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Obesity Treatment News: Fighting childhood obesity starts with education

Fighting childhood obesity starts with education

CORPUS CHRISTI — Does severe child obesity constitute a form of child abuse or neglect?

I’m not referring to being mildly overweight, but to severe, physically debilitating obesity in a preteen child, such as a 10-year-old weighing 400 pounds, or a 150 pound 6-year-old. Severe child obesity increases the risk for early-onset Type 2 diabetes, heart disease, high blood pressure and sleep disturbances. Collectively, severe obesity and its consequences jeopardize the health, longevity and quality of life of any affected child.

Children removed from the home because of their weight often generate sensational news stories. But with more than two million American children severely obese and growing, is there a role for the state in dealing with this problem more aggressively?

Obesity results when too many calories are consumed than are needed for normal growth or daily metabolism. Average kids consume about 100 calories each day more than they need, but the severely obese child often consumes 1000 more calories daily than what they need.

But few parents really know how many calories to feed a growing child. Fewer than one in 10 adults even try to count calories in their own food. Therefore, it may be left up to the child to know when enough is enough. Parents then behave as overseers of sorts, making sure things don’t get too far out of control. With so many severely obese kids now in the world, is this just the a new form of deadbeat parenting?

If the physical or emotional well-being of a child is at stake, it is in the child’s best interest for the state to place the child in a different environment, especially after attempts to remedy the problem in the home have failed. It’s a completely accepted legal practice to remove an undernourished child from a dangerous or non-nurturing home. By removing the child, two goals are sought. The first is to make changes in the child’s eating and activity habits.The second is to attempt to educate the family in healthier living and parenting skills.

Is removal of the severely obese child too drastic? Death by starvation is more imminent and demands more immediate action compared to death by obesity. Should parents of severely obese children be held accountable for the weight of their child? Most will say it’s an adults right to do and eat whatever they want so long as they don’t cause harm to someone else. But if a child is so heavy that their current and future health is in serious jeopardy, when is it society’s role to step in?

Many parents underestimate the degree of their child’s obesity. In a recent study of American parents of obese children, up to 43 percent thought the weight of their obviously obese child was “about right.”

But it’s more than just parenting. A recent study in the United Kingdom described a newly discovered gene deletion in five of 300 severely obese children that causes rapid and excessive weight gain. Interestingly, four of these children already had been under the observation of child protective services. There are undoubtedly more genetic reasons for severe child obesity yet to be discovered.

So, removing a severely obese child and placing them into a controlled environment is not necessarily a condemnation of the parents. If you consider obesity more like a disease, then it makes sense to provide the best possible treatment for a seriously affected child, even if it could not be provided in the home. No one questions admitting a child to a hospital or long term facility to treat a severe illness or addiction.

There is little chance of the state removing overweight or just plain obese kids from their homes. But the severely obese child is arguably at special risk. The degree of obesity in this group might represent an example of medical or genetic forms of obesity that are not simply a collective failure of willpower on the part of the child and family. Still, even the severely obese child can be placed in an environment that can reduce weight. It’s been proven many times.

Is there a greater role for protective services in the fight against severe child obesity? It’s an emotionally charged question. I don’t have the answer.

Effectiveness of slimming clubs tested

“Weight-loss courses such as Weight Watchers should be used by the NHS as a weapon to tackle the obesity crisis,” according to the Daily Express. The story is based on research that found that overweight and obese adults referred to Weight Watchers lost twice as much weight over a year as those who received standard advice on losing weight at their local GP surgery. Participants on the Weight Watchers programme also had greater reductions in waist size and body fat, which are both changes associated with a lower risk of cardiovascular disease and diabetes.

This was a well-conducted study. Although it had some limitations, the overall results should be reliable. It should be noted that in the trial, which was sponsored by Weight Watchers, participants received free access to the programme, which may mean that their behaviour was not typical of people having to pay for the course themselves. Another limitation in the study is that it only lasted 12 months, and therefore does not address the common difficulty of maintaining weight loss in the long-term.

Where did the story come from?

The study was carried out by researchers from the Medical Research Council Human Nutrition Research Laboratory, Cambridge; the University of Munich, Germany; and the University of Sydney, Australia. It was funded by a grant from Weight Watchers International to the UK Medical Research Council. The researchers say that the sponsor had no role in the study design, data collection, data analysis, data interpretation or writing of the report. The study was published in the peer-reviewed medical journal, The Lancet.

In general, the media reported the study fairly. In its story the Daily Express mentioned another commercial organisation, Slimming World, which could be misleading since this programme was not assessed by the trial. The Daily Mail included comments from an independent expert and mentioned the source of funding – a pertinent point which many other newspapers left out.

What kind of research was this?

This was a randomised controlled trial (RCT), involving 772 overweight and obese adults. They were assigned to receive either 12 months of standard care for weight loss (as defined by national guidelines) or 12 months of free membership to the Weight Watchers commercial weight loss programme. The researchers aimed to assess weight change in both groups over a 12-month period.

One thing to note is that the trial was not blinded – the participants knew which group they were in, as did some of the researchers. Given the nature of the interventions being investigated, the lack of blinding was unavoidable, but it means that knowing which treatment group they were in could have unconsciously influenced participants’ motivation and therefore the amount of weight they lost. The randomisation procedure (how the participants were randomly allocated to each group) was concealed from the researchers by use of an online database.

The researchers say that there is an urgent need for interventions to deal with the global health problem of obesity, as excess weight accounts for 44% of the global burden of diabetes, 23% of heart disease and 7%-41% of some cancers. They also highlight that for overweight individuals a weight loss of 5%-10% is associated with significant health benefits. They suggest that partnerships between primary care and commercial organisations could be used to deliver weight-management programmes on a large scale, but say that prior to their study there had been few RCTs of commercial weight-loss programmes and that their effectiveness has not yet been compared with standard care.

What did the research involve?

Between September 2007 and November 2008, researchers recruited 772 overweight and obese adults from primary care practices in Australia, Germany and the UK. Participants were 18 or over, with a BMI of 27kg-35 kg/m2. They had at least one additional risk factor for obesity-related disease, including “central adiposity” (a waist circumference of more than 88cm in women and more than 102cm in men), type 2 diabetes or mild to moderate high cholesterol (dyslipidaemia). They had initially recruited 1,010 potential participants but excluded 238 on the grounds of recent weight loss of 5kg or more and various health and medical disorders.

Participants were randomly assigned to receive either 12 months of free membership to Weight Watchers, or standard care, as defined in national treatment guidelines for obesity. The Weight Watchers system places emphasis on a balanced diet based on healthy eating principles, increased physical activity and group support. In this research participants received 12 months of free access to weekly community-based Weight Watcher meetings, which involve weigh-ins, group discussion, behavioural counselling and motivation. Participants are also able to access internet-based systems to monitor food intake, physical activity and weight change, to join community discussion boards and to access recipes and meal ideas.

Participants in the standard care group received weight loss advice from a health professional at their local GP surgery, based on national treatment guidelines. It is not clear how often people in this group met with health professionals or how much support they received.

Researchers followed the two groups for a period of 12 months. They measured body weight, fat mass, waist circumference and blood pressure at at the start of the study and at 2, 4, 6, 9 and 12 months. Blood samples were also taken to measure blood sugar, insulin and lipid levels at 6 and 12 months.

As well as recording weight change, the researchers also looked at changes in fat mass, waist circumference, blood pressure and markers of cardiovascular risk. They analysed their data using validated statistical methods.

What were the basic results?
Of the 377 participants assigned to the commercial programme, 230 (61%) completed the 12-month study. Of the 395 assigned to standard care, 214 (54%) completed the study.
Participants on the Weight Watchers programme lost twice as much weight on average than those in the standard care group.
The average amount of weight lost at 12 months was 5•06 kg for those in the commercial programme, compared to 2•25 kg for those receiving standard care. This equated to a difference of 2•77 kg [95% CI −3•50 to −2•03].
Over the 12 months of the study the Weight Watchers participants were three times more likely to lose at least 5% of their initial body weight than those assigned to standard care (OR 3.0, 95% CI 2.0-4.4). They were also three times more likely to lose 10% or more (3.2, CI 2.3-5.4) of their initial weight.
Participants in the commercial programme also had larger reductions in waist circumference and fat mass, greater improvements in insulin levels and improved cholesterol ratios.
Small reductions in blood pressure were recorded in both groups at 12 months.
Participants reported no adverse events related to participating in the trial.

How did the researchers interpret the results?

