Posts Tagged ‘Institute of Medicine’

Obesity and Cancer

May 15th, 2012

I testified last week at the FDA AdCom on lorcaserin. I prepared my testimony to talk about cancer in humans, rather than cancer in rats, which I knew would be the topic of the meeting. I didn’t deliver all of the following testimony. I only had about 4 minutes so I go through about half.

M. Downey Prepared statement before Endocrinologic and Metabolic Advisory Committee on lorcaserin, May 10, 2010.

Mr. Chairman, thank you for this opportunity to appear before the Advisory Committee. I have no financial relationship with the sponsor and no one paid for my participation at this hearing.

This morning we learned a lot about tumors in rats. Thank you. I learned a lot. Over several years, the committee has discussed the health effects of obesity but I do not recall many discussions about the effects of obesity on human cancer. I have three quick points:

  • Obesity/low physical activity is associated with increased risk of cancer in both men and women

  • Mechanisms of action in different cancers is unknown

  • Weight management appears useful for cancer survivors

Mortality

One study, using NCI Surveillance, Epidemiology, and End Results (SEER) data, estimated that in 2007 in the United States, about 34,000 new cases of cancer in men (4 percent) and 50,500 in women (7 percent) were due to obesity. Recent studies indicate that obesity and being overweight may increase the risk of death from many cancers, accounting for up to 14 percent of cancer deaths in men and 20 percent of cancer deaths in women. NCI:Fact Sheet:Obesity

Epidemiology

Not only is obesity increasing, the normal weight population is totally collapsing. This is an unique change in human physiology.

This is the graph of changes in the US from 1971 to 2008.

However, new projections show that in two decades, the overweight/obese population will increase by 33% and the severe/morbidly obese population will increase by a staggering 138%, according to a new publication by Finkelstein and colleagues at RTI and CDC. AJPM:Finkelstein:Projections_2030

According to the Annual Report to the Nation on the Status of Cancer:

  • Considerable evidence suggests that excess weight may be associated with increased risk of other cancers, including gallbladder, liver, thyroid, and hematopoietic cancers.

  • Lack of physical activity is associated with increased risk of colon, endometrial and postmenopausal and maybe premenopausal breast cancer.

    Excess weight is associated with poorer survival among patients with breast cancer and colorectal cancer.” Eheman C, et al Annual Report to the Nation on the Status of Cancer, 1975-2008, Cancer 2012 May 1;118(9):2338-66

The connection between obesity and cancer have been attributed to:

  • Hormones

  • Growth Factors

  • Inflammation

However, no definitive path of causality has been established.

A study by Ma and colleagues has found starkly increased death rates due to cancer, as well as cardiovascular disease, in a large cohort of 112,000  Americans aged 18-39, followed for 16 years.  Ma J, et al,

But obesity does not appear to have a blanket effect on all types of cancers, nor to affect cancer risk the same in men and women. One study found that obesity increases the risk of dying from all cancers by about 52% in men, but nearly doubled the risk of dying from any type of cancer in women.” PubMed:Calle_2003

In 2011, the Institute of Medicine National Cancer Policy Forum held a workshop on the impact of obesity on cancer survivorship, the general trend of the dialogue was that:

  • It is still an open question on recommending and implementing weight loss among cancer survivors

  • But sufficient evidence of general benefit of lower weight on health and increased risk of recurrence with obesity

  • Practical problems of cancers survivors attempting to lose weight.

Current research:

  • Imayama et al examined the effects of diet and exercise on inflammatory biomarkers in 439 postmenopausal women. The women were randomized to 1 year of caloric restriction diet, aerobic exercise or combined diet and exercise. Women in the diet and diet + exercise group with a 5% or more weight loss reduced inflammatory biomarkers compared with controls. The diet only and diet plus exercise groups showed reductions. Inflammation has been hypothesized to be a mechanism for cancer in obese patients. Cancer Research : Effect of Caloric Restriction

    • Last year, the same research team found that a combined diet and exercise intervention had positive effects on health related quality of life (HRQOL) in overweigh/obese postmenopausal women. Weight loss predicted improvements in physical functioning, vitality and mental health. Improved HRQOL led to positive changes in depression, stress and social support. PubMed: Dietary weight loss and exercise effect on HRQOL

