Posts Tagged ‘hunger’

Hunger, Prader-Willi Sydrome and differences between the brains of persons at normal weight and with obesity

January 15th, 2014

A New York Times report today by Andrew Pollock details the efforts of researchers and drug companies to unravel the mysteries of Prader-Willi Syndrome. Prader-Willi Syndrome is marked by insatiable appetite and obesity. Patients often slow metabolisms, intellectual difficulties and autistic behavior. (For more information see the Prader-Willi Syndrome Association website.) The condition is known to be caused by missing segments on chromosome 15. While Prader-Willi is a genetic disease, it is not necessarily found in families. 70% of cases are due to a deletion in chromosome 15 from the father; deletion from the maternal side is responsible for about 20%.  This is known as genomic imprinting where the gene turns on or off depending on which parent contributes it.

Drug developers Ferring Pharmaceuticals, Rhythm, Arena Pharmaceuticals (which sells Belviq, an FDA approved drug for weight loss) and Zafgen are looking at drugs for the condition. Zafgen is releasing results of a small clinical trial today.

While Prader-Willi is a rare condition and is well-understood regarding its genetic cause, research on the syndrome is helping to open up research on the fundamental aspects of hunger.

One of the great gaps in public and policy-makers understanding of obesity is the role of hunger, driven by powerful networks within our bodies. Hunger is clearly one of the most powerful of human emotional states as it involves existential survival, much like the inability to breathe or drowning. In my experience, many persons with obesity report nearly constant states of hunger which our food-laden environment is almost universally able to slake. But reports from individuals are a poor substitute for research. Now, in the past decade, science has filled in the gaps.

After a meal, appetite is suppressed; after energy expenditure hunger is increased. Those sensations, satiety and hunger, are caused by changes in nutrients and hormones, including PYY, GLP-1, ghrelin, leptin and insulin circulating in the body. In normal physiology, the hypothalamus balances the food intake with the metabolic requirements. This system works, usually, with great precision. This appetite process is called homeostatic. Non-homeostatic food control is driven by sight, smell, taste, habits, emotional and economic influences. The brains areas involved in nonhomeostatic food control include the hippocampus, the amygdala, insula, striatum and orbitofrontal cortex. The two systems are not independent but highly integrated.

Recent research points to understanding that higher food intake in persons with obesity is due, probably in substantial part, to differences in how the brains of  persons with obesity respond to food cues compared to  persons at “normal” weights.

Researchers using techniques such as functional Magnetic Resonance Imaging (fMRI) are mapping the physiological networks of hunger and are understanding  why we get hungry and why maintaining weight loss is so hard. FMRI allows scientists to locate specific areas of the brain which show responses to specific stimuli. Thus they can compare obese and lean subjects in different conditions. (For an explanation of the use of fMRI studies in appetite regulation see this article from de Silva and colleagues and from which this illustration is taken.

Using fMRI, researchers at Emory University have identified areas in the brain identified with taste and the reward system that ‘light up’ when subjects just looked at pictures of appetizing food.  Meanwhile, other researchers, also using fMRI, found different reactions to pictures of high-calorie foods between men and women. When healthy subjects were given injections of ghrelin, fMRI scans showed increased brain activity in response to pictures of food and were correlated with self-reported hunger ratings. (Ghrelin is a peptide hormone that stimulates hunger and food consumption.) Just in October, a study was published showing that images of high fat foods produced stimulation of the brain’s reward network in Hispanic females.

It isn’t only pictures of food which tweak the brain. Subjects with obesity differed from lean subjects in which area of the brain responded to food aromas. The brain areas affected by food aromas are similar to those affected by addictive substances, like alcohol.

In short, individuals prone to weight gain and obesity have altered neuronal responses to food cues in brain regions known to be important in energy intake regulation and these differ from lean person’s responses.

Of great concern is when such differences occur? A study from the University of Kansas Medical Center used fMRI on children and adolescents, ages 10-16, half at a healthy weight and half with obesity. They found the obese group showed greater activation to food pictures both before and after a meal than the healthy weight group. Unlike the healthy weight group, the obese group’s response to food stimuli did not diminish significantly after eating. The authors concluded, “This study provides initial evidence that obesity, even among children, is associated with abnormalities in the neural networks involved in food motivation, and the origins of neural circuitry dysfunction associated with obesity may begin in early life.”