The authors say that referring selected patients to commercial weight loss programmes providing group support and dietary advice can present a “clinically useful intervention” for managing the weight of overweight and obese people. They also say that these programmes can be delivered on a large scale.

Conclusion

This was a well-conducted study and its findings are likely to be reliable. Some points are worth noting:
There were high drop-out rates in both groups (40 to 50%), which may have affected the study’s results. Although the researchers say that they anticipated this possibility when calculating the sample sizes needed to obtain meaningful results, the difference in drop-out rates between groups could have affected the reliability of the results.
The lack of blinding was unavoidable given the nature of the two interventions being tested. It is possible that participants knowing which treatment they were assigned could have had an influence on results. However, the objective measurement of weight makes this less important as it does quantify the effect of these interventions.
The researchers ensured that the allocation of participants at randomisation was concealed. This means that allocation could not be influenced by the researcher or the participants, and this is an important feature of this well-designed trial.

One aspect not addressed by this report is the cost-effectiveness of the different approaches. Although the more intensive support organised by Weight Watchers (including weekly weigh-ins and group support) resulted in more weight loss than standard guideline advice from a GP practice, more research will be needed to assess the financial costs to achieve this extra benefit. Also, as participants were given free access to the Weight Watchers programme, it is unclear from this study how having to pay to attend might affect the amount of weight lost or the chances of dropping out.

Finally, the study does not address a well-established problem with weight loss: the difficulty of keeping the weight off in the long term. Future studies could look at this too, particularly in people who discontinue the programme once they have achieved their target weight.

How socializing and pals help in turning bad fat into good

Yearning to be slim without hitting the gym? Then have an active social life, says a new study.

Scientists from Ohio State University found that socializing and meeting with friends aid weight loss by converting energy-storing white fat into energy-burning brown fat.

Lead researcher Dr. Matthew J. During and colleagues used mice to study the effects a socially and physically engaging environment has on weight loss and obesity.

They found that mice in an ‘enriched’ environment with friends and stress expend more energy and lose weight even as they eat more.

They said that the animals’ abdominal fat decreased by 50 percent after four weeks in the enriched environment.

Scientists believe the same process probably occurs in humans.

“I’m still amazed at the degree of fat loss that occurs. The amount that comes off is far more than you would get with a treadmill,” said During.

Co-author Lei Cao said that the new result might offer insight into studies showing a link between loneliness and ill health.

The findings appear in the September Cell Metabolism.

Weight Loss News: Carrie Fisher’s weight loss is no joke

Carrie Fisher’s weight loss is no joke

Back in December, writer and actress Carrie Fisher began a long journey to shed pounds, hiring on as a celebrity spokeswoman for weight loss company Jenny Craig and targeting 30 lbs. She did far better.

On Wednesday, the woman who in her twenties made many a young man swoon as “Star Wars” Princess Leia in her metal bikini, revealed that she’d lost 50 lbs.

Fisher, now 54, has used her sly wit to write seriously about her life’s struggles growing up in a celebrity family, daughter of Debbie Reynolds and Eddie Fisher. One book, “Wishful Drinking,” morphed into a one-woman stage show. Here, she reveals how she went from a chubby 180 lbs to a fit 130.

Q: Everyone always wants to know, what’s the secret?

A: “It is better to not do it all by yourself, so I had the consultant that Jenny Craig provides. You can vent any frustration to that person, and it’s good to have someone cheering for you when you don’t feel like cheering for yourself, and to keep you focused on the positive.”

Q: When you think back, just before you decided to diet, what did you think about yourself?

A: “I was ashamed. I knew also what the weight implied — that you’re saying ’screw it’ to your health. I have a daughter; I can’t afford to risk my health anymore. But it was just like, ‘no one’s going to see me, and I’m too old anyway and what am I doing trying to fit into a bathing suit and trying to get picked up in a bar in Acapulco.’ The bottom line is: I was really embarrassed, and didn’t think I could do it.”

Q: Had you tried other weight loss programs?

A: “I hadn’t really done a lot of them. I’d always tried myself, but nothing had worked for me in the last four years. I’d always had excuses like I was on the road…It was getting annoying that my mother was thinner than I was! And, of course, my daughter — that’s where my old body is, she has it. Now, I wear one size higher than she.”

Q: A big problem people have with dieting is that it feels like they are denying themselves all the foods they want? Or, at least, what they are accustomed to eating.

A: “There’s not a lot of room for (denial) in the Jenny Craig system, so you don’t. The food is good enough that you don’t feel denied…You have to stay focused on that. You are getting results, and that is the good thing about having someone else help you keep your eye on the prize.”

Q: I asked you what you thought about yourself when you started the program. How about now? How do you see yourself?

A: “I can’t even believe I did it. It’s amazing. I really did think, ‘I’m never going to look good again, so screw it.’ I never did think I looked that good, even when I was cute.”

Q: In May, you reached your target of losing 30 lbs, but you kept going to take off the additional 20. Why?

A: “Because it looks better, because as you do it, you get on a roll and it’s not a fat roll! It’s going well, so you’re reassured because you have results…I lost the 30 lbs kind of comparatively easy. The last 20 were hard. It was not easy, but it is fun to be able to focus your rage at the consultant.”

Q: And, I’d guess, it gave you new material for a book.

A: “Yes, a new chapter called ‘Wishful Shrinking.’”

Medical Minute 8-24: Weight Loss Procedure Curing Diabetes

He was the personal chef for millionaire Donald Trump.

And now, Tom Haynes is responsible for bringing students into the Institute of Culinary Education.

“I’ve had the great pleasure of working with tens of thousands of students,” said Tom Haynes, Chef.

But he’s most proud of what he did for his health.

Weighing in at 285, Tom was diabetic for 10 years.

“I had to stab myself 13 times a day with insulin.”

Today, Tom is insulin- and medication-free — all because of a side effect of bariatric surgery.

“Some patients who take insulin for type 2, they have an operation, and very often, we don’t put them back on insulin,” said Francesco Rubino, M.D., New York-Presbyterian/Weill Cornell.

Doctor Francesco Rubino is spearheading the studies of gastric bypass surgery and its effects on type-two diabetes. It started back in 1999 when he noticed an unexpected side effect to the surgery he was performing on morbidly obese patients.

“I noticed some patients had diabetes remission as early as days or weeks after the operation.”

Once a surgery only used for people with body mass indexes over 35, now a new clinical trial at New York-Presbyterian is using gastric bypass for people suffering from diabetes with BMI as low as 26.

“I thought changing the gut anatomy, you change the way the way the gut speaks to the body.”

And the way the pancreas creates insulin, which doesn’t work properly for people with type-two diabetes. But why this surgery sends diabetes into remission is still a mystery.

“It’s totally changed my life.”

Miranda Kerr’s Weight Loss ‘Secret’ Is a Sham

Victoria’s Secret supermodels tend to look like they came from a completely different universe of beautiful, so it’s no wonder that when one of them spills the details of how she stays slim and gorgeous, many women cling to every word. And it’s really not all that surprising that women on both sides of the pond and Down Under are fascinated by new mom and wife to Orlando Bloom, Miranda Kerr. After all, she did just drop her baby weight like it was nothing. How the heck did she do it?

Well, apparently, coconut oil plays a major role in her beauty and weight maintenance regimen. She revealed last month that she’s been taking four tablespoons a day of the “healthy fat” (diluted in green tea or drizzled on salads) since she was 14, and it’s the one thing she “can’t live without.” She attributed her svelte body, clear skin, and glossy hair to the supplement. Then, surprise, surprise, within weeks, sales of coconut oil SOARED!

Oh man, are we all that gullible?

Don’t get me wrong. I’m pleased to hear Miranda’s touting a natural supplement that probably doesn’t cause any harm, and may do a body good, but is it a magic bullet for weight loss? Uhm … doubtful.

Some quick myth-busting: The medium-chain triglycerides (MCTs) in coconut oil have been said to boost metabolism and promote weight loss. I know we all wish this was really true (myself included!), but the fact of the matter is that preliminary human studies haven’t really shown weight loss effects from MCTs. And the evidence is slim on other “heart-healthy benefits.” Bummer.

That said, it’s totally annoying that so many of us are so hard up for beauty and weight loss fast fixes that we’re not even curious about what the research shows. We just think, “Miranda Kerr likes it? Sign me up!” failing to remember that uh … the supermodel is only 27 years old with fab genes, and also follows a hardcore regimen of daily yoga, light jogging, steamed veggies, fresh fruit, and fish. Coconut oil probably doesn’t hurt, but I’m sure it’s not doing the heavy lifting when it comes to keeping Miranda looking fit and gorgeous. Any woman who buys into the hype will probably just end up looking foolish.