    • A study published last November showed that a high body mass index BMI) at the time of diagnosis of breast cancer is associated with higher mortality, as is weight gain at later times. A low-fat diet rich in fruit, vegetables and fiber seems to be weakly associated with a better prognosis. There was no evidence of any benefit from micronutrients, supplements or antioxidant foods. Alcohol consumption did not affect outcomes in breast cancer. PubMed: Effect of overweight on breast cancer prognosis

    • Early stage overweight and obese endometrial cancer survivors randomized to 6 month lifestyle intervention or usual care. Adherence was 84%. Difference in weight at six months was -4.4kg and -4.6 at 12 months conclusion, behavior change and weight loss are achievable but clinical implications unclear. PubMed: Survivors of Uterine Cancer, SUCCEED Trial

    • A study published last November showed that a high body mass index BMI) at the time of diagnosis of breast cancer is associated with higher mortality, as is weight gain at later times. A low-fat diet rich in fruit, vegetables and fiber seems to be weakly associated with a better prognosis. There was no evidence of any benefit from micronutrients, supplements or antioxidant foods. Alcohol consumption did not affect outcomes in breast cancer. PubMed: Effect of overweight on breast cancer prognosis

    • Early stage overweight and obese endometrial cancer survivors randomized to 6 month lifestyle intervention or usual care. Adherence was 84%. Difference in weight at six months was -4.4kg and -4.6 at 12 months conclusion, behavior change and weight loss are achievable but clinical implications unclear. PubMed: Survivors of Uterine Cancer, SUCCEED Trial

    • A study published last November showed that a high body mass index BMI) at the time of diagnosis of breast cancer is associated with higher mortality, as is weight gain at later times. A low-fat diet rich in fruit, vegetables and fiber seems to be weakly associated with a better prognosis. There was no evidence of any benefit from micronutrients, supplements or antioxidant foods. Alcohol consumption did not affect outcomes in breast cancer. Hauner D, et al, The effect of overweight and nutrition on prognosis in breast cancer. Dtsch Arztebl Intl 2011 Nov. 108(47):795-801/ PubMed: Effect of overweight on breast cancer prognosis

    • Early stage overweight and obese endometrial cancer survivors randomized to 6 month lifestyle intervention or usual care. Adherence was 84%. Difference in weight at six months was -4.4kg and -4.6 at 12 months conclusion, behavior change and weight loss are achievable but clinical implications unclear. Von Gruenigen V et al, Survivors of uterine cancer empowered by exercise and healthy diet (SUCCEES): A randomized controlled trial, Gyneco Oncol 2012 Mar 28 PubMed: Survivors of Uterine Cancer, SUCCEED Trial

 

USAToday Coverage of IOM Recommendations

May 8th, 2012

Multiple strategies needed to fight obesity, study suggests

By Nanci Hellmich, USA TODAY

Updated 1h 12m ago

WASHINGTON – Taming the obesity epidemic in this country needs an all-hands-on-deck strategy so that schools provide students 60 minutes of physical activity daily, fast-food restaurants offer healthier fare for kids, and communities build recreational spaces that encourage physical activity, says a new report out Tuesday. 

  • A new report recommends kids have 60 minutes of active time per day.By Reed Saxon, APA new report recommends kids have 60 minutes of active time per day.

By Reed Saxon, AP

A new report recommends kids have 60 minutes of active time per day.

Sponsored Links

It’s going to take “bold actions” like these and a full-scale effort across all segments of society to reduce the obesity epidemic, says the report from experts convened by theInstitute of Medicine, which provides independent advice on health issues to policy makers, foundations and others.

The goals and some of the strategies were presented here at the Centers for Disease Control and Prevention’s “Weight of the Nation” meeting, where experts are discussing ideas for the prevention and control of obesity.

Currently, two-thirds of adults and a third of children in the USA are overweight or obese, government statistics show. Another study out Monday predicted that as many as 42% of adults may be obese, roughly 30 or more pounds over a healthy weight, by 2030 if actions aren’t taken to reverse the trend.

Extra weight takes a huge toll on health increasing the risk of type 2 diabetes, heart disease, stroke, many types of cancer, sleep apnea and other debilitating and chronic illnesses, and it costs billions of dollars in extra medical expenditures.