This understanding of obesity has great implications for the prevention and treatment of obesity and for the establishment of effective public policies.

A New Understanding of Body Weight Regulation

September 17th, 2012

John Blundell and colleagues have come out with an interesting new paper, “Role of resting metabolic rate and energy expenditure in hunger and appetite control: A New Formulation.” The paper provides a fascinating insight into human body weight regulation, appetite and the recurring drive to eat. The  resting metabolic rate (RMR) refers to the energy needed to keep our bodies functioning. Of all of the components of energy expenditure, it is the largest, accounting for about 50%-70% of total energy expenditure.  The liver contributes about 20% to the RMR, the brain another 20%, the heart 11%, the GI tract 9% and skeletal muscle another 20%. The drive to eat is predicated on getting enough energy to these systems to keep them running.

Blundell and colleagues’ paper explores a long-running research question as to the influence energy expenditure has on energy intake. As many people know, one of the problems with the ‘eat less, exercise more’ prescription is that exercising often leads to greater hunger, then to more eating, negating or lessening the weight-related benefits of exercise in the first place.  They noted previous research that found that exercise caused a significant increase in levels of hunger but this was highly variable between individuals. However, they also observed an increase in post-feeding satiety signalling. What the researchers found was that fat-free body mass but not fat mass or BM is strongly correlated with meal size and daily energy intake. The write, “The strong implication of this relationship is that some privileged molecules arising from FFM (fat free mass) or some physiological consequences that reflect the activity of FFM, act as a signal to drive food intake.” They note, further, that RMR is positively associated with meal size and daily energy expenditure. It is also a strong predictor of fasting levels of hunger and influences the daily profile of hunger. Ergo, RMR is the driver of food intake. They suggest three components of appetite regulation: a drive for food arising from the physiological demand for energy; an inhibition of eating arising from signals of energy storage, primarily adipose tissue; and additional inhibitory signals arising from the mouth and GI tract.

Regarding weight management, the authors note that their observations bring additional dissatisfaction with the Body Mass Index (BMI) as a measure of excess weight. They note that persons with obese, as well as people with large muscle mass, would have a higher tendency to consume larger meals just to maintain their RMR and greater difficulty in tolerating dietary restrictions. RMR is not the cause of obesity; it is the mechanism for preserving body weight. The amount of food actually consumed is determined by energy density. A high RMR could influence weight gain by maintaining a high level of hunger but a positive energy balance (i.e. gaining additional weight) would “depend on the energy density and palatability of the diet.” Increasing fat-free mass and RMR would increase the drive to eat “meaning that weight gain becomes part of a positive, rather then a negative, feedback system. Increasing body weight therefore could facilitate further weight gain and increase the difficulty of weight loss or maintenance.” See PubMed: Role of Resting Metabolic rate and Energy Expenditure

The universal call to “maintain a healthy weight”, “avoid weight gain” and “eat less to lose weight” begs the question, “How many calories should I be consuming?” The answer is your resting metabolic rate. Going well below that rate induces strong hunger signals and a return to earlier calorie consumption levels. Almost all diet advice tries to get dieters to consume just about their RMR to encourage weight loss and avoid triggering hunger cues. RMR can be measure in the laboratory using very sophisticated tools. But most consumers will look to web-based calculators. And this is a sorry story indeed.

 

Why the weight lost comes back

October 28th, 2011

It comes as no surprise that regaining weight after weight loss is common and frustrating to dieters. It also limits choices for policy makers who, in general, had avoided treatment strategies because of the transient nature of weight loss.

It also comes as no surprise that, after weight loss, metabolism of overweight persons slowed down and hormonal changes increased the powerful sensation of hunger. This double whammy makes maintenance of weight loss so challenging.

