Posts Tagged ‘drugs’

Information on dosing of drugs for children with obesity not available

October 9th, 2015

A new study has concluded that only 2 of 25 emergency care drugs for children contained dosing information on the FDA approved label for obese children and adults compared with 22 of 25 for normal weight children. Rowe and colleagues found no sufficient pharmacokinetic data in the literature for any of the emergency care drugs for children with obesity. Obesity is an important component of the appropriate dosing for drugs do to altered body composition and physiologic mechanisms. Another article by Kendrick and colleagues points out the uncertainties in prescribing information for children with obesity. Also, see this article by Oeser and colleagues on the same topic. Roux-en-Y gastric bypass surgery in adults can also affect the pharmacokinetics of drugs but the information, according to a paper by Srinivas, is mixed.

 

Opportunity to Expand Coverage of Bariatric Surgery and Anti-obesity Drugs

January 6th, 2015

Kaiser Health News reports today on the poor coverage of drugs for obesity by Medicare and private insurance plans. Health plans which are part of the health exchanges established by the Affordable Care Act also have poor coverage. However, there is a strategy to deal with the health exchange ( or marketplace) plans.

As reported here in a paper (see p.8)  Christopher Still and I wrote on the Affordable Care Act’s impact on persons with obesity, the law has a unique provision allowing for review of plans for ‘discriminatory benefit design.’ Robert Pear of the New York Times reports that the Center for Medicare and Medicaid Services is looking at plans to see if their benefit are structured to discriminate against persons with H.I.V./AIDs, autism, diabetes, bipolar, schizophrenia and other diseases. The article reports that the Obama Administration has said it would challenge restrictions on benefits if they were “not based on clinically indicated, reasonable medical management practices.”

This is a huge opportunity for the obesity community to persuade CMS to look at the lack of coverage of anti-obesity drugs and bariatric surgery in plans on the health marketplaces. It is also an opportunity to have CMS look at whether health plans are adequately including behavioral counseling for adult obesity as they are required to do.

 

Improvements Seen in Obesity Reimbursement

May 13th, 2012

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.

 

Sign Up for Future FDA Hearings

April 17th, 2012

The safety and effectiveness of lorcaserin, developed by Arena Pharmaceuticals will be the subject of a meeting of the Endocrinologic and Metabolic Drug Advisory Committee on May 10, 2012. April 18, 2012 is the deadline for filing a request to present oral testimony. See http://www.fda.gov/AdvisoryCommittees/Calendar/ucm296516.htm

Medical Devices for the treatment of obesity will be the subject of two days of a meeting of the Gastroenterology and Urology Devices Panel on May 10 and 11, 2012.  The committee will discuss general issues regarding trial design for clinical studies on the safety and effectiveness of weight loss devices. The deadline for signing up for participating as a public witness is April

http://www.fda.gov/AdvisoryCommittees/Calendar/ucm297473.htm?utm_source=fdaSearch&utm_medium=website&utm_term=Gastroenterology%20advisory%20committee&utm_content=1


 

Senate Pushes FDA toward Approvable Drugs

September 18th, 2011

The Senate Appropriations Committee has passed its Report accompanying the appropriations   bill for the Department of Agriculture and Related Agencies, which includes the Food and Drug Administration. The Report includes the following language, “Obesity Therapeutics– The Committee is concerned with the absence of novel medicines to treat obesity, the second leading cause of preventable deaths in the United States and a disease linked to cancer, high blood pressure, heart disease, diabetes, and stroke. With only diet, exercise, and gastric surgery as options, the lack of obesity medications is a significant unmet medical need. The Committee directs FDA to report by March 30, 2012 on the steps it will take to support the development of new treatments for obesity, including the use of its Risk Evaluation and Mitigation Strategy and other post-marketing authorities, to mitigate risk and ensure rigorous post-market scrutiny while increasing access to novel medications. “ No doubt this will continue to put pressure to have FDA act more positively to find ways to find approvable drugs.

A Diet for the New Administration

September 27th, 2009

December 30, 2008

By Morgan Downey

At this time of year, millions of Americans are hoping the new Administration will solve our seemingly intractable problems at home and abroad. Millions are also hoping to lose weight in the New Year. The two are not unrelated.

Over the past three decades, obesity has increased among all segments of the population, in the United States and abroad. Obesity is now recognized as the fuel behind many major health problems from cancer to diabetes to heart disease, and a significant cause of increasing health care utilization and health care costs.