The Institute of Medicine committee reviewed more than 800 obesity prevention recommendations to pinpoint the most effective ones.

The report says there is no one answer to this problem, but it’s going to require bringing all the pieces together — the schools, the workplace, health care providers, says Dan Glickman, chairman of the institute committee and former secretary of the U.S. Department of Agriculture. “There are no magic bullets in here, but this report puts it all together.”

The illnesses and costs associated with obesity are spiraling out of control, he says. “If we don’t address this comprehensively, it will basically take us down as a society.”

M. R. C. Greenwood, vice chairwoman of the committee and president of the University of Hawaiisystem, says, “Many people will probably say ‘what’s new’ and what’s new is the clear statement that we must begin to attack this problem collectively on all fronts. It’s a massive problem unlike anything we have ever tackled before.”

Here are the five goals and a some strategies suggested for achieving them:

Make it easier for people to work physical activity into their daily lives. For instance, people need to have safe places to be active including trails, parks, playgrounds and community recreation centers.

Create an environment where healthy food and beverage options are the routine, easy choice.

Fast-food and chain restaurants could revise menus to make sure at least half of their kids’ meals comply with government’s dietary guidelines for moderately active 4- to 8-year-olds, and that those meals are moderately priced.

Businesses, governments and others should adopt policies to reduce the consumption of sugar-sweetened beverages including making clean water available in public places, work sites and recreation areas.

Improve messages about physical activity and nutrition.

The food, beverage, restaurant and media industries should take voluntary action to adopt nutritionally based standards for marketing aimed at children and adolescents, ages 2-17. If those standards aren’t adopted within two years by the majority of companies, then local, state and federal policymakers should consider setting mandatory nutritional standards for marketing to this age group.

Expand the role of health care providers, insurers and employers in obesity prevention.

Employers should provide access to healthy foods at work and offer opportunities for physical activity as part of their wellness/health promotion programs.

All health care providers should adopt standards of practice for preventing, screening, diagnosing and treating people who are overweight or obese.

Make schools a national focal point for obesity prevention.

Students should have nutrition education throughout their school years, and kids in kindergarten through 12th grade should have the chance to engage in a total of 60 minutes of physical activity each school day. This should include participation in quality physical education.

“There’s so much to do, and the country is still doing so little,” says Margo Wootan, director of nutrition policy for the Center for Science in the Public Interest, a Washington-based consumer group. “It seems heartless that we’re abandoning two-thirds of the American population to obesity-related diseases.”

There are lots of ways for students to get an hour of physical activity during the school day including recess, PE, walking and biking to school, classroom activities and after-school sports, Wootan says. “Kids need a chance to run around in order to sit still and learn in the classroom.”

When it comes to food marketing to kids, “companies claim to be taking meaningful action, but still the overwhelming majority of food ads aimed at kids are for unhealthy foods,” she says.

“What industry says is healthy to market to kids is not what most parents and health professionals think is healthy.”

Not everyone is convinced that the actions outlined in the report will make a dent in the obesity problem. “The literature in evaluating interventions like these shows weak effectiveness at best,” says Morgan Downey, editor and publisher of the downeyobesityreport.com. “So rather than evaluate the strategies’ effectiveness, they (the committee members) are just shouting them even louder.”

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Posted 11h 11m ago | Updated 1h 12m ago

 

IOM Supports Calorie Info on Front of Package

October 22nd, 2011

This week the Institute of Medicine issued its recommendations for Front-of-Package labeling, including specific calorie labeling in common household measures. The recommendation reads:

 Recommendation 1

FDA and USDA should develop, test, and implement a single, standard FOP system to

appear on all products. The system should have the following characteristics:

One simple, standard symbol translating information from the Nutrition Facts

panel (NFP) on each product into a quickly and easily grasped health meaning,

making healthier options unmistakable;

Displaying: Calories in common household measure serving sizes (shelf tags to be

used on bulk items such as fruits and vegetables as well as packaged goods),

and Zero to three nutritional “points” (for saturated and trans fats, sodium,

and added sugars);

Appearing on all grocery products, allowing consumers to compare food

choices across and within categories (determination for universal implementation of the symbol system must be preceded by consumer testing and conducted in conjunction with an education and promotion program);

Appearing in a consistent location across products;

Practical to implement by being consistent with nutrition labeling regulations;

Integrated with the NFP so that the FOP symbol system and the NFP are mutually reinforcing;

Providing a non-proprietary, transparent translation of nutrition information into health meaning; and

Made prominent and useful to consumers through an ongoing and frequently refreshed program of promotion integrating the efforts of all concerned parties.