Now come researchers from Australia who studies a small group (only 50 overweight and obese patients without diabetes) . The group lost about 13.5kg  which led to reductions in levels of leptin, peptide YY, cholesystokinin, insulin and amylin and increases in ghrelin. There was also an increase in subjective appetite.(See Brain and Gut for background.) What is new is that these changes persisted for one year after initial weight loss. They did not revert to the levels recorded before weight loss, probably explaining why so many dieters relapse. See http://www.ncbi.nlm.nih.gov/pubmed/22029981.

Gina Kolata, writing in the New York Times, quotes Dr. Jules Hirsch as saying that researchers may just not know enough about obesity to prescribe solutions yet. “One thing is clear, he said, “A vast effort to persuade the public to change its habits just hasn’t prevented or cured obesity.” “We need more knowledge,” Dr. Hirsch said, “Condemning the public for their uncontrollable hedonism and the food industry for its inequities just doesn’t seem to be turning the tide.” Study Shows Why It’s Hard to Keep Weight Off – NYTimes.com

Obesity A-Z

September 26th, 2009

There are numerous issues involved in understanding, preventing and treating obesity. Specific diseases are treated in the Health Effects section. Below are a number of other issues. The citations are not meant to be exhaustive but merely to help the reader begin the search for various sources of information. MD

Adherence

Adherence can also be called willpower or compliance. It refers to individual behavior continuing a program of recommended advice, from following a diet to taking medications. Adherence or compliance is a major issue in health care.

http://obssr.od.nih.gov/pdf/Workshop_final_report.pdf

In spite of many efforts to improve Americans life style, the percentage of Americans following all five recommendations has dropped to an all time low – just 8% Adherence to healthy lifestyle habits in US adults…[Am J Med. 2009] – PubMed Result

For more information, see NIH Office of Behavioral and Social Sciences Research (OBSSR) – Adherence

Adiponectin

Higher adiponectin levels associated with lower risk of type 2 diabetes Adiponectin levels and risk of type 2 diabetes: a …[JAMA. 2009] – PubMed Result

Adipose Tissue

Obesity is about excess adipose tissue. However, adipose tissue is essential for survival and reproduction of the species. In excess amounts, it can, of course cause poor health and early mortality. Researchers have made great strides in understanding this tissue.

The perfect storm: obesity, adipocyte dysfunction,…[Clin Chem. 2008] – PubMed Result

Impact of increased adipose tissue mass on inflamm…[Curr Diab Rep. 2009] – PubMed Result

The role of adipose tissue dysfunction in the path…[Physiol Behav. 2008] – PubMed Result

Fat storage and the biology of energy expenditure. [Transl Res. 2009] – PubMed Result

Adiposity Rebound

Adiposity or fatness increases in the first of year of life and then decreases. About age 6, fatness increases again. This is called adiposity rebound and it is considered to be a critical time when the conditions for adult obesity can become established.

Early adiposity rebound: review of papers linking …[Curr Opin Clin Nutr Metab Care. 2005] – PubMed Result

Adolescence

Food companies targeting adolescence in the digital age Interactive food and beverage marketing: targeting…[J Adolesc Health. 2009] – PubMed Result

Maternal gestational weight gain and offspring wei…[Obstet Gynecol. 2008] – PubMed Result

Adolescent pregnancy and subsequent obesity in Afr…[J Adolesc Health. 1994] – PubMed Result

Changes in physiology with increasing fat mass. [Semin Pediatr Surg. 2009] – PubMed Result

Drugs shown to have efficacy, safety for adolescents Efficacy of weight loss drugs on obesity and cardi…[Obes Rev. 2009] – PubMed Result

No difference between obese and non-obese adolescent food consumption Comparison of high-calorie, low-nutrient-dense foo…[Obes Res. 1999] – PubMed Result

Problem eating behaviors Problem eating behaviors related to social factors…[Int J Behav Nutr Phys Act. 2007] – PubMed Result

Changes in adolescent beverage consumption Five-year longitudinal and secular shifts in adole…[J Am Diet Assoc. 2009] – PubMed Result

And in physical activity Longitudinal and secular trends in physical activi…[Pediatrics. 2006] – PubMed Result

International Journal of Obesity – Clinical research in adolescents: challenges and opportunities using obesity as a model