While this recognition has increased among both Republicans and Democrats (for the first time, both parties recognized obesity in their 2008 party platforms), changing public policy has not caught up with the problem. Under President George W. Bush, Medicare did undo its policy that obesity was not a disease and did expand coverage of surgery for the treatment of obesity. There have been modest increases in the research and prevention budgets at the National Institutes of Health and the Centers for Disease Control and Prevention. But by and large, the efforts of the last eight years have been largely educational: tell people they should lose weight, eat more nutritiously, and exercise more.

Duh! We get it. And it doesn’t work. Frankly, other than bariatric surgery, nothing works very well to lose significant amounts for a long period of time. There simply is not one ‘fix’ that will reverse this disturbing trend.

So here is some advice to the incoming Administration. It should be noted that many appointees named so far have a solid exposure to obesity from a public policy perspective, including former Senator Tom Daschle, nominee for Secretary of Health and Human Services, Peter Orszag, named to head the Office of Management and Budget, Governor Bill Richardson, nominated for Secretary of Commerce, and Melody Barnes, incoming chief of domestic policy at the White House.

Universal health insurance is often put forward as the panacea for all ills. However, Democrats may have to learn that expanding health insurance coverage alone does not translate to a healthier population, especially if obesity continues to increase among children and adolescents. Truth be told, we do not have adequate medical interventions to affect the rates of obesity and its effects. So, if we do not know how to truly prevent obesity or create a long term treatment, what should a new Administration do? Basically, it should focus on how to create the conditions where it is more likely than not that we will find effective strategies for prevention and treatment in the future.

  1. Being a role model is not enough. It’s been noted that George Bush and Barack Obama share a passion for physical activity. Unfortunately, the habits of the chief executive do not translate to population changes. And then there is the smoking thing. Being a role model is not an excuse for inadequate policies.
  2. Make someone responsible for obesity policy development. Right now there is no one tasked at the upper levels of the U.S. Government with dealing with obesity. True, periodically the heads of different agencies give a speech, start a new website or create a new task force but little happens because so many do so little with scant coordination.
  3. Prepare to spend some money. For one of the most significant health problems in the country, the federal government spends vastly less than on obesity than other conditions. Research, prevention and treatment costs for diabetes and heart disease, to name but two, swamp comparable figures for obesity. The federal government is spending more on getting TV converters boxes in US homes than the entire NIH research budget on obesity.
  4. Do not just focus on childhood obesity. While childhood obesity is critical, remember that the population between 7 and 16 spans only 9 years out of a lifetime. Look at obesity over the lifetime and look for relevant interventions. Support childhood prevention programs but require that they have a competent evaluation method so we will know what is working and what is not.
  5. Do focus on research. Perhaps 90% of what we know about obesity has been learned since the discovery of leptin in 1994. Too many people believe that we know everything we need to know about obesity and do not need any more research. That’s not true. A great deal is known but there are many more questions than answers. Scientific credibility on issues around body weight is sorely needed. Every hour on television another weight loss program or product is hyped as being based on doctor’s advice or scientific study. What can help on both fronts is for the Administration to create a National Institute of Obesity Research at the National Institutes of Health. A new entity like this can reenergize researchers on obesity, can more closely coordinate the many disparate programs across NIH, provide leadership to other federal agencies, states and local governments and provide much needed focus on the social and economic impacts of obesity. Furthermore, a director who is articulate can help lead policymakers and the public away from harmful and dangerous products and keep a focus on developing effective interventions. The NIH bureaucracy will oppose “disease specific” research but their interests should not trump the public health needs and the best use of taxpayer dollars.
  6. As part of your health care reform package, remove the bias against drugs for weight loss in the Medicaid statute and change the exclusion of these drugs under Medicare Part D. Then have the Food and Drug Administration revisit its risk/benefit views of drugs to treat obesity. There are few fans of pharmaceutical companies in a Democratic Congress and Administration and there are even fewer who favor drugs to treat obesity. Nonetheless, there is a huge treatment gap. We have more and more effective surgical options, one over-the-counter FDA approved pill, a couple of tried medicines, commercial plans and self-help. What we do not have are the drug treatment options we have for high cholesterol, hypertension or diabetes. Recently, major pharmaceutical companies such as Merck, Pfizer, Solvay and Sanofi-Aventis have dropped or cut back on their programs to develop drugs for obesity. There are two reasons. First, insurance companies will not reimburse for most obesity treatments, including counseling, drugs and surgery. For the pharmaceutical industry, it just did not make economic sense to invest in drugs which were not going to be reimbursed. This is where leadership by Medicaid and Medicare is critical. If these programs support obesity products, private insurance may follow. This is in the government’s long term interest because insurers can avoid treating or preventing obesity knowing that the big effects, like diabetes and heart disease will not be seen until later in life, when Medicare will become the payor. Second, many involved in obesity drug development feel, rightly or wrongly, that the Food and Drug Administration is so risk-averse that they simply cannot afford the long and expensive trials necessary to meet the rising bar of safety. A National Institute of Obesity Research can help shape clinical trials needed by the FDA and speed the process along.
  7. Look to multiply your opportunities. For example, you can use the public works part of the economic stimulus package to construct new gyms in schools, sidewalks, playgrounds, green spaces and biking/walking trails to encourage more physical activity.
  8. Let the states experiment with taxes and proposals like displaying caloric content in restaurants. Vending machines, non-diet soft drinks, high-fat foods have all come under fire in recent years for contributing to the obesity epidemic. The problem is that these products still only contribute a fraction to an individual’s total caloric intake. But no one is sure that they won’t be replaced by other calories. Likewise, there will be voices to restrict food advertising to children through the federal government’s regulatory powers. Use your National Institute of Obesity Research to design evaluation studies so that there is an objective review to see if these policies will work.
  9. Take some leadership internationally. The United States has a long history of involvement in global health issues, such as HIV/AIDs. However, very little is done on the federal level to learn from other countries’ experiences and to help shape global patterns of eating and physical activity.
  10. Avoid the single fix ideas. The obesity field is full of good advice and scant evidence. Focusing on a single fix, such a TV advertising, agricultural subsidies or sweetened beverage may consume a great amount of political resources without producing the outcome you seek.

