Outlook: Obesity

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Calorie Counts Don’t Sway Teens or Parents
Requiring fast-food retailers to post calorie counts on their menus has little impact on the food choices of adults and teenagers, according to a study published online in February by the International Journal of Obesity.

In the study, a research team led by Brian Elbel, PhD, MPH, of New York University School of Medicine, surveyed customers before and after New York City implemented its calorie labeling law in 2008. Both teens and parents said they saw the calorie counts, but that the information did not influence their food choices. For teens, taste and price were paramount.

Of the 427 adolescents and parents who participated in the study, 57% said they noticed the information, but just 9% of teens and 28% of adults said they used it to consume fewer calories. After examining receipts provided by study participants, the researchers concluded that labeling did not change the number of calories consumers purchased.

The authors said that menu labeling laws are “not likely to be enough to influence obesity in a large scale way,” and that a broader approach—one that involves public policy changes and a coordinated effort by food manufacturers—is needed to drive down the nation’s rising obesity rates.

Physicians Fall Short on Weight Loss Advice
Although most obese patients know they need to lose weight, new data suggest that many lack the support they need from health care professionals to achieve that goal. A poll conducted by Harris Interactive in January found that many physicians fail to provide weight loss counseling to patients who are obese or overweight.

Of the 2566 adults surveyed, 19% of those who are morbidly obese, 46% of those who are obese, and 72% who are overweight but not obese said their physicians had never advised them to lose weight. Only a third of all adults (32%) said a physician had told them to lose weight.

Physicians’ silence on the subject didn’t stop patients from setting ambitious weight loss goals, however. A total of 62% of the morbidly obese, 59% of the obese, and 49% of the overweight said they made a New Year’s resolution to lose weight in 2011.

The results indicate an opportunity for pharmacists to provide counseling and ongoing support to patients who are actively trying to lose weight, but may not have adequate guidance from their physician or other health care professionals.

FDA Loosens Limits on Gastric Band Surgery
The FDA announced in February that it relaxed its criteria for a weight loss surgery that was previously only available to patients with a body mass index (BMI) of at least 40, or 35 in the presence of an obesity-related medical condition.

The new rules stipulate that patients must have a BMI of 30 or greater and at least 1 obesity-related condition to be eligible for gastric banding surgery. The procedure involves placing an inflatable ring, called the Lap-Band, around the upper part of the stomach to restrict its capacity and limit food intake.

Allergan, the specialty pharmaceutical company that manufactures the band, called the FDA’s decision “a significant advancement in obesity treatment.” According to the company, approximately 37 million Americans have a BMI of 30 to 40 and at least 1 comorbid disease.

Under the band’s initial approval, a patient with a height of 5 ft, 6 in would qualify for the band if he or she weighed 247 lb, or 216 lb in the presence of heart disease, diabetes, or another obesity-related condition. Now, a patient of the same height weighing just 186 lb could qualify.

The Lap-Band is still indicated only for patients who have failed to lose weight by exercise, diet, or drug therapy, Allergan noted in a press release. To win the expanded approval, the company conducted a study of 149 patients who carried an extra 62 lb and had been obese for 17 years on average.

After a year, 83.9% of participants had lost at least 30% of their excess weight, and more than 65% were no longer obese. Allergan will follow these patients for an additional 5 years to measure the band’s long-term impact on mild to moderate obesity.