Comorbidities of overweight/obesity experienced in…[Arch Dis Child. 2009] – PubMed Result

Longitudinal and secular trends in weight-related …[Obesity (Silver Spring). 2008] – PubMed Result

Overweight, obesity, and health-related quality of…[Pediatrics. 2005] – PubMed Result

Depression in adolescents A prospective study of the role of depression in t…[Pediatrics. 2002] – PubMed Result

Agricultural subsidies

No effect on obesity, from USDA http://www.agecon.ucdavis.edu/extension/update/articles/v11n2_1.pdf

EconPapers: Farm subsidies and obesity in the United States: National evidence and international comparisons

Are rising obesity rates linked to U.S. farm aid? | McClatchy

Farm Subsidies Over Time

ScienceDirect – Food Policy : Farm subsidies and obesity in the United States: National evidence and international comparisons

Alcohol Calorie Calculator

http://www.collegedrinkingprevention.gov/CollegeStudents/calculator/alcoholcalc.aspx

Basal Metabolic Rate

The basal metabolic rate (closely related to the resting metabolic rate) is the amount of calories our bodies need to just maintain their normal functions, like metabolism, breathing, blood flow, etc. It is the baseline for determining one’s caloric input.

Basal Metabolism Rate Calculator (note: BMR calculators can have a high degree of variation : BMR Calculator

Breakfast

Is consumption of breakfast associated with body m…[J Am Diet Assoc. 2005] – PubMed Result

Breast-feeding

Mothers more likely to cease breastfeeding The association of maternal overweight and obesity…[J Pediatr. 2006] – PubMed Result

Overweight obese mothers less likely to breastfeed. A systematic review of maternal obesity and breast…[BMC Pregnancy Childbirth. 2007] – PubMed Result

Breastfeeding in infancy and adult cardiovascular …[Am J Med. 2009] – PubMed Result

Australian study shows mothers with obesity more likely to cease breastfeeding Maternal obesity and initiation and duration of br…[Matern Child Nutr. 2008] – PubMed Result

Exclusive breastfeeding of Swedish children and it…[BMC Pediatr. 2008] – PubMed Result

Calculators

Calories Burned UMMS: Calories Burned Calculator

Canada

See Canadian Obesity Network – Obesity Canada

Quality of life of patients with obesity The health status of obese individuals in Canada. [Int J Obes Relat Metab Disord. 2001] – PubMed Result

Prevalence of obesity in Canada. [Obes Rev. 2005] – PubMed Result

BMI and Mortality: Results From a National Longitu…[Obesity (Silver Spring). 2009] – PubMed Result

Child Abuse

Childhood maltreatment in extremely obese male and…[Obes Res. 2005] – PubMed Result

Relation of childhood sexual abuse and other forms…[Obes Surg. 2006] – PubMed Result

Childhood sexual abuse and obesity. [Obes Rev. 2004] – PubMed Result

Child abuse is associated with both obesity and depression in middle age women

Associations of child sexual and physical abuse wi…[Child Abuse Negl. 2008] – PubMed Result

Obesity risk for female victims of childhood sexua…[Pediatrics. 2007] – PubMed Result

Obesity and type 2 diabetes risk in midadult life:…[Pediatrics. 2008] – PubMed Result

Common Sense

‘Common sense’ when used to describe some obesity intervention usually is short for “there’s no data to support this.” Usually within 18 to 24 months there is study showing the ‘common sense’ recommendation didn’t work.

Cuba

Cuba presents an interesting case study. With the fall of the Soviet Union, Cuba, faced with reduction of subsidies from their former patron, went into an economic crisis, known as the “Special Period.” As a result, calories consumed per day dropped, physical activity increased and there was a modest 1.5 unit shift in BMI with reductions in obesity prevalence and increases in overweight and normal weight. Deaths attributed to diabetes, coronary heart disease, stroke and all causes declined as well, suggesting population wide measures might reduce disease and increase mortality. Obesity reduction and its possible consequences: w…[CMAJ. 2008] – PubMed Result and Impact of energy intake, physical activity, and po…[Am J Epidemiol. 2007] – PubMed Result (While the Cuban experience is an extremely interesting situation, the question must be asked whether a democratic government not in extreme economic peril could impose such a draconian situation on its people. MD)

Disparities

While rates of obesity are increasing in all demographic categories, large difference between groups are very evident, leading researchers to ask why different groups in the same environment should have such divergent outcomes.