The obesity epidemic is more likely than not to continue to grow over the next four to eight years. However, the new Administration can position the United States for meaningful change if it takes its time and devotes attention to organizing the effort. With any luck, we can make future New Year’s resolutions more likely to be successful.

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

Research

September 26th, 2009

                                                                                                                                                                                                                                                                              

Research is fundamental to understanding, preventing and treating obesity. And yet research reports are often not accepted by the public or policy-makers. One reason is that almost every adult is their own self-study of weight control. A study might have the most precise protocol, a powerful sample size and control for a variety of factors but if it does not comport with what “I” experience, I am not likely to believe it. But research itself in obesity is not without its difficulties. Many studies are ‘underpowered”, i.e. they have too few subjects to draw a conclusion from. That is why many preliminary studies do not pan out in larger tests. Also, in many cases, especially in drug trials, researchers try to remove “confounders” from the test subjects so they can see if there is an effect of the drug. That means that many patients who are sick, smoke, take other drugs, etc. are excluded from the trial. When the drug, for example, gets used by a more ‘real-world’ sample, the effects sometimes vanish. Studies that rely on self-reported weights or dietary recall or physical activity diaries are sometimes less reliable than studies where a more objective measurement is needed. Self-reported weight and height — Rowland 52 (6): 1125 — American Journal of Clinical Nutrition and COMPARISON OF SELF-REPORTED AND MEASURED HEIGHT AND WEIGHT — PALTA et al. 115 (2): 223 — American Journal of Epidemiology

There also may be a bias from the funding source (See Conflict of Interest in Medical Research, Education, and Practice – Institute of Medicine, Relationship between funding source and conclusion…[PLoS Med. 2007] – PubMed Result, Scope and impact of financial conflicts of interes…[JAMA. 2003 Jan 22-29] – PubMed Result) or a selection of participants which may skew the results one way or another. Currently, there is a lot of concern about ghost written scientific articles. Ghostwriting Widespread in Medical Journals, Study Says – NYTimes.com

What’s a reader to do? The first is to read skeptically. The second is to go to several different papers or research articles. If different authors appear to agree upon key points, chances are that they are on to something. Remember, extraordinary claims require extraordinary evidence. Research is a communications process among researchers and it should be thought of as a dialogue to which we can all listen.

Many readers may find useful this site, The Little Handbook of Statistical Practice. It is a handy guide to understanding some of the statistical issues involved…like association is not causation.

