outlook: OBESITY epidemic

SEPTEMBER 01, 2007
Susan Farley

New Research Questions Effects of Breast-feeding on Obesity Risk

Whereas previous research suggested that breast-feeding reduced a child?s risk for obesity, a new report from the American Journal of Clinical Nutrition contends that the playing field is all but leveled when certain factors are considered, including the following:

  • Mother?s education and socioeconomic class
  • Maternal body mass index
  • mount of television watching
  • Amount of time spent in a car

Any positive effects that breast-feeding may have in staving off obesity will likely be weakened by the basic stressors of life. Children who were breast-fed for 6 months or longer, however, were 55% less likely to reside in the top tenth of their age group in body fat percentage. The researchers theorize that the protective effects of breast-feeding are reinforced by qualities in the mothers ?that would make them less likely to raise obese children.?

Dietary Counseling Takes Off the Weight

A review of weight-loss trials has shown that dietary counseling is responsible for a weight loss of 6% of body weight after 1 year, compared with the weight loss in people who had no counseling. The data were obtained from 46 different trials that included 6386 people participating in dietary counseling?based weight-loss programs and 5467 people not involved in such counseling programs. The data review also showed that weight-loss programs that included more frequent meetings and greater calorie restrictions resulted in more successful weight loss over time.

It is important to note that the review showed that, at 3 years, approximately half the weight loss remained, but at 5 years almost none of the weight loss remained. One of the study authors, Michael L. Dansinger, MD, MS, at Tufts- New England Medical Center?s Division of Endocrinology, said that, although researchers were unable to determine how much weight people lost or how long it took them to gain it all back, ?this study shows that lifestyle changes need to be for the long term.? The full study appears in the July 3, 2007, issue of Annals of Internal Medicine.

Attitudes Toward Weight Loss Different for White and Black Women

In the United States, overweight and obese Caucasian women are more likely to seek help with their weight than overweight and obese black women, according to an article from Ethnicity and Disease. Seeking help encompasses getting counseling from a medical professional, a prescription, membership in a weight-loss group, or personal training.

According to the study, black women did not differ from white women in their concern about their body shape and weight, but the white women were more motivated to seek assistance. Neither group named obesity-related health concerns as being the primary reason for wanting to lose weight. Body image was named as an important motivator for white women to seek dieting help, but this was not the case for black women.

These results stem from a survey of 120 Philadelphia-based women. The study authors concluded that modifying weight-loss programs so that the needs and interests of black and other minority women are addressed might be an important first step in encouraging weight loss.

Uncovering Clues to Obesity Risk

Researchers studied a group of 261 women born between 1959 and 1965 to determine which factors might predict their risk of obesity at age 20 and again at age 40.

Risk Factor at Age 20: The amount of weight their mother gained during pregnancy influenced the women?s risk of being overweight at age 20. In fact, every 10-lb increase of weight correlated with a 65% greater risk of being overweight. This factor had no bearing on whether the women would be overweight at age 40, however.

Risk Factor at Age 20 and Age 40: A rapid weight gain between 1 and 7 years of age was a risk factor.

It is important to note that people are heavier today than they were 40 years ago, and women tend to gain more weight during pregnancy (30.5 lb in 2005, compared with 22 lb in the 1960s). The original article appeared in the July 1, 2007, issue of the American Journal of Epidemiology.

Snipping the Vagus Nerve May Control Hunger

An ulcer surgery popular in the 1970s that involved cutting the vagus nerve where it attaches to the front and back of the stomach (vagotomy) may trigger weight loss and is now being considered a viable weight-loss surgery. Although the procedure once provided relief to people suffering from ulcers, it was abandoned when acid-reducing medications became available.

So far, 30 patients have had vagotomies for weight loss at the University of California, San Francisco, or the University of Rochester. Of the 11 who have passed the 1-year mark since their surgery, all but 1 are losing weight, with an average weight loss of 18% of body fat. There were no serious side effects, and patients were able to return home hours after surgery with little pain. At one time, a vagotomy was considered an arduous surgery, but it has since been simplified to just 5 pencil-sized cuts in the abdomen.

Some surgeons are even adding a vagotomy when a patient gets gastricbanding surgery, which is currently one of the more modest weight-loss operations. Patients with the added vagotomy achieved a 43% loss of excess weight at 6 months. Vagotomies are still considered experimental and are being funded by the medical device company EndoVx Inc, which aims to simplify the vagotomy even further by directing high-intensity ultrasound waves down the throat.