Does Miranda Kerr’s love for coconut oil make you want to try it?

The Only Weightloss Is Essex: Kirk Norcross appears to have shed pounds over heartbreak of splitting from Lauren Pope

He might have recently had a nose job to thin the bridge after it was broken boxing – but it appears there’s a whole lot less of Kirk Norcross all round at the moment.

The 23-year-old Only Way Is Essex star appeared to have slimmed down drastically in these pictures taken yesterday as the ’scripted reality’ show was filming.

Perhaps his drastic weightloss is in a bid to impress his slender on-off DJ girlfriend Lauren Pope – or perhaps he’s been on the heartbreak diet.

The Only Way Is Essex couple have already split and reconciled twice, and earlier this month, they were said to be trying to give their troubled love affair a third try.

Lauren, 27, and Kirk, 23, split in June but according to sources close to the pair they want to give themselves one last go.

A source told the MailOnline: ‘It’s clear how much Kirk and Lauren love each other but the timing’s not right. The pressure of being in the public eye certainly put a strain on things.

‘We all think they will get back together as he can’t be without her. ‘

A bereft Lauren was said to have lost weight and became unhealthily skinny over their split – but fortunately, she has since regained much of the weight she lost and looks great.

However, now it looks like it’s Kirk’s turn to drop the pounds, having previously been so buff, he featured on the front cover of Attitude magazine.

The source said: ‘They both want to be together but it’s hard for them right now.’

Lauren and Kirk started dating last November when Kirk hired the model-turned-DJ to appear at his club Sugar Hut in Brentwood, Essex.

However, Sugar Hut promoter Kirk was minus Lauren today – and revealed on his Twitter he was on a day trip to Drayton Manor theme park in Tamworth with porn star Gemma Massey.

The 26-year-old was apparently a dental nurse before she got into adult modelling and films.

It’s not known how long she has known Kirk or what they’re relationship is.

Still, spending the day on rollercoasters is one way to forget about the ups and downs of his love life.

Obesity Treatment News: EnteroMedics to Present at the Canaccord Genuity Annual Growth Conference

EnteroMedics to Present at the Canaccord Genuity Annual Growth Conference

EnteroMedics Inc. ETRM
+0.38% , the
developer of medical devices using neuroblocking technology to treat obesity and other gastrointestinal disorders, today announced that Mark B. Knudson, Ph.D., Chief Executive Officer, is scheduled to present at the Canaccord Genuity Annual Growth Conference in Boston, MA on Thursday, August 11, 2011 at 9:00 am ET. Dr. Knudson will provide an overview of the Company and an update on its VBLOC(R) vagal blocking therapy development program.

The presentation will be webcast live and may be accessed by visiting EnteroMedics’ website at www.enteromedics.com . A replay of the webcast will also be available immediately after the conclusion of the presentation. Investors can access the webcast under “Press Room” in the “Investors” section of EnteroMedics website.

About VBLOC(R) Therapy

EnteroMedics developed VBLOC(R) vagal blocking therapy to offer bariatric surgeons and their patients a less invasive alternative to existing surgical weight loss procedures that may present significant risks and alter digestive system anatomy, lifestyle and food choices. VBLOC(R) Therapy is delivered via the Maestro(R) System through laparoscopically implanted leads to intermittently block the vagus nerves using high-frequency, low-energy electrical impulses. VBLOC(R) Therapy is designed to target the multiple digestive functions under control of the vagus nerves and to affect the perception of hunger and fullness.

About EnteroMedics Inc.

EnteroMedics is a development stage medical device company focused on the design and development of devices that use neuroblocking technology to treat obesity and other gastrointestinal disorders. EnteroMedics’ proprietary neuroblocking technology, VBLOC(R) vagal blocking therapy, is designed to intermittently block the vagus nerves using high-frequency, low-energy electrical impulses. These electrical impulses are delivered by a neuroregulator, EnteroMedics’ Maestro(R) System, which is powered by an integrated rechargeable battery. For more information, visit www.enteromedics.com .

Forward-Looking Safe Harbor Statement:

This press release contains forward-looking statements about EnteroMedics Inc. Our actual results could differ materially from those discussed due to known and unknown risks, uncertainties and other factors including our limited history of operations; our losses since inception and for the foreseeable future; our lack of commercial regulatory approval for our Maestro(R) System for the treatment of obesity in the United States or in any foreign market other than the European Community; our preliminary findings from our EMPOWER(TM) pivotal trial; our ability to comply with the Nasdaq continued listing requirements; our ability to commercialize our Maestro System; our dependence on third parties to initiate and perform our clinical trials; the need to obtain regulatory approval for any modifications to our Maestro System; physician adoption of our Maestro System and VBLOC(R) vagal blocking therapy; our ability to obtain third party coding, coverage or payment levels; ongoing regulatory compliance; our dependence on third party manufacturers and suppliers; the successful development of our sales and marketing capabilities; our ability to raise additional capital when needed; international commercialization and operation; our ability to attract and retain management and other personnel and to manage our growth effectively; potential product liability claims; potential healthcare fraud and abuse claims; healthcare legislative reform; and our ability to obtain and maintain intellectual property protection for our technology and products. These and additional risks and uncertainties are described more fully in the Company’s filings with the Securities and Exchange Commission, particularly those factors identified as “risk factors” in the Annual Report on Form 10-K filed with the Securities and Exchange Commission on March 7, 2011. We are providing this information as of the date of this press release and do not undertake any obligation to update any forward-looking statements contained in this document as a result of new information, future events or otherwise.

Caution – Investigational device. Limited by Federal (United States) law to investigational use.

The implantation procedure and usage of the Maestro(R) System carry some risks, such as the risks generally associated with laparoscopic procedures and those related to treatment as described in the ReCharge clinical trial informed consent.

School Obesity-Prevention Curriculum Can Reduce Medical Costs

Teaching middle-school children about nutrition and exercise and encouraging them to watch less TV can save the health care system a substantial amount of money, suggests an economic analysis from Children’s Hospital Boston and the Centers for Disease Control and Prevention.

Using data from a randomized, controlled study conducted at 10 Massachusetts middle schools, five of which adopted the obesity prevention curriculum Planet Health, the researchers created a model projecting a net savings of $14,000 for the 254 girls receiving the curriculum, by averting the costs of treating obesity and eating disorders. They project that expanding the program to even just 100 schools could save the health care system $680,000.

The study, published in the August issue of the Archives of Pediatrics & Adolescent Medicine, was led by S. Bryn Austin, ScD, an epidemiologist in Children’s Hospital Boston’s Division of Adolescent Medicine, and CDC health economist Li Yan Wang.

Planet Health, developed at the Harvard School of Public Health, is a curriculum for academic, physical education and health education teachers to guide middle-school students in choosing healthy foods, increasing physical activity and limiting TV and other screen time. It provides teacher training, lesson plans, materials and FitCheck, a self-assessment tool for students.

In an earlier study of 10 middle schools, half offering the Planet Health program and half offering regular programs (schools were matched by town, school size and ethnic composition), obesity prevalence declined in the schools with Planet Health but increased in control schools over the two years of follow-up. In addition, overweight girls in Planet Health schools were twice as likely as girls in control schools to return to a healthy weight over the two years.(Gortmaker SL et al, 1999). Unexpectedly, girls in Planet Health schools were also less than half as likely as girls in control schools to begin purging or using diet pills to control their weight (Austin SB et al, 2005); this study was later replicated in a separate group of middle schools (Austin SB et al, 2007). The effects were not statistically significant for boys.

“We were really surprised and encouraged to see how protective Planet Health was for eating disorder symptoms in girls,” says Austin, the study’s senior author. “When we found the same protective effect – cutting the risk for girls in half — in a different set of middle schools several years later, we knew we were on to something important.”

Bulimia typically develops in adolescence, and often begins with a few behaviors, such as using diet pills or purging to control weight. Full-blown bulimia is a life-threatening disorder that carries a variety of medical complications such as electrolyte imbalances, dehydration, metabolic alkalosis (an imbalance in the body’s acid/base balance), heart rhythm disturbances, tooth erosion and bowel dysfunction.

“Eating disorders cause an enormous amount of suffering,” says Austin. “They can also be chronic and expensive to treat, which is often a big financial burden on individuals, their families, and society. That’s what led us to want to do the economic study.”