Research is key. If you are interested in furthering research, you should look into participating in a clinical research activity. To see what clinical trials are underway in obesity research, see www.ClinicalTrials.gov/Search of: Open Studies | “Obesity” – List Results – ClinicalTrials.gov

A major NIH initiative is support for Obesity and Nutrition Research Centers. In addition to the research they carry out, these centers are critical training facilities for new investigators exploring obesity. Most have their own websites which can provide additional, valuable information. Their sites may provide you with helpful information. Also included are their annual reports.

  1. University of Alabama Nutrition & Obesity Research Center | Nutrition & Obesity Research Center Annual report at http://www2.niddk.nih.gov/NR/rdonlyres/E6AE7940-23AC-402E-BCAC-D4F11A9213B0/0/Alabama.pdf
  2. University of Colorado at Denver and Health Science Center. No website. Annual report at http://www2.niddk.nih.gov/NR/rdonlyres/061BCC83-261E-4B39-95CC-226C97B03ED2/0/Colorado.pdf
  3. Pennington Biomedical Research Center PBRC – Nutrition Obesity Research Center. Annual report at: http://www2.niddk.nih.gov/NR/rdonlyres/841B5FA5-7AC1-4DDB-AD3F-300B94468560/0/Pennington.pdf
  4. University of Maryland, http://medschool.umaryland.edu/cnru/index.asp. Annual report at http://www2.niddk.nih.gov/NR/rdonlyres/BF6E7D31-948E-450A-AFF5-B863FF427B24/0/Maryland.pdf
  5. Boston, MA  Boston Obesity Nutrition Research Center Annual report at: http://www2.niddk.nih.gov/NR/rdonlyres/83F114DD-E707-4623-BA20-BCE02C33ADF6/0/Boston.pdf
  6. Harvard,MA,  no website. Annual report at: http://www2.niddk.nih.gov/NR/rdonlyres/9AFA2465-42C0-40CB-87DB-35813E80A978/0/Harvard.pdf
  7. University of Minnesota. Minnesota Obesity Center | College of Food, Agricultural and Natural Resource Sciences | University of Minnesota Annual Report at http://www2.niddk.nih.gov/NR/rdonlyres/78A3842A-030C-45F7-856E-5C27BE202C15/0/Minnesota.pdf
  8. Washington University, Missouri http://www2.niddk.nih.gov/NR/rdonlyres/BB5BBA2D-AA63-4B73-99D6-56741BB220B3/0/WashingtonUniversity.pdf
  9. Columbia/Cornell, New York, NY http://www.nyorc.org/favicon.ico Annual Report at: http://www2.niddk.nih.gov/NR/rdonlyres/28E027FF-5212-4F15-960B-4E5C84FF952A/0/NewYork.pdf
  10. University of North Carolina at Chapel Hill. No website. Annual report at: http://www2.niddk.nih.gov/NR/rdonlyres/8836D29C-0AF8-4C6A-914E-9D12828A1A82/0/NorthCarolina.pdf
  11. University of Pittsburgh. No web site. Annual Report at: http://www2.niddk.nih.gov/NR/rdonlyres/C8B65B24-EE7A-495C-B441-05EAD3372283/0/Pittsburgh.pdf
  12. University of Washington. http://depts.washington.edu/favicon.ico. Annual Report at: http://www2.niddk.nih.gov/NR/rdonlyres/739D3F88-98FE-4733-9D31-6BB81A1DA915/0/Washington.pdf

 

New Studies , updated October 16, 2009

Obesity driven GERD drives up health care visits Trends in Gastroesophageal Reflux Disease as Measu…[Dig Dis Sci. 2009] – PubMed Result

Psychiatrists survey on attitudes to obese patients Psychiatrists’ perceptions and practices in treati…[Acad Psychiatry. 2009 Sep-Oct] – PubMed Result

More evidence for role of FTO gene in obesity via loss of control and selecting diet high in fat The FTO gene rs9939609 obesity-risk allele and los…[Am J Clin Nutr. 2009] – PubMed Result

AHRQ summarizes evidence on breast-feeding, finds reduced risk of obesity, type 2 diabetes A Summary of the Agency for Healthcare Research an…[Breastfeed Med. 2009] – PubMed Result

Weight loss after bariatric surgery may be explained by changes in gut hormones controlling appetite. The Gut Hormone Response Following Roux-en-Y Gastr…[Obes Surg. 2009] – PubMed Result