Obesity, Gynecological Factors, and Abnormal Mammo…[J Womens Health (Larchmt). 2009] – PubMed Result

State of disparities in cardiovascular health in t…[Circulation. 2005] – PubMed Result

Disparities in preventive care by body mass index …[Women Health. 2008] – PubMed Result

The obesity epidemic in the United States–gender,…[Epidemiol Rev. 2007] – PubMed Result

Racial divergence in adiposity during adolescence:…[Pediatrics. 2001] – PubMed Result

Gender-ethnic disparity in BMI and waist circumfer…[Obesity (Silver Spring). 2009] – PubMed Result

Women Obesity in black women. [Epidemiol Rev. 1987] – PubMed Result

Eating Behavior

The psychology of food craving. [Proc Nutr Soc. 2007] – PubMed Result

RAND | RAND Health | Eating as an Automatic Behavior

Food cravings and energy regulation: the character…[Int J Obes (Lond). 2007] – PubMed Result

Eating Disorders

[Night eating syndrome and nocturnal eating–what …[Psychother Psychosom Med Psychol. 2009] – PubMed Result

Teasing history, onset of obesity, current eating …[Obes Res. 2000] – PubMed Result

Childhood psychological, physical, and sexual malt…[Obes Res. 2001] – PubMed Result

Eating disorders and obesity: two sides of the sam…[Epidemiol Psichiatr Soc. 2009 Apr-Jun] – PubMed Result

http://www.womenshealth.gov/BodyImage/bodyworks/CompanionPiece.pdf

Does talking about weight lead to eating disorders? A Parent’s Innocent Word Can Trigger a Dangerous Eating Disorder – washingtonpost.com

Role of parents: Risk Factors for Full- and Partial-Syndrome Early …[J Am Acad Child Adolesc Psychiatry. 2009] – PubMed Result

Elderly

Obesity: What is an elderly population growing int…[Maturitas. 2009] – PubMed Result

Elderly risk for obese men Overweight and obesity and the burden of disease a…[Int J Obes Relat Metab Disord. 2004] – PubMed Result

Applicability of Federal Guidelines An evidence-based assessment of federal guidelines…[Arch Intern Med. 2001] – PubMed Result

Fat or Fit Debate

Relationship between low cardiorespiratory fitness…[JAMA. 1999] – PubMed Result

Fitness and abdominal obesity are independently as…[J Intern Med. 2009] – PubMed Result

Food

The obesity-by-choice debate. Effect of nutrient composition Obesity by choice revisited: effects of food avail…[Physiol Behav. 2007] – PubMed Result

Biology trumps knowledge in model of food choices Is Dietary Knowledge Enough? Hunger, Stress, and Other Roadblocks to Healthy Eating

USDA Food Plans: Cost of Food Cost of Food at Home

Eating and Health Module (ATUS)

Food and Beverage Marketing

See Institute of Medicine Report, Food Marketing and the Diets of Children and Youth – Institute of Medicine

CDC Congressional Testimony CDC Washington Testimony September 23, 2008

Use of branded web sites Food and beverage brands that market to children a…[J Nutr Educ Behav. 2009 Sep-Oct] – PubMed Result

Use of cartoon and other characters Marketing foods to children and adolescents: licen…[Public Health Nutr. 2009] – PubMed Result

The ‘Sydney Principles’ for reducing the commercia…[Public Health Nutr. 2008] – PubMed Result

Glycemic Index

Low glycaemic index or low glycaemic load diets fo…[Cochrane Database Syst Rev. 2007] – PubMed Result

Hunger

Hunger as powerful, primordial emotion The role of primordial emotions in the evolutionar…[Conscious Cogn. 2009] – PubMed Result

Ireland

Prevalence of overweight and obesity on the island…[BMC Public Health. 2007] – PubMed Result