In their economic analysis, Austin and Wang first estimate that 3.4 percent of girls receiving the Planet Health intervention would be prevented from developing disordered weight-control behaviors by the age of 13 1/2, based on numbers from the original randomized study (7 of 254 girls in the Planet Health schools, or 2.8 percent, developed these behaviors, versus 14 of 226 controls, or 6.2 percent). Based on current knowledge about the progression of eating disorders, they calculate that, in turn, 1 case of bulimia would be prevented by the age of 17 among the 254 girls.

Factoring in typical treatment costs — which can be tens of thousands of dollars over a decade — and known rates of remission and relapse, Austin and Wang estimate that an average of $34,000 would be saved by preventing one girl in the five Planet Health study schools from developing bulimia nervosa. Adding Wang’s previous finding of $27,042 in savings resulting from prevention and reduction of obesity in the same schools (Wang LI et al, 2003), the program would yield a net savings of $14,238 after subtracting the $46,803 cost of offering Planet Health in those schools.

“Because eating disorders can be so expensive to treat, preventing even one case in the five Planet Health schools translated into reducing medical costs by $34,000,” says Austin. “But if we scale up our calculations to include, say, 100 middle schools in Massachusetts, the medical costs reduced by preventing bulimia increase to over half a million dollars. And if we scale up nationwide, to say 1,000 schools, the potential reduction in the medical cost burden is sizable.”

Austin notes that obesity prevention programs that stigmatize obesity or create a sense of blame can actually contribute to eating disorders. “We need to be smart about choosing obesity prevention strategies that, at the same time, can prevent eating disorders,” she says. “Our study shows that when we do both, we substantially increase the benefits, both in terms of health and reducing medical costs.”

The study was funded by the Maternal and Child Health Bureau of the Health Resources and Services Administration. Lauren Nichols of the Division of Adolescent and Young Adult Medicine at Children’s Hospital Boston was coauthor.

Lannett gets FDA approval for anti-obesity treatment

Lannett has received the US Food and Drug Administration (FDA) approval for the abbreviated new drug application (ANDA) of Phentermine Resin Extended-Release Capsules, 15mg and 30mg.

Lannett’s Phentermine Resin Extended-Release Capsules, 15mg and 30mg is the generic version of UCB’s Ionamin Capsules, 15mg and 30mg.

Phentermine Resin is indicated in the management of exogenous obesity as a short-term adjunct (a few weeks) in a regimen of weight reduction.

Cody Laboratories, the pain management subsidiary of Lannett, is responsible for producing the active pharmaceutical ingredient (API) of the product.

Obesity Treatment News: Benefits of obesity treatment depend on individual

Benefits of obesity treatment depend on individual

Recent research has suggested that different groups of people stand to gain in different ways from obesity treatment.

Published in the JAMA journal, the study looked at 850 veterans who underwent obesity treatment between 2000 and 2006.

A control group were also monitored, who had an average age of 54.7 and an average Body Mass Index (BMI) or 42.

The veterans, meanwhile, had an average age of 49.5 years and a BMI of 47.4.

A total of 1.29 per cent of the surgical cases died within 30 days of surgery, but once six years had passed, a mortality rate of 6.8 per cent was recorded in this group.

Meanwhile, the control group had a mortality rate of 15.2 per cent after this time.

However, further analysis concluded that the surgery was not significantly associated with reduced mortality when propensity-match patients were looked at.

The study’s authors noted: “Our results highlight the importance of statistical adjustment and careful selection of surgical and nonsurgical cohorts, particularly during evaluation of bariatric surgery according to administrative data.”

Obesity Groups See Evidence FDA Decisions Will Discourage Obesity Research

The Obesity Care Continuum (OCC), represented by The Obesity Society (TOS), the Obesity Action Coalition (OAC), the American Society for Metabolic and Bariatric Surgery (ASMBS) and the American Dietetic Association (ADA), expresses a deep concern for the recent decision by the FDA, Division of Metabolic and Endocrinologic Products (DMEP), to require Orexigen to conduct a pre-approval cardiovascular outcomes trial for Contrave, even after the FDA Advisory Panel voted for approval of Contrave with a post-approval cardiovascular trial. Furthermore, the OCC believes that the requested pre-approval outcomes trial is unprecedented for any disease and would generate more information than is necessary or feasible.

This verdict has far broader consequences than simply impacting one company and one drug. The decision falls on the heels of two other decisions to disallow additional drugs for obesity treatment made over the last 12 months by the FDA, Center for Drug Evaluation and Research (CDER). The FDA/CDER’s charge is “to perform an essential public health task by making sure that safe and effective drugs are available to improve the health of people in the United States.” The agency has not approved an obesity drug since 1999, and, last year, also removed from the market a drug it approved in 1997. The OCC feels this track record shows a trend of the FDA being “benefit-blind” causing an overly risk averse position. “We believe that in order to comprehensively treat the disease of obesity, healthcare professionals must have access to a variety of treatment options. We are extremely disappointed in the short-sightedness of the FDA to objectively and fairly evaluate benefits as well as risks of potential obesity medications,” said Jennifer Lovejoy, TOS President.

If the Agency’s approach to this class of drugs continues, it will likely further discourage any research and development in the area of obesity ever again. We have already witnessed the withdrawal of the major pharmaceutical companies from this market given the lack of clear predictability surrounding FDA’s approval process. We are now seeing the same result in the small biotech market and truly wonder who will fill this void in the absence of any firm drug approval guidance from the FDA.

The greatest consequence however is the impact that lack of treatment options has on the American people. More than a third of US adults are obese, and vulnerable to obesity’s damaging consequences and a growing number are severely affected and left without treatment options. Obesity is responsible for the deaths of more than 100,000 Americans each year. Costs attributable to obesity and overweight have been estimated at $270 billion annually, including direct medical costs and indirect costs, such as absenteeism and productivity losses. “The result of limiting treatment options for healthcare professionals will be catastrophic to the health of millions of Americans and our healthcare system,” said Joe Nadglowski, OAC President and CEO.

With the obesity epidemic driving risk for type 2 diabetes, sleep apnea, fatty liver disease and many other co-morbidities, we cannot afford to wait any longer to fairly weigh the risks against the benefits and the benefits lost to find a way toward drug approval.

About OCC

All of our organizations work together representing patients, registered dietitians, scientists, clinicians, and surgeons to elevate the recognition of both the prevention and treatment of obesity.

About TOS

The Obesity Society is the leading scientific society dedicated to the study of obesity. Since 1982, The Obesity Society has been committed to encouraging research on the causes and treatment of obesity, and to keeping the medical community and public informed of new advances. Visit TOS at obesity.org.

About OAC

The OAC is a national nonprofit charity dedicated to helping individuals affected by obesity. The OAC was formed to bring together individuals struggling with weight issues and provide educational resources and advocacy tools. In 2011, the OAC launched a national Membership Drive to recruit 50,000 members to strengthen its advocacy efforts and raise awareness of the disease of obesity. For more information on OAC Membership, please visit www.obesityaction.org.

About the ASMBS

The mission of the ASMBS is to advance the art and science of bariatric surgery by continued encouragement of its members to: improve the care and treatment of people with obesity and related diseases; advance the science and understanding of metabolic surgery; foster communication between health professionals on obesity and related conditions; and advocate for health care policy that ensures patient access to high-quality prevention and treatment of obesity. Visit ASMBS at asmbs.org.

About ADA

The American Dietetic Association is the world’s largest organization of food and nutrition professionals. ADA is committed to improving the nation’s health and advancing the profession of dietetics through research, education and advocacy. Visit ADA at eatright.org.

Genetic factor controls obesity-induced inflammation

ISLAMABAD: Scientists have discovered a genetic factor that can regulate obesity-induced inflammation that contributes to chronic health problems.

Researchers at Case Western Reserve University School of Medicine feel if they learn to control levels of the factor in defense cells called macrophages, they would find a new treatment for health-harming obesity.

“We have a shot at a novel treatment for obesity and its complications, such as diabetes, heart disease and cancer,” Mukesh K. Jain, MD, Ellery Sedgwick Jr. Chair, director of the Case Cardiovascular Research Institute, and senior author of the new study, said.

Macrophages contain low levels of KLF4 and are more easily irritated by cytokines, which are cell-signalling proteins, and fatty acids released by fat cells, and they respond by producing a low level of inflammation, Jain explained.

“A low level of inflammation over time is deleterious,” he said.

In people, long-lasting inflammation is connected to diabetes, increased risk of cardiovascular disease, cancer and other chronic illnesses.

