’m saying is let’s take the example of something like diabetes, one of — a disease that’s skyrocketing, partly because of obesity, partly because it’s not treated as effectively as it could be. Right now if we paid a family — if a family care physician works with his or her patient to help them lose weight, modify diet, monitors whether they’re taking their medications in a timely fashion, they might get reimbursed a pittance. But if that same diabetic ends up getting their foot amputated, that’s $30,000, $40,000, $50,000 — immediately the surgeon is reimbursed. Well, why not make sure that we’re also reimbursing the care that prevents the amputation, right? That will save us money. Text – Obama’s Health Care Town Hall in Portsmouth – NYTimes.com

August 10, 2009

Nominee for Surgeon General attacked over body weight Does it matter what the doctor weighs? — latimes.com

Arena preparing to submit new obesity drug to FDA San Diego Business Journal Online – business news for San Diego, California

August 7, 2009

Recession could worsen obesity prevalence Recession could have negative impact on obesity levels | News | Nursing Times

July 17, 2009

Minorities, blacks hardest hit by obesity reports CDC Atlanta health, diet and fitness news | ajc.com

July 16, 2009

AHA: severe obesity increases risks in surgery Severe obesity increases risks of health problems during surgery

AHA: Clarity on the overweight mortality confusion Mortality, Health Outcomes, and Body Mass Index in the Overweight Range: A Science Advisory From the American Heart Association — Lewis et al. 119 (25): 3263 — Circulation

July 14, 2009

Excess weight speeds up osteoarthritis Excess Weight Speeds Up Osteoarthritis: MedlinePlus

July 14, 2009

RWJ releases report on taxes for sugar sweetened beverages Sugar-Sweetened Beverage Taxes and Public Health – RWJF

July 14, 2009 WHO addresses swine flu vaccine for persons with obesity. Swine Flu Vaccine Recommendations from World Health Organization – Health Blog – WSJ

July 10, 2009 CDC finds high prevalence of obesity in swine flu patients. Intensive-Care Patients With Severe Novel Influenza A (H1N1) Virus Infection — Michigan, June 2009

July 2009 Study finds insulin resistance in overeating lean humans for the first time. Short-term overeating induces insulin resistance i…[Mol Med. 2009 Jul-Aug] – PubMed Result

July 10,2009

The economy, stress and overeating Job Stress, Economy Weighing on Americans: MedlinePlus

June 24, 2009

Obesity: Africa’s Next Big Killer Africa’s newest silent killer: obesity | FP Passport

July 2, 2009

Connecticut Governor Vetoes Labeling Bill

Rell rejects nutritional labeling for chain restaurants – The Connecticut Post Online

July 1, 2009

Obama Address Obesity in Town HallObama Addresses Health-Care Reform at Virtual Town Hall Meeting – washingtonpost.com

July 1, 2009

Trust for America’s Health releases “F as in Fat 2009” http://www.rwjf.org/files/research/20090701tfahfasinfat.pdf

June 30, 2009

Institute of Medicine Issues Report on Comparative Effectiveness Research

Initial National Priorities for Comparative Effectiveness Research – Institute of Medicine

Read Morgan Downey’s Testimony

http://www.iom.edu/Object.File/Master/64/740/Speaker%20Testimonies%203-4PM%20b

lock.pdf

June 30, 2009

Oregon enacts restaurant labeling bill AP Wire – Oregon | kgw.com | News for Portland Oregon and SW Washington

June 29, 2009

More Data on surgery for diabetes Weight-Loss Surgery May Be Beneficial for Diabetes – NYTimes.com

June 29, 2009

Kentucky phasing out sugar sweetened beverages Congress May Look to Ky. Schools’ Healthy Example in Creating Nutritional Policy – washingtonpost.com

June 25, 2009

IOM release workshop on Food Desserts The Public Health Effects of Food Deserts. Workshop Summary – Institute of Medicine

May 28, 2009

IOM Releases report on Weight Gain in Pregnancy Report Brief. Weight Gain During Pregnancy: Reexamining the Guidelines – Institute of Medicine

May 9, 2009

Do obesity related diseases predispose to swine flu severity? Other Illness May Precede Worst Cases of Swine Flu – NYTimes.com

Prevention of Obesity

September 26th, 2009

Everybody wants to prevent obesity and there is ample reason to do so. Unfortunately, studies on ways in which to prevent obesity, especially in children are disappointing. MD

Prevention in Adults

A systematic review of interventions aimed at the …[Public Health Nutr. 2009] – PubMed Result

A systematic review of the evidence regarding effi…[Obes Rev. 2008] – PubMed Result

Systematic prevention of overweight and obesity in…[Obes Rev. 2009] – PubMed Result

Prevention in Adolescents

Reducing obesity and related chronic disease risk …[Obes Rev. 2006] – PubMed Result

Prevention in Children

Interventions for preventing obesity in children. [Cochrane Database Syst Rev. 2005] – PubMed Result

Recommended community strategies to prevent obesity Recommended community strategies and measurements …[MMWR Recomm Rep. 2009] – PubMed Result

American Heart Association Scientific Statement on Childhood Obesity, prevention and treatment Overweight in Children and Adolescents: Pathophysiology, Consequences, Prevention, and Treatment — Daniels et al. 111 (15): 1999 — Circulation

The impact of prevention on reducing the burden of…[Circulation. 2008] – PubMed Result

Preventing cardiovascular disease in the 21st cent…[Am J Cardiovasc Drugs. 2006] – PubMed Result