outlook: OBESITY epidemic

Pharmacy Times, Volume 0, 0

Ms. Farley is a freelance medical writer based in Wakefield, RI.

New Research Questions Effectsof Breast-feeding on Obesity Risk

Whereas previous research suggestedthat breast-feeding reduced a child?s riskfor obesity, a new report from theAmerican Journal of Clinical Nutritioncontends that the playing field is all butleveled when certain factors are considered,including the following:

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

Any positive effects that breast-feedingmay have in staving off obesity willlikely be weakened by the basic stressorsof life. Children who were breast-fedfor 6 months or longer, however, were55% less likely to reside in the top tenthof their age group in body fat percentage.The researchers theorize that the protectiveeffects of breast-feeding are reinforcedby qualities in the mothers ?thatwould make them less likely to raiseobese children.?

Dietary Counseling Takes Off theWeight

A review of weight-loss trials hasshown that dietary counseling is responsiblefor a weight loss of 6% of bodyweight after 1 year, compared with theweight loss in people who had no counseling.The data were obtained from 46different trials that included 6386 peopleparticipating in dietary counseling?basedweight-loss programs and 5467 peoplenot involved in such counseling programs.The data review also showed thatweight-loss programs that included morefrequent meetings and greater calorierestrictions resulted in more successfulweight loss over time.

It is important to note that the reviewshowed that, at 3 years, approximatelyhalf the weight loss remained, but at 5years almost none of the weight lossremained. One of the study authors,Michael L. Dansinger, MD, MS, at Tufts-New England Medical Center?s Divisionof Endocrinology, said that, althoughresearchers were unable to determinehow much weight people lost or howlong it took them to gain it all back, ?thisstudy shows that lifestyle changes needto be for the long term.? The full studyappears in the July 3, 2007, issue ofAnnals of Internal Medicine.

Attitudes Toward Weight LossDifferent for White and BlackWomen

In the United States, overweight andobese Caucasian women are more likelyto seek help with their weight than overweightand obese black women, accordingto an article from Ethnicity andDisease. Seeking help encompasses gettingcounseling from a medical professional,a prescription, membership in aweight-loss group, or personal training.

According to the study, black womendid not differ from white women in theirconcern about their body shape andweight, but the white women were moremotivated to seek assistance. Neithergroup named obesity-related health concernsas being the primary reason forwanting to lose weight. Body image wasnamed as an important motivator forwhite women to seek dieting help, butthis was not the case for black women.

These results stem from a survey of120 Philadelphia-based women. Thestudy authors concluded that modifyingweight-loss programs so that the needsand interests of black and other minoritywomen are addressed might be animportant first step in encouragingweight loss.

Uncovering Clues to Obesity Risk

Researchers studied a group of 261women born between 1959 and 1965 todetermine which factors might predicttheir risk of obesity at age 20 and againat age 40.

Risk Factor at Age 20: The amount ofweight their mother gained during pregnancyinfluenced the women?s risk ofbeing overweight at age 20. In fact, every10-lb increase of weight correlated witha 65% greater risk of being overweight.This factor had no bearing on whetherthe women would be overweight at age40, however.

Risk Factor at Age 20 and Age 40: Arapid weight gain between 1 and 7 yearsof age was a risk factor.

It is important to note that people areheavier today than they were 40 yearsago, and women tend to gain moreweight during pregnancy (30.5 lb in 2005,compared with 22 lb in the 1960s). Theoriginal article appeared in the July 1,2007, issue of the American Journal ofEpidemiology.

Snipping the Vagus Nerve MayControl Hunger

An ulcer surgery popular in the 1970sthat involved cutting the vagus nervewhere it attaches to the front and back ofthe stomach (vagotomy) may triggerweight loss and is now being considereda viable weight-loss surgery. Althoughthe procedure once provided relief topeople suffering from ulcers, it was abandonedwhen acid-reducing medicationsbecame available.

So far, 30 patients have had vagotomiesfor weight loss at the Universityof California, San Francisco, or theUniversity of Rochester. Of the 11 whohave passed the 1-year mark since theirsurgery, all but 1 are losing weight, withan average weight loss of 18% of bodyfat. There were no serious side effects,and patients were able to return homehours after surgery with little pain. At onetime, a vagotomy was considered anarduous surgery, but it has since beensimplified to just 5 pencil-sized cuts inthe abdomen.

Some surgeons are even adding avagotomy when a patient gets gastricbandingsurgery, which is currently oneof the more modest weight-loss operations.Patients with the added vagotomyachieved a 43% loss of excess weight at6 months. Vagotomies are still consideredexperimental and are being fundedby the medical device company EndoVxInc, which aims to simplify the vagotomyeven further by directing high-intensityultrasound waves down the throat.