In experiments using mouse models, Jain’s team found that when KLF4 was removed from macrophages, they all assumed the inflammatory state.

Furthermore, when the KLF4-deficient mice were fed a high-fat diet for 10 weeks, they gained 15 percent more weight than control animals fed the same diet, and developed severe diabetes as evidenced by glucose tolerance tests.

The researchers are now designing experiments to determine if they can prevent or reverse the shift from anti-inflammatory to inflammatory by increasing KLF4 levels in macrophages as cytokines or fats bombard them.

The findings have been published online in the Journal of Clinical Investigation

New Study Identifies Key Risk Factors for Bariatric Surgery

Newswise — ORLANDO, FL – June 15, 2011 – University of California at Irvine (UC Irvine) researchers reviewed data from more than 100,000 bariatric surgery patients and discovered the top six risk factors that could help doctors and patients predict, evaluate, reduce or avoid in-hospital mortality after weight loss surgery. The findings* were presented here at the 28th Annual Meeting of the American Society for Metabolic & Bariatric Surgery (ASMBS).

The risk factors include the type of weight loss operation (gastric bypass or gastric band), surgical technique (open or laparoscopic), patient gender, type of insurance (private or Medicare), age and the presence of Type 2 diabetes. Researchers say one or more of these risk factors may increase the risk of death before discharge from the hospital.

“Bariatric surgery is safer than it has ever been, but there may be more we can do to make it even safer and improve the odds of survival for high risk patients,” said Ninh T. Nguyen, MD, the study’s primary author and Chief of the Division of Gastrointestinal Surgery at UC Irvine Medical Center. “Doctors can use these risk factors to help in pre-operative planning and to help patients better understand his or her individual risk.”

Researchers analyzed hospital discharge data from the University HealthSystem Consortium (UHC) database where they identified 105,287 patients who underwent bariatric surgery between 2002 and 2009 at academic medical centers in the United States. More than 80 percent of the patients were female and nearly three-quarters were Caucasian. The type of operations included laparoscopic gastric bypass (45%), open gastric bypass (41%) and laparoscopic adjustable gastric banding (14%). The overall in-hospital mortality rate was 0.17 percent, which was the primary outcome examined in the study.

For each top risk factor an adjusted odds ratio (AOR) was calculated using statistical analyses to determine its individual and relative impact on in-patient mortality. The higher the AOR, the greater the odds of it having an impact on patients.

The study showed a person who had an open, rather than a laparoscopic, weight loss operation faced nearly five times (AOR 4.8) the risk of in-hospital mortality. The AOR was 5.8 if the patient had a gastric bypass versus non-bypass patients, 3.2 if the patient was male, 3.0 if the patient had Medicare coverage rather than private insurance, 1.9 if the patient was age 60 or over and 1.6 if Type 2 diabetes was present.

“It’s important to remember that despite these risk factors, we are still talking about highly effective and safe operations that result in significant weight loss and improvement or resolution of obesity-related diseases. Morbid obesity itself is a major risk factor for premature death, and in fact may be riskier without intervention than the surgery itself,” added Dr. Nguyen. “The data shows laparoscopic bariatric surgery has become no riskier than gallbladder or hip replacement surgery.”

Previous studies have shown that the risks of living with morbid obesity outweigh the risks of bariatric surgery ,(1) and that patients may improve life expectancy by 89 percent(2) and reduce their risk of premature death by 30 to 40 percent ,(3,4) after bariatric surgery.

Dr. Nguyen and his colleagues also identified a simple risk classification system that aims to enable clinicians to predict individual patient risk of mortality that they can use to strategize a preoperative plan that may reduce surgical risk. In this bariatric mortality risk classification, patients can be grouped according to a score that is calculated based on the number of points assigned to their individual risk factors (I, II, III, or IV). The lowest risk group (class I) has an in-hospital mortality of 0.10 percent while the highest risk group (class IV) has a mortality of 0.70 percent.

Bariatric surgery has been shown to be the most effective and long lasting treatment for morbid obesity and many related conditions.(5) People with morbid obesity have BMI of 40 or more, or BMI of 35 or more with an obesity-related disease such as Type 2 diabetes, heart disease or sleep apnea. Recently the FDA approved the use of an adjustable gastric band for BMI 30 and above, recognizing that there is an increase in mortality and medical complications of obesity at even this level of obesity.

According to the ASMBS, more than 15 million Americans have morbid obesity. Studies have shown patients may lose 30 to 50 percent of their excess weight 6 months after surgery and 77 percent of their excess weight as early as one year after surgery.(6)

The most common methods of bariatric surgery are laparoscopic gastric bypass and laparoscopic adjustable gastric banding (LAGB). Bariatric surgery limits the amount of food the stomach can hold, and/or limits the amount of calories absorbed, by surgically reducing the stomach’s capacity to a few ounces.

The federal government estimated that in 2008, annual obesity-related health spending reached $147 billion,(7) double what it was a decade ago, and projects spending to rise to $344 billion each year by 2018.(8) The Agency for Healthcare Research and Quality (AHRQ) reported significant improvements in the safety of bariatric surgery due in large part to improved laparoscopic techniques and the advent of bariatric surgical centers of excellence. The overall risk of death from bariatric surgery is about 0.1 percent(9) and the risk of major complications is about 4 percent.(10)

In addition to Dr. Nguyen, study authors include Brian Nguyen BS, Brian Smith MD, Xuan-Mai T. Nguyen PhD, Christian Elliott BS, Kevin Reavis MD, and Samuel Hohmann PhD.

About the ASMBS

The ASMBS is the largest organization for bariatric surgeons in the world. It is a non-profit organization that works to advance the art and science of bariatric surgery and is committed to educating medical professionals and the lay public about bariatric surgery as an option for the treatment of morbid obesity, as well as the associated risks and benefits. It encourages its members to investigate and discover new advances in bariatric surgery, while maintaining a steady exchange of experiences and ideas that may lead to improved surgical outcomes for morbidly obese patients.

Obesity Today: News and Treatment

Could obesity treatment lower death risk?

Obesity treatment could be needed by people suffering from coronary artery disease who tend to put weight on around their stomach.

According to research from the Mayo Clinic, published in the Journal of the American College of Cardiology, people with belly fat and coronary artery disease are twice as likely to die as those who tend to put on weight elsewhere.

Francisco Lopez-Jimenez, lead investigator of the project, commented: “Visceral fat has been found to be more metabolically active. It produces more changes in cholesterol, blood pressure and blood sugar.

“However, people who have fat mostly in other locations in the body, specifically, the legs and buttocks, don’t show this increased risk.”

The research team looked at data from nearly 16,000 people involved in five studies around the world and confirmed that ‘central obesity’ increased the risk of death.

According to the researchers, physicians should consider counselling coronary artery disease patients with normal body mass indexes to lose weight if they have a large waist circumference or a high waist-to-hip ratio.

Discrimination hurts: Lack of fair treatment leads to obesity issues

People, especially men, who feel any kind of discrimination, are likely to see their waistlines expand, according to research from Purdue University.

“This study found that males who persistently experienced high levels of discrimination during a nine-year period were more likely to see their waist circumference increase by an inch compared to those who did not report discrimination,” said Haslyn E.R. Hunte, an assistant professor of health and kinesiology. “Females who reported similar experiences also saw their waistlines grow by more than half an inch. This shows how discrimination hurts people physically, and it’s a reminder how people’s unfair treatment of others can be very powerful.

“People who feel unfairly treated should be aware of this connection between the stress related to their perception and consider coping strategies like exercise or other healthy behaviours as a coping mechanism for such stress. More importantly, as a society we must become more aware of how we treat people and that treating others unfairly matters beyond hurt feelings.”

These findings are published online in the American Journal of Epidemiology. The study, based on a predominantly white sample of more than 1,400 people, compared health and ageing data from the 1995 and 2004 National Survey of Midlife Development in the United States. Hunte found that people who reported recurring discrimination tended to have a higher increase in waist circumference over time. Men reported an average of 2.39 centimetres increase in waist circumference compared to those who reported low levels of discrimination, and women reported an average increase of 1.88 centimetres over others during the nine-year period.

“While this study shows there is a difference between men and women, it doesn’t provide specific reasons for that difference,” Hunte said. “More research will need to be done to understand how and why men and women cope differently with this stress or if there are differences in how their bodies react.”

Hunte focused on waist circumference – instead of the body mass index formula, which measures obesity based on height and weight –because abdominal fat is a better indicator of poor cardiovascular-related health outcomes than body mass index.