Intensive Care

Effect of obesity on intensive care morbidity and …[Crit Care Med. 2008] – PubMed Result

Menu Labeling

Menu Labeling in Food Chains http://www.yaleruddcenter.org/resources/upload/docs/what/reports/RuddMenuLabelingReport2008.pdf

Microorganisms

Fat Factors – New York Times

Obesity – Extending the Hygiene Hypothesis. [Nestle Nutr Workshop Ser Pediatr Program. 2009] – PubMed Result

Interplay between obesity and associated metabolic…[Curr Opin Pharmacol. 2009] – PubMed Result

Gut microbiota and its possible relationship with …[Mayo Clin Proc. 2008] – PubMed Result

Military

Military family physician attitudes toward treatin…[Mil Med. 2008] – PubMed Result

Attitudes and practices of military family physici…[Mil Med. 2001] – PubMed Result

Mortality

For many years, the issue of whether obesity causes an increase in premature deaths has been hotly debated. The public frequently receives conflicting information on the topic. Is it ok to be overweight? Are only persons with severe obesity at risk? In the final analysis, I think the American Heart Association’s Scientific Consensus gets it right…at some point (the curve of body weight) the heavier have higher rates of premature deaths. At what exact point on the BMI scale that takes place is open to discussion, but the curve always goes up. MD)

See Mortality, health outcomes, and body mass index in…[Circulation. 2009] – PubMed Result

An August 2009 study shows obesity is responsible for about 95 million Years-of-Life-Lost. White femals account for more than 2/3 of that amount. Without changes in the obesity prevalence, the life expectancy of US adults may decrease. Individual and Aggregate Years-of-life-lost Associ…[Obesity (Silver Spring). 2009] – PubMed Result

New: Study estimates overweight/obesity and physical inactivity each responsible for 1 in 10 deaths in the US.The preventable causes of death in the United Stat…[PLoS Med. 2009] – PubMed Result

Will the rise in obesity affect future mortality rates? Trends in Health Behaviors and Health Outcomes

The preventable causes of death in the United Stat…[PLoS Med. 2009] – PubMed Result

Optimal Body Weight for the Prevention of Coronary…[Obesity (Silver Spring). 2009] – PubMed Result

Will the rise in obesity affect future mortality rates? Trends in Health Behaviors and Health Outcomes

Does intentional weight loss increase longevity? Long-term weight loss effects on all cause mortali…[Obes Rev. 2007] – PubMed Result

Obesity and Mortality after Stroke The Impact of Body Mass Index on Mortality After S…[Stroke. 2009] – PubMed Result

Preventable causes of death The preventable causes of death in the United Stat…[PLoS Med. 2009] – PubMed Result

Effect of physical inactivity Effects of physical inactivity and obesity on morb…[Med Sci Sports Exerc. 1999] – PubMed Result

Obesity, Mortality and Nursing Home Residents Obesity and mortality in elderly nursing home resi…[J Gerontol A Biol Sci Med Sci. 2005] – PubMed Result

Morbid obesity is an independent determinant of de…[Crit Care Med. 2006] – PubMed Result

The body mass index paradox and an obesity, inflam…[Semin Dial. 2004 May-Jun] – PubMed Result

Overweight, obesity, and mortality from cancer in …[N Engl J Med. 2003] – PubMed Result

Nursing Homes

Elderly in nursing homes Obesity in nursing homes: an escalating problem. [J Am Geriatr Soc. 2005] – PubMed Result

Oral Bacteria

Is obesity caused by an oral bacteria? Is obesity an oral bacterial disease? [J Dent Res. 2009] – PubMed Result

Pets

The young and old, rich and poor, black and white are becoming more obese. Is it any wonder that our pets would also see increases in their weight? As a matter of fact, veterinarians are very concerned about obesity in pets and have even formed a society to address the problem. See Pet Obesity Facts and Risks

Overweight in dogs, but not in cats, is related to…[Public Health Nutr. 2009] – PubMed Result

Portion Size/Control

The contribution of expanding portion sizes to the…[Am J Public Health. 2002] – PubMed Result