It will be up to the Food and Drug Administration to act on the IOM recommendations. For background on FOP calorie labeling, see my post.

Top Secret: Washington Works

January 25th, 2011

Sticking up for Washington DC and for the joys of lobbying is like celebrating the Black Death these days. No one can deny that virtually all the country thinks Washington is broken, corrupt and at least dysfunctional. And that’s when we residents are on good behavior. The rest of the time we are actually working to destroy the republic. Lobbying and the special interests are intrinsically entwined in this pattern of corruption. Lobbyists, tools of the wealthy, use their money and clout, to win special favors by stealing from good, hard-working families.

Well, there’s a dirty little secret: living and working in Washington is actually great fun. It’s a great place to raise a family and the people here, for the most part, are good, hard-working families who also were attracted from across the globe to be part of this exciting city and involved in important issues and causes.

I wax on because today the newspapers carried stories about the food industry moving to front-of-package labels for calories and other information . Food Makers Offer Own Nutrition Label Plan – NYTimes.com. The effort involves the White House, the food industry, the Institute of Medicine and the Food and Drug Administration (FDA). They are battling over whether the labels on the front should basically inform consumers of the ‘bad’ stuff like calories, salt and fats or allow the food industry to promote the ‘good’ stuff as well, like vitamins, protein, etc. At stake is whether consumers can access better, more accurate information.

Ok, I’ll confess! Stop the waterboarding! Yes, it might be all my fault. I believe I was the first person to propose putting calorie information on the front of the package to stop gaming the calorie information on the current Nutrition Label by setting to the number of servings in a package. At least I don’t know of anyone else who started it before I raised in 2003.

At that time, under the Bush Administration, Secretary of Health and Human Services Tommy Thompson became very concerned about obesity. It was the first time obesity got such high level attention. The FDA was charged with formulating a plan and held a public hearing on the NIH campus. I testified and offered up the front of package calorie information as a suggestion. (See the transcript at US Food and Drug Administration: 03n-0338-tr00002, page 145.) I had no corporate interest at stake, no big law firms, pr firms, thing tanks. Just a number of witnesses offering suggestions.  I just thought it was a good idea. Well, someone at the FDA liked it because it continues to get attention.

There is an old adage, “the world belongs to those who show up.” This is one of those instances where that phrase comes true. It happens in Washington all the time which is why many of us love being here and see ideas transform into reality.

Time for Obesity in Health Care Reform

September 27th, 2009

January 30, 2009 :: By Morgan Downey

These are exciting times for health care reformers. We seem to have a President who is truly committed to reform of the health care system with the political strength to get his program enacted, at least a good part of it. What is the President’s program and how does or can, obesity be part of it?

First, some parts have already been enacted in the American Recovery and Reinvestment Act (ARRA), aka the Stimulus Bill. Millions of federal dollars are starting to flow into (a) expanded Health Care Information Technology, (b) comparative-effectiveness research and (c) expanded research at the National Institutes of Health. In addition, President Obama and several of his key aides, such as Melody Barnes, Director of Domestic Policy Council, and Peter Orszag, director of Office of Management and Budget have both addressed obesity and its important role in reducing health care costs and increasing the nation’s health.

Second, a major component to be worked on this summer is providing health insurance to millions of Americans without health insurance.

How might these plans affect obesity?