“Being fat is not healthy, but there are greater problems with individuals who are more pear shaped, meaning that fat builds up in their waist region, rather than someone whose fat is deposited throughout the body,” Hunte said. “There is some indication that stressors, such as interpersonal discrimination, can concentrate fat around the midsection. We’re not sure why, and more work needs to be done to understand this connection between behaviour and physiology. How does what’s above the skin affect what is taking place under the skin?”

People who reported ongoing perceptions of discrimination said they were treated with less courtesy than others, received poorer customer service or people acted as if they were afraid of them. The source of discrimination is not known, but Hunte did exempt individuals who reported that they felt discrimination due to their weight.

Hunte is planning to investigate this further by studying biomarkers, such as cortisol, which is a stress-induced hormone, in relationship to effects of discrimination.

Hunte was supported by the Department of Health and Kinesiology and the Robert Wood Johnson Foundation Health and Society Scholars program. The national survey was funded by National Institute of Aging and the John D. Catherine T. MacArthur Foundation Research Network on Successful Midlife Development.

Vivus trims 1st-quarter loss on lower spending

Drug developer Vivus Inc. said Monday that it posted a smaller loss for the first quarter as it spend less on research and development as its drugs neared approval.

Vivus also said it is looking to resubmit its application for approval of obesity drug Qnexa to the Food and Drug Administration in the fourth quarter. The approval is being sought to market Qnexa as a weight-loss treatment for men and women past child-bearing age.

The FDA declined to approve Qnexa in October, and it has asked Vivus to look into the risk of birth defects in women who use topiramate as a migraine treatment. Topiramate is an ingredient in Qnexa. The company met with the FDA earlier this month to discuss performing a retrospective study using existing electronic healthcare databases to assess birth defects in the children of women who were exposed to topiramate during pregnancy. Vivus said it has reached agreement with the FDA on the study’s design, goals and eligibility criteria.

Vivus reported a loss of $9.9 million, or 12 cents a share, for the three months ended March 31. That compares with a loss of $18.8 million, or 23 cents a share, in the prior-year quarter. The results beat analysts’ consensus forecast for a loss of 15 cents a share, according to FactSet.

The company spent $4.5 million on research and development during the quarter, down from $10.2 million in the prior-year period. The sharp decline in spending was due to Vivus’ avanafil project and potential obesity treatment Qnexa each progressing from the clinical trial stage to the approval stage.

Shares of Vivus added 45 cents, or 5.8 percent, to $8.23 in aftermarket trading. The shares rose 3 cents to $7.80 during the regular session.

Needed health care put off because of high cost, UW study shows

The high cost of health care is hurting everyone, with parents forgoing taking their sick kids to the doctor even if they have health insurance and make enough money to cover the cost, according to a new study from researchers at UW-Madison.

A research team from the UW-Madison School of Medicine and Public Health said the cost of health care relative to a family’s income, plus having a child with a limitation such as asthma, autism or obesity, can make families put off needed medical care.

The findings were presented on Sunday at the Pediatric Academic Societies annual meeting in Denver, and were released on Tuesday by the UW-Madison news service.

The research team was headed by doctoral student and graduate research assistant Lauren Wisk.

“Families aren’t choosing to spend their money on going to the doctor when someone is sick because of how much it cost them to see the doctor the last time,” Wisk said in the release. “They are sacrificing their health because it costs too much to be healthy.”

The team looked at data from six years’ worth of surveys on 6,273 families with at least one child.

Excessive financial burden was defined as a family using at least 10 percent of its income on insurance premiums and out-of-pocket health care expenses, and delayed or forgone care was defined as putting off or going without treatment or prescription medication because of the cost.

The study showed families experiencing excessive financial burdens, having a child with an ongoing limitation and a parent with intermittent insurance all increased the chances health care would be delayed or not used.

“Every U.S. family has a finite amount of resources available, and every day decisions have to be made how to allocate those resources,” Wisk said. “This study shows the unfortunate reality of the situation.”

More research is planned to see how delaying or forgoing care affects health down the road.

“We expect that if people aren’t getting the care they need, they will be sicker as a result,” Wisk said.

“When you put this all together, the cost of health care in the U.S. could actually be causing Americans to be sicker.”

Editor’s Commentary – Association of obesity with prostate cancer: A case-control study within the population-based PSA testing phase of the ProtecT study

Obesity is not associated with prostate cancer (CaP), according to a report by Dr. Polyxeni Dimitropoulou and collaborators that appears in the online version of the British Journal of Cancer.

The authors note that obesity is associated with a number of chronic diseases such as coronary artery disease, hypertension and diabetes as well as CaP mortality, but it is not clearly associated with CaP incidence. This is a case-control study nested within the PSA-testing phase of the Prostate testing for cancer and Treatment (ProtecT) study. It evaluates associations of obesity with screening-detected CaP. Obesity was measured by body mass index (BMI), waist circumference and waist-to-hip ratio (WHR).

Patients included in the analysis were age 50-69 years who had PSA testing and a diagnosis of CaP. They were matched for clinicopathologic characteristics with controls. Assessed metrics were both objective and patient-reported. Data was complete for BMI, age and family history for 3,931 controls and 919 cases.

More cases (8.1%) than controls (5.2%) had a family history of CaP. Regarding obesity, in the highest tertiles there were 18.4% cases and 21.5% controls with a BMI ≥30kg m-2. There were 30.5% of cases with >99cm waist circumference compared with 32.1% for controls. WHR was >0.95 in 31.8% of cases and 33.9% of controls. After exclusions for missing data, the number of cases (1,089) and controls (5,020) used in the analysis was similar to the eligible participants not included in the analysis in terms of family history of CaP. However, in terms of age, those included were on average one year older than those not included. Considering BMI, waist measurement and WHR, there was no relationship between any of these three obesity measures and total prostate cancer. Only BMI had a minimally significant relationship to pathological stage or grade.

Dimitropoulou P, Martin RM, Turner EL, Lane JA, Gilbert R, Davis M, Donovan JL, Hamdy FC, Neal DE

Weight Loss Today

Dukan Diet: Newest Fad or Weight-Loss Answer?

It’s supposed to be the French version of the Atkins Diet and it’s making big waves – both in Europe and now in America, but one New York City-based dietitian said the Dukan Diet can be a dangerous choice – despite the fact that princess-to-be Kate Middleton and her mother are allegedly using the diet to shed pounds before Middleton’s big day.

“The Dukan Diet is not based on any scientific data, and seems to be a modified version of the Atkins Diet,” Tanya Zuckerbort, a Fox News contributor said.” This diet is protein-centric and highly restrictive in the initial stages, without much research to back it up.”

The Dukan Diet has been popular in France for years, and now Dr. Pierre Dukan is bringing his weight-loss plan overseas to North America. It consists of high-protein, low-fat meals—which is nothing new—but adds very large amounts of water and oat bran. The diet is cut into week-long cycles with some including vegetables. There is no fruit allowed, but wine and dessert are allowed for a certain number of days—thus appealing to the French.

And what about exercise? The requirement is very light, about 20 minutes a day, with no elevators allowed.

Zuckerbrot was concerned about the restrictions on fruits and vegetables in the plan.

“A diet consisting of high fiber carbohydrates, lean proteins, fruits, vegetables and a small amount of heart healthy fat is the key to looking and feeling your best,” she said.

Dukan’s book has already sold millions of copies worldwide and has been translated into 14 languages—but is it all just hype?

According to Zuckerbrot, the Dukan Diet already has a bad reputation in the world of dietitians.

“France’s National Agency for Food, Environmental and Work Health Safety pointed out the Dukan Diet as one of 15 imbalanced and potentially risky diets. The British Dietetic Association, has also listed the Dukan Diet as one of the five worst diets of 2011,” she said.

By eliminating key foods from your diet, Zuckerbrot said Dukan’s plan can create a nutrition deficiency as well as high cholesterol and even kidney problems.

The bottom line with this diet, is it will more than likely come and go with the rest — there is just not enough variety, Zuckerbrot added.

“You will initially see weight loss on the Dukan Diet, but this eating plan is not sustainable. Also a diet high in protein and low in carbohydrates is expensive. This diet is just that, a diet, not a healthy maintainable lifestyle,” she said.

HCG is High Markup, Fast Selling Weight Loss Supplement

Back in the 1950s, one of the trendy activities for overweight and wealthy Americans was to travel to Europe for special, “HCG Drops,” unavailable in the states. Times have changed, and now these same drops are available for general consumption for anyone looking to shake off a few pounds. A great source of HCG for independent retailers is Buywise.biz. “I did the six week program myself and lost 30 pounds, as well as 16” total around my body,” says Debbie Burks, owner of Buywise. “The program really does work. This past holiday season was the first one for me where I not only didn’t gain weight, but actually lost weight instead.”

