outlook: OBESITY epidemic

Pharmacy Times, Volume 0, 0

Moms' Weight Loss FollowingGastric Bypass Impacts FutureChildren's Weight

Recent research shows that womenwho are morbidly obese can help preventtheir children from becomingobese by losing a large amount ofweight after gastric bypass surgery andbefore they become pregnant.

The study looked at obesity rates in172 children between the ages of 2and 18, who were born to 113 motherswho were previously obese and lostweight following surgery. These rateswere compared with those of 45 siblingsborn to the mothers prior to theirweight loss through gastric bypass.

For children born after mom's surgery,obesity rates dropped by 52%, andsevere obesity rates dropped by 45%.Among children between 6 and 18years old, rates of overweight were similarto those in the general population.

Researchers noted no increase inunderweight children in this studygroup, as a concern exists that weightloss surgeries may cause harmfulundernutrition. They also note that gastricbypass may preventthe harmful effectsof excess pregnancyweight, whichmay cause "overnutrition"of the fetus.

Lead author John G.Kral, MD, PhD, remarked,"It is nothingshort of remarkablethat both genes andfamily environmentare nullified by preventingovernutritionin the womb."

Healthy LifestyleWithout Dieting IsOK

British researcherstested a program oflifestyle changes on 62 obese womenand found that health benefits can beachieved without dieting. By implementingexercise programs such as taichi, water aerobics, and circuit trainingand adding behavior modification, theobese women were able to improvetheir health risks in the absence of significantweight loss.

Women following this lifestyle-modificationprogram for a year lost a smallamount of weight—5.3 lb, but theyshowed significant improvements inself-image, they were more fit, and theywere experiencing less stress. They alsoshowed improvements in blood pressure,cholesterol levels, and heart rates.

Researchers encouraged the women,aged 24 to 55, not to diet, but theywere taught healthy eating choices,how to understand food labels, andhow to prepare nutritious meals. Theprogram also included 4 hours of exerciseper week and social support.

Erika Borkoles, MSc, of Leeds MetropolitanUniversity in England noted,"Psychological and physical healthimproved independent of substantialweight loss." She went on to say thatweight is a proper predictor of health.

Lack of Exercise Affects Bone Health

Weight loss through calorie restrictioncan result in bone loss at the hipand spine, resulting in fractures andosteoporosis, according to a study publishedin the December 2006 issue ofArchives of Internal Medicine.

Researchers at the Washington UniversitySchool of Medicine in St. Louis,Mo, studied the effects of weight losson bone health in 48 men and womenwhose average age was 57 and whowere overweight and not obese.

For one year, 19 participants adheredto a restricted-calorie diet, 19consumed their usual calories butadded regular exercise, and 10 in acontrol group received only healthylifestyle tips. Only 2 participantsdropped out of the study. After a year,the calorie-restricting group lost anaverage of 18.1 lb, the exercising grouplost an average of 14.8 lb, and the controlgroup had no significant weightloss. The dieters also lost an average of2.2% of bone density in the lower spineand hip, whereas participants in theother 2 groups had no significantchanges in bone mineral density.

The effect of muscles pulling onbones during exercise is believed toimpose a healthy strain on bones,including stimulating the production ofnew bone.

Lead author Dennis T. Villareal, MD,asserts, "It's important that calorierestriction not be seen as a bad thingbecause it offers enormous benefits...however, to maintain healthy bones,exercise should be an important componentof a weight-loss program to offsetadverse effects of calorie restrictionon bone."

Obesity Adversely Affects Type 1Diabetics

According to a new study, the risk ofkidney disease is increased for individualswith type 1 diabetes who also sufferfrom obesity. Normally, obesity isassociated with adult-onset type 2 diabetes,which makes up 95% of allreported diabetes cases.

This study, however, focused on thedata of 1300 individuals with type 1diabetes who were participating in alarge study of intensive insulin therapyand its effects onreducing the risk ofkidney disease andother disease-relatedcomplications. Researchersspecificallyzeroed in on obesity'seffect—namely,central obesity—onthe risk of developingkidney disease.

During the averagefollow-up of 6 years,8.4% of the patientsdeveloped microalbuminuria,the first signof a diabetic kidney.The risk of microalbuminuriawas 4.5%among those who receivedintensive insulintherapy and12.8% among those who received standardinsulin treatment.

The data review revealed that thelarger a person's waist measurement,the greater his or her risk was fordeveloping kidney disease. For every 4-inch increase in waist measurement,risk for microalbuminuria increased by34%, which remained true even whenadjusted for other factors.

Results of the data review appearedin the January issue of the Journal ofthe American Society of Nephrology.

Bacteria May Cause Obesity

New research on obese humans andmice has pinpointed a "microbial component"to the presence of obesity. Thestudy from Washington University'sCenter for Genome Studies posits thatobese humans and mice have a lowerpercentage of the bacteria Bacteriodetesand more of the bacteriaFirmicutes. Whether obesity causesthe production of more Firmicutes, orthe bacteria cause obesity, is not yetunderstood. Scientists do, however,believe that the bacteria can fight bothobesity and malnutrition.

Professor of Infection and ObesityNikhil Dhurander,MD, of Louisiana State University's Pennington BiomedicalResearch Center remarked, "We are gettingmore and more evidence to show obesityisn't what we thought it used to be. It isn't just [that]you're eating too much and you'relazy."

He goes on to say that "infectobesity"addresses various causes of obesityand that the current solution of dietand exercise "is like treating all feverswith one aspirin."

The study included 12 obese peoplewhose gut bacteria, before starting adiet, was 3% Bacteriodetes. After dieting,the people—now considered normalsize—had close to 15% Bacteriodetes.

Whereas doctors previously approachedbacteria in an adversarialmanner, recent research demonstrateshow beneficial these microbes can be.Findings appear in the December 21,2006, issue of Nature.

Ms. Farley is a freelance medicalwriter based in Wakefield, RI.