The influence of food portion size and energy dens…[Am J Clin Nutr. 2005] – PubMed Result

Energy density and portion size: their independent…[Physiol Behav. 2004] – PubMed Result

Public Health

Prevalence of selected risk behaviors and chronic …[MMWR Surveill Summ. 2008] – PubMed Result

Reimbursement

Should medicare reimburse providers for weight los…[Am Psychol. 2007] – PubMed Result

http://www.obesityaction.org/advocacytools/insurance/OAC%20Insurance%20Piece.pdf

Social Networks

In the past couple of years, researchers have been exploring new theories for the rapid spread of obesity. One of these areas is social networks of individuals, i.e. their close friends and relatives.

One of the earlier studies can be found here The spread of obesity in a large social network ov…[N Engl J Med. 2007] – PubMed Result but also see Adolescent obesity and social networks. [Prev Chronic Dis. 2009] – PubMed Result

Weight loss may positively impact spouses Weight loss treatment influences untreated spouses…[Int J Obes (Lond). 2008] – PubMed Result

Stress

Shaping the stress response: interplay of palatabl…[Mol Cell Endocrinol. 2009] – PubMed Result

Chronic stress and comfort foods: self-medication …[Brain Behav Immun. 2005] – PubMed Result

Role of stress and weight gain Stress and obesity: the role of the hypothalamic-p…[Curr Opin Endocrinol Diabetes Obes. 2009] – PubMed Result

Sugar sweetened Beverages

Sugar-sweetened soft drinks and obesity: a systema…[Nutr Res Rev. 2008] – PubMed Result

Soft drinks and weight gain: how strong is the lin…[Medscape J Med. 2008] – PubMed Result

Intake of sugar-sweetened beverages and weight gai…[Am J Clin Nutr. 2006] – PubMed Result

Soft drinks and weight gain: how strong is the lin…[Medscape J Med. 2008] – PubMed Result

Sugary soda consumption and albuminuria: results f…[PLoS One. 2008] – PubMed Result

Soft drinks and ‘desire to drink’ in preschoolers. [Int J Behav Nutr Phys Act. 2008] – PubMed Result

Taxing Soft Drinkshttp://www.yaleruddcenter.org/resources/upload/docs/what/reports/RuddReportSoftDrinkTaxFeb2009.pdf

Taste

What is role of taste and obesity Taste and weight: is there a link? [Am J Clin Nutr. 2009] – PubMed Result

Technology

Smartphone apps for weight loss Smartphone Training Apps Help You Sweat the Details – NYTimes.com

Computerized BMI prompt increases counseling Effect of a computerized body mass index prompt on…[Fam Med. 2009 Jul-Aug] – PubMed Result

Television Viewing

According to this study, food advertising on TV is a major contributor to childhood obesity By how much would limiting TV food advertising red…[Eur J Public Health. 2009] – PubMed Result

http://www.nber.org/digest/aug06/aug06.pdf

Association between television viewing and poor di…[Int J Pediatr Obes. 2008] – PubMed Result

The association of television and video viewing wi…[Obesity (Silver Spring). 2006] – PubMed Result

Television viewing and television in bedroom assoc…[Pediatrics. 2002] – PubMed Result

Association of maternal obesity and depressive sym…[Arch Pediatr Adolesc Med. 2003] – PubMed Result

Time

USDA: Why working parents outsource children’s meals 2008 Farm Act Makes It Easier for Food Assistance Households To Save – Amber Waves March 2009

Eating and Health, USDA time use study data Eating and Health Module (ATUS) – ERS/USDA Data

Who has time to cook? Who Has Time To Cook? How Family Resources Influence Food Preparation

Americans of different weights spend same amount of time eating How Much Time Do Americans Spend Eating? – June 2008

United Kingdom

Tackling Obesities: Future Choices Project

Vending Machines

Vending machine offerings unhealthy The food and beverage vending environment in healt…[Pediatrics. 2009] – PubMed Result

Virus

Adenovirus Picture: adenovirus Ad-36 (implicated in obesity epidemic) by Russell Kightley MediaOb