HCG is an all natural and homeopathic product that works in conjunction with the body’s hypothalamus gland. “You use it along with following a strict protocol and diet,” Burks says. “You take it three times a day, 10 drops at a time, and there are many doses in a bottle. Depending on how much weight you want to lose, you can do a three or six week program,” she adds.

Burks has studied up on the product, and is very knowledgeable on exactly how it works. “The body consists of three types of fat,” she says. “Structural fat, around your face and cheekbones; reserve fat, which is what the body normally draws from when it needs to, and abnormal fat. If you do a low-calorie diet without the drops, you’ll be affecting your regular fat,” Burks says. “Yet with the HCG drops, it actually works with the abnormal body fat, and because you’re on a low calorie diet, your body will draw what it needs from your abnormal stored fat. That’s where the weight loss comes in.”

Because of its high success rate among users, HCG is selling well, with a high markup for retailers. Buywise wholesales a starter pack of twelve, two oz. bottles for $192, or $16 each, and Burks has seen them advertised in a national vitamin chain store for $159.98 for the two oz. size. “I recommend keeping one bottle at the register to generate POS interest,” Burks says. “We have brochures we can email to our customers. Once they buy HCG, we also have an ebook that we can send, so retailers can read about the product and then pass that knowledge on to customers.” Buywise has a $100 minimum order. However, new customers receive a 10 percent discount off any order over $100. “This is a product that’s going to be a fast seller with a big markup, and it really works,” Burks says. “I’m living proof of that.”

FDA loosens belt on weight loss surgery

REGION — Three and a half years ago, Mike Ross was headed for an early grave.

He weighed 405 pounds, led a sedentary lifestyle, and suffered from sleep apnea, high blood pressure and other health issues.

“I was in pretty rough shape,” Ross, a Norwalk resident, recalled. “I was told more or less by my doctor that I needed to do something, and do something soon.”

So Ross did do something.

He consulted with Dr. Neil Floch, owner of Fairfield County Bariatrics & Surgical Specialists, P.C. in Norwalk, and in October 2007, underwent laparoscopic surgery and had an adjustable gastric band– or LAP-BAND — inserted on his stomach.

Within 13 months, Ross had shed most of the 227 pounds he would ultimately lose. He now regularly visits the gym, is conscience of what he eats and has cured the conditions that once ailed him.

“I feel like I did when I was in my mid-20s,” Ross said. “The surgery really made a big difference in my life, and I recommend it to anyone that’s even considering it.

“It’s life changing,” he said, “and I think it’s something a lot of people can benefit from.”

Last month, the U.S. Food and Drug Administration expanded the use of the LAP-BAND system to 27 million obese American adults who have failed more conservative weight loss alternatives.

Adults with a Body Mass Index (BMI) between 30 and 40 who have at least one related comorbid condition, such as Type 2 diabetes, hypertension or sleep apnea, are now eligible for the LAP-BAND system, created by the California-based health care company Allergan, Inc.

According to Floch, director of minimally invasive and bariatric surgery at Norwalk Hospital, the FDA’s decision to loosen the restrictions on the LAP-BAND system adds a new category of patients, specifically those with lower BMIs, but who suffer from a major medical problem.

“It’s really a great help to a lot of people,” Floch said of the surgery. “We know that only 5 percent of patients who are 80 pounds overweight will be able to lose that weight and keep it off, and long-term diets only work maybe 15 percent of the time.”

The approval to expand the use of LAP-BAND is based on a five-year study of 149 patients to determine the safety and effectiveness of the system as a treatment for obesity in adult patients with a BMI of less than 30 and greater than 40, with and without comorbid conditions.

Floch, whose practice participated in the clinical trial, said the study found that patients with lower BMIs did just as well, if not better, than heavier patients.

“There’s no magic about this,” he said. “This is a device to limit how much and how quickly you eat, and it also helps to take away some of your hunger.”

Laparoscopic gastric banding is the second most common weight loss surgery, after gastric bypass. With gastric banding, an adjustable silicone band is placed around the top portion of the stomach.

Squeezed by the silicone band, the stomach becomes a pouch with about an inch-wide outlet. After banding, the stomach can only hold about an ounce of food.

On average, patients who have undergone gastric banding lose about 60 percent of excess body weight, so a person who is 100 pounds overweight can expect to lose 60 pounds, Floch said.

Gastric banding is considered the least invasive and safest weight loss surgery, he said. The procedure can be reversed if complications occur.

Roberta Burn of New Canaan said she experienced complications, such as vomiting and internal bleeding, after having LAP-BAND surgery in 2006.

She lost 115 pounds after the surgery, but regained 50 pounds after the band was removed. She later had gastric bypass surgery and has since lost the weight she put back on.

And although Burn’s complications with the band forced her to undergo multiple surgeries, she still recommends it for people struggling with obesity.

“It did good things for me,” she said. “Only 10 percent of people have compilations and have to have it taken out. It doesn’t seem like a significant amount of people.”

Floch said the majority of people who struggle with gastric banding surgery are heavier patients with addictive eating habits.

Patricia Grissom of Southington identifies herself as a “depressed eater.”

She tried multiple diets with minimal success, which along with the embarrassment of being overweight, made her depressed.

“I would sit and eat for no reason,” she said. “I didn’t know how to stop myself.”

Grissom said she chose to have gastric banding surgery last year because she knew the surgery would force her to change her eating habits.

And it worked.

Instead of sweets and chocolate, Grissom now craves the taste of fruits and vegetables. Bread and red meat are difficult to digest, so she steers clear of those, as well.

“It’s a whole lifestyle change,” she said. “It’s not a quick fix. You can’t rely on the surgeon to do everything for you. He gets you started and you have to be accountable for yourself and what you do.”

Obesity News and Treatment

Campbell aims to reduce hunger and obesity among Camden kids

CAMDEN — Can you teach a kid to make a fresh fruit smoothie instead of popping a can of cola?

Campbell Soup Co. wants to give it a try.

The world’s largest soup maker today will launch a $10 million plan to reduce obesity and hunger over the next 10 years among children living in its hometown.

Initially, Campbell will focus on elementary schools and services in Parkside, where its headquarters is located, and in North Camden, the city’s poorest sector.

“We plan to concentrate our efforts on these sites in Camden and gradually expand to other locations until we have a citywide program,” said Denise Morrison, Campbell’s chief operating officer.

“Over time, we plan to extend it to other U.S. communities where we have operations,” added Morrison, who will become CEO in July.

Statistics show the need is great.

“Obesity is a national crisis, but it is even more acute in Camden,” said CEO Douglas R. Conant.

Nearly 40 percent of Camden’s children between ages 3 and 19 are obese, an 8 percent jump over the national average.

Working with schools and an array of nonprofits, Campbell’s goals are to increase access to affordable, healthy food; expand opportunities for physical exercise and increase nutrition and health education.

Founded in Camden in 1869, Campbell is the city’s and county’s only Fortune 500 company.

High on the company’s list of objectives is to help bring a second major supermarket to the city, a task residents and groups have been unable to accomplish for decades. Today, the city’s 78,000 residents are served by a single Pathmark on Mount Ephraim Avenue.

Meanwhile, the company will work with the Food Trust on a Healthy Corner Store Network to supply small mom-and-pop grocery stores with equipment and training to order, price and display fresh produce.

Campbell also will combine with the city and the Children’s Garden on the waterfront to convert abandoned urban lots into leafy green vegetable gardens.

Recognizing that physical exercise is integral to good health, the soup maker will fund recess and after-school activities at six pilot sites in conjunction with the YMCA of Burlington and Camden counties. Camden’s own YMCA closed more than two years ago due to lack of funding and membership.

And the last ingredient in a recipe for good health is knowledge. Campbell plans to teach free, six-week cooking courses at sites administered by the Food Bank of South Jersey and offer nutrition education directly to students. Campbell expects many of its 1,200 Camden employees to volunteer as part of the program.

The company released its plan to reduce childhood obesity and hunger in its 2010 corporate responsibility report. Kim Fremont Fortunato, hired by Campbell in November, will head the novel program.

Fortunato, 53, will work with government, nonprofit partners and the medical community at local, regional and national levels to build the program, according to a press release.

Before joining Campbell, Fortunato was president of Operation Warm, an organization that distributed more than 200,000 coats a year to the needy.

