Posts Tagged ‘The Obesity Society’

The Obesity Society Meeting-Day Two

October 26th, 2009

Today’s sessions of the Obesity Society’s annual scientific meeting covered a lot of ground.  I think the most interesting  was the session on the relationship of cancer and obesity organized by Ruth Ballard-Barash of the National Cancer Institute and Ted Adams of the University of Utah School of Medicine. Christine Friedenreich, Ph.D. of the Alberta Health Services presented a comprehensive overview of the association between specific cancers and obesity, reviewing the published literature for each cancer. At the end, she proposed that obesity was responsible for about 20% of all cancers. If (in an ideal world) obesity levels could be resolved to normal BMIs, she speculated 1.6 million deaths due to cancer could be saved, 2.2 million new cancer cases could be avoided and we could avoid having 5 million persons living with cancer.

Other key presentations addressed the powerful influence of sleep and circadian rhythms, or the lack thereof, on rising rates of obesity. This led one presenter to suggest that we should have our biggest meals at breakfast and gradually reduce caloric input throughout the day to a light salad at dinner. Rena Wing reported on the 4 year results of the Look Ahead Trial which provided persuasive information for intensive lifestyle counseling over less intensive interventions in reductions in body fat and related metabolic indicators.

Sometimes these meetings morph into abstract, perhaps irrelevant, discussions of minutia   among researchers.  At other times, you feel you are witnessing an emerging new insight into obesity and its effects. So it was today in a session, Is There Good and Bad Body Fat? chaired by Richard Bergman, editor of Obesity, and including prominent researchers, Tamara Harris, Michael Jensen (who readers may remember from our conference at the 2008 Republican National Convention) and Sam Klein. Their task was to unravel which fat was bad and which was good. Their presentations covered detailed, precise research into these tangled issues.  Why are there some obese individuals who were, nevertheless, metabolically normal? Why did bariatric surgery resolve diabetes in some cases but not others?  Why does weight loss resolve some metabolic disorders but not others? For many in the audience, these are the cutting edge questions – today – to understand the metabolic sequela of weight gain, insulin resistance, diabetes and cardiovascular disease. The presenters provided exciting new data interspersed with a camaraderie and jocularity which is the realm of highly accomplished and competitive scientists who admire each other’s works but are not going to give them an inch. Bottom line: adipose cell build up in the liver may explain many of the inconsistencies in present views of the obesity-insulin resistance-metabolic disorders axis. But, build up of adipose cell in the liver is hard to measure given today’s technology and bio-statistical resources. On the other hand, there may well be another factor, not yet identified (kind of like dark matter in astrophysics), which modulates the effects of obesity, insulin resistance and metabolic disorders. The large, enthusiastic audience no doubt left with many possible research proposals in mind to unravel this conundrum. Stay tuned, as they say, “we wait with bated breath,” for the next insight.

The Obesity Society Meeting, Day One

October 25th, 2009

This Saturday, October 24 is the “pre-meeting” day which means it is outside the constraints of the Continuing Medical Education limitations on corporate participation. Most participants head right for the Pharmacology update section. This section involves presentations by mainly pharmaceutical company researchers as to where their compounds are on the tortuous path to approval by the Food and Drug Administration (FDA). To researchers, it is a tip-off as to where their research should be going; to competitors, it is an indication of how their compounds may fare. There are not a few investment advisors in the audience looking to where their clients should place bets as to which company’s products may get approved or not.
A cautionary note: This Saturday show is not unlike the paddock at the Kentucky Derby. Some horses look just beautiful; some are not so handsome but have great records; some are nags but just keep moving along. Over the next few days, more details on these compounds eke out in oral and poster presentations. Sometimes the beautiful horses stumble; sometimes the nags win. It’s a horse race.
Today, however, presentations by three pharmaceutical companies and one researcher for a device manufacturer focused on their products in Phase II or Phase III of development. The companies were Arena, Vivus, Orexigen and Amylin. The one device company was represented on the platform by Lee Kaplan of Harvard, commenting on GI Dynamics’s EndoBarrier system.
I was seated among several highly experienced, knowledgeable obesity researchers and, frankly, keyed off their reactions. The Arena information was impressive but not inspiring. The Vivus presentation showed real promise and indicated a good bet for approval. The Orexigen data was impressive but not overwhelming. Amylin’s products were at an earlier stage of development and should not be compared with those at later stages of development. However, they seem to have a good track on products which may not have the side effects of the other compounds. The GI Dynamics data involved a new surgical intervention which, while promising, had a number of issues around delivering the product.
In short, a lot more needs to be discussed about these compounds. However, these presentations were inspiring to the audience of researchers and clinicians that a new generation of therapies are closer than we think. The Devil is, alas, in the details and over the next few days more details on these and other products will emerge. Stay tuned.