Healthcare Information Technology (HIT) may provide some interesting opportunities. In a few places, extensive clinical databases are already in use which track patients receiving bariatric surgery. The Surgical Review Corporation, for one, has 100,000 surgical patients which are being tracked for long-term outcomes. The Geisinger Medical Center in central Pennsylvania also has extensive database on patients in surgical and medical treatment. Such clinical registries can provide a vast improvement in understanding obesity and its co-morbidities as well as tracking long-term improvements. Doing this in real time with real-world patients can add tremendous information to clinical trials, which, by their nature, have more restrictive populations and end-points. Last year, the National Committee on Quality Assurance (NCQA) expanded the widely used HEDIS system which measures quality in managed care plans to capture Body Mass Index (BMI) for adults and children. The Administration’s emphasis on electronic medical records (EMR) in primary care practice, by requiring capture of BMIs, along with other clinical indicators, such as blood pressure, cholesterol levels and lipids, can provide a tremendous database for researchers and has the potential to greatly improve patient care. But there is a third level as well. Private entities, such as Google and Microsoft, are developing Personal Health Records (PHR) for individuals to track their own information, which might include nutritional and exercise patterns. One can almost envision a system whereby food and exercise diaries, clinical indicators, pharmaceutical and surgical information is available for patients, health care professionals and researchers.

Of course, such systems take a lot of effort. Common terminology must be agreed to. Data has to be able to be verified. Systems have to interface and patient privacy has to be protected. Who owns this information is a critical issue.

Comparative effectiveness research has already received a great deal of funding under ARRA. The Institute of Medicine has a panel recommending research priorities and, given the discussion at a public meeting on March 20, 2009, there is good reason to anticipate that obesity will be one of the priorities. But the question should not be just what is the best way to lose weight. The research should look at weight loss by various interventions against standard treatments for a number of the co-morbid conditions associated with obesity. And, while there is good data on the efficacy of weight loss for resolution of type 2 diabetes and cardiovascular disease, less is know about its efficacy in mobility problems, such as knee and hip replacements, asthma or breast cancer.

Finally, the Obama Administration has an enormous opportunity in the coverage of the uninsured to make a real change for persons with obesity. First, the Administration should oppose using overweight or obesity as a pre-existing exclusion. While we do not know what percent of the uninsured population is overweight or obese, it is unlikely that the rate is any lower than the national averages. To exclude 30-60% of the uninsured population because of their weight would be poor policy indeed. Next, the Administration should provide a full range of interventions from counseling on nutrition and physical activity to pharmaceutical and surgical interventions. Not only would this directly address the source of many of the uninsured population’s health care problems, it could break the logjam of resistance to coverage of obesity prevention and treatment. While these two steps will be costly, we have seen the rising rates of health care costs and obesity go hand-in-hand. Economists today see obesity as a major contributor to chronic illness and its costs. Finally, coverage should be tied into electronic records which can track long term outcomes.

In the April 15, 2009 issue of the Journal of the American Medical Association, Johathan Q. Purnell and David R. Flum estimate that gastric bypass surgery could save 14, 310 diabetes-related deaths over five years. The evidence on the power of weight loss to prevent and improve chronic disease is there, if not yet perfect. The Administration has an opportunity to make a major leap forward in addressing obesity. It should not miss this chance.

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

States and Localities

September 27th, 2009

Institute of Medicine guide to localities IOM Releases Action Steps for Local Governments to Prevent Childhood Obesity – RWJF

Gallup map of state obesity, diabetes rankings. Obesity and Diabetes: Across States, a Clear Relationship

Map of state’s health America’s Health Rankings 2008 – Nation at a Glance

State Policies and Prevalence: F as in Fat 2009 – Trust for America’s Health

How States can use evaluation http://www.yaleruddcenter.org/resources/upload/docs/what/communities/HowStatesCanUseEvaluation.pdf

Counties

What Counties Can Do: NACo | Childhood Obesity Crisis: What Can Counties Do?

Cities

Mayors’ Guide to Combating Obesity: http://usmayors.org/chhs/healthycities/documents/guide-20080306.pdf

Neighborhoods

CDC community guides The Community Guide – Obesity Prevention

https://www.policyarchive.org/bitstream/handle/10207/4602/RAND_RB9267.pdf?sequence=1

How Neighborhoods Affect Obesity. RAND | Research Briefs | How Neighborhoods Can Reduce the Risk of Obesity

CDC Community Physical Activity The Community Guide – Promoting Physical Activity

The National Library of Medicine’s Medline Plus can help you find local community resources at MedlinePlus Go Local Index