Michelle Obama portrayed as overweight in cartoon attacking her obesity campaign

US First Lady Michelle Obama has been portrayed as an overweight, hamburger-munching glutton in a very personal cartoon attack.
The offensive caricature, which was posted on Biggovernment.com, is a dig at her obesity campaign, which celebrated its one-year anniversary last week, reports the Daily Mail.

It comes as Barack Obama’s wife pushes her campaign to improve workplace rules for breastfeeding to reduce the number of overweight children.

Conservatives have criticised the campaign, calling her a hypocrite and suggesting it is not her place to tell Americans what they can and cannot eat.

In the cartoon, she is seen telling her husband: “I’ve stepped up my efforts to control America’s eating habits by telling restaurants to lower portion sizes and fat content.”

Obama, who is shown looking slender and eating some morsels of salad, dismisses her remark, saying: “Michelle, I want to get re-elected. What you’re doing is only going to annoy a lot of people.”

“Shut up and pass the bacon!” she replies.

The First Lady began her Let’s Move! initiative – which is dedicated to improving the disastrous U.S. childhood obesity rates within a generation – last year. (ANI)

Obesity in kids doubles over the last decade

COIMBATORE: In the backdrop of today’s fast food culture, it is hardly surprising that one in ten children in Coimbatore, between six and 12 years is obese. What is alarming is that an equal number of children in semi-rural areas are overweight and one in every twenty five children is obese.

Pediatricians say childhood obesity is signaling a distressingly new health trend. Of 10,229 children, aged between six to twelve years, treated as outpatients at a private hospital in Coimbatore in 2010, as many as 1,118 were obese. It is a disturbing fact that 10% of children in the city are obese. “Ten years ago, this was less than five per cent” says Dr C Srinivasan, chief paediatrician at the KG Hospitals.

The data showed that except for 10 children (among the 10,229) who had hormonal imbalances or genetic predisposition, obesity in the other children was largely due to lifestyle. With both parents working, and fast food affordable and easily available, it has become a major part of a child’s diet. Depending on height and age, children should ideally get about 1200 to 1700 calories a day. But with high fat, low protein food like burgers, pizza and French fries, children tend to eat about 2,500 calories a day. Add to this the sedentary lifestyle children lead, spending most of their free time watching TV or playing video games.

In 2009, the department of health found 9.59% of school children in Coimbatore district overweight and 4.6 per cent were obese. Studies done in Chennai by MV Hospital shows that 22% of girls from higher socio-economic group were overweight when compared to 9% from those of low income group. Among boys it was found to be 13% and 7% respectively. Obese children are at the risk of developing serious health problems that normally affect middle age adults. For instance, these children are more susceptible to chronic disorders like type-2 diabetes and heart ailments.

Weight Loss News

Jennifer Hudson Talks about Family Tragedy and Weight Loss with Oprah

Jennifer Hudson appeared on The Oprah Winfrey Show Thursday to talk about her family tragedy that resulted in the loss of her mother, brother and nephew. Oprah also pressed the former American Idol contestant to share how much weight she has lost after finding success through the Weight Watchers program.

Hudson’s family members were murdered on October 24, 2008, in Chicago. Hudson’s sister’s estranged husband, William Balfour, was the accused murderer.

Hudson told Oprah, “It’s such a shocking thing and it’s a lot to take in,” according to ET. “It’s a very emotional subject.” Hudson credits her baby, God and the lessons she learned from family members for helping her though these hard times.

Oprah discussed Husdon’s weight loss and asked the singer how many pounds she has lost so far. According to CNN, Hudson’s reply was, “I’ve lost 80 pounds.”

Hudson’s decision to lose weight all started when she became pregnant, she shared. She continued that she is still adjusting to her new body and dropped from a size 16 to a size 6. “It’s like a brand new me,” she said. “Sometimes I don’t even recognize myself.”

Oprah surprised the audience in attendance with three, free one-year memberships to Weight Watchers at the end of her show. Hudson’s interview with Oprah airs on Thursday’s episode of The Oprah Winfrey Show.

Kevin Smith On Weight Loss And His New Movie

Actor/Director Kevin Smith’s weight loss was the topic of discussion on CNN’s Joy Behar show last night. The New Jersey native said he has lost over 65 lbs in the past year after his public dispute with Southwest Airlines.
Last year, Southwest Airlines asked Kevin Smith to leave the plane he was already boarded on even though he was appropriately buckled up in his seat.

“What frustrated me more than anything in the world was I felt like nobody told the real story,” Smith said. “The real story was I was a consumer that a company … with poorly and without good reason and I spoke up about it … but to everyone else it was ‘fat guy in a little chair.’”

Kevin Smith went on to say about his weight loss, “I feel mixed feelings about losing the weight. I sympathize far more with heavier people than I ever will with thin, I’ll never be thin. Let’s be honest, I’ve lost 65 pounds but nobody’s going ‘I want to sleep with you,’ they’re just like, ‘Keep going, you look better keep going.’”

Kevin Smith was on the program to promote his new movie Red State which is due out in October of this year. Kevin Smith is also well known for his classic comedic hits Mallrats and Clerks. Smith is also the owner of the comic book store, Jay and Silent Bob’s Secret Stash in Red Bank, New Jersey.

Royal wedding inspires weight loss challenge

Southlake residents are being offered a unique opportunity to take part in a royal wedding-inspired weight-loss challenge designed to get participants back into their wedding clothes.

Local Slimming World consultant Tammy Musack is heading the challenge, the completion of which is scheduled to coincide closely with the royal wedding of Prince William of Wales to Kate Middleton on April 29.

Participants are challenged to lose enough weight to be able to fit into their wedding clothes.

“It may be the little bit of incentive that people need to make the step [to start losing weight],” Musack said. “Sometimes the hardest thing for people is making the decision. The idea was that maybe this will get people to say, ‘I think I’m going to try and lose the weight, and I’ll try and get into my wedding dress. That would be fun.’ We’re creating the opportunity to get rid of the weight and revisit getting into that dress and being able to actually wear it, which is something nobody ever gets to do.”

Participants would follow the Slimming World weight loss program. The Slimming World program has a 41-year history of success and is a household name in the United Kingdom, where it originated, and has only been in the United States a little more than a year, according to Musack.

“It’s a healthy diet, not a fad,” she said.

Musack said there is no deadline to join, but participants would need to reach their goal by the Tuesday, April 26 group meeting.

“Obviously, the sooner they join, the easier it will be to hit their target,” she said. “If they think that they can lose the weight to make it to the deadline, they’re welcome to do it. The goal is to get them into their dress (or tuxedo).”

Musack said those interested in the challenge may attend a regularly scheduled group meeting at no obligation. There is a half-price membership available to those who participate in the challenge. Cost for participants is $10 per week.

“They’re not obligated to spend any money to come and look,” she said. “They can actually come and sit through an entire session and hear how the whole plan works, and if it’s something they don’t think they’re ready for, it won’t cost them a thing.”

Although she said she would be thrilled if many people participated in the challenge, numbers are not Musack’s primary focus.

“I would be happy if it was one or if it was 20; it doesn’t matter,” she said. “If this was the thing that really helped one person bring on a change from where they’re at and make them feel happy about themselves, it makes it worth it.”

Musack said the Slimming World program always seeks to build self-confidence and provide support.

“We do not humiliate anyone,” she said. “We never share what someone’s actual weight is or anything like that. We share the journey of their victories and struggles with them.”

Musack said she plans to arrange a small ceremony to celebrate the challenge’s completion, preferably a vow-renewal ceremony in Pathways Church, where the group meetings are held.

She still has to present this idea before the Pathways Board of Directors for approval. If the idea is not approved, Musack might hold a small ceremony – complete with a small cake and flower bouquet – during her regular Slimming World group meeting. The cake will be provided by Micki Hardy of Elegant Cakery in Southlake.

“We’re looking at having a small ceremony at the church where we actually have them kind of exchange vows,” she said. “It’s sort of in the works.”

Musack said the challenge is distinctive in its design.

“Who out there says, ‘Hey, get back into your wedding dress and you can re-exchange your vows?’” she said. “That’s totally unique in itself.”

Obesity Treatment News

Obesity puts children and adults at risk

According to a new study at the Pediatrics Department of the University of Chicago, children who sleep for at least nine hours do not have problems of obesity and the accompanying metabolic disorders like diabetes and cardiovascular disease.
The study indicated that children who consistently get nine to 10 hours of sleep on both weekdays and weekends have the healthiest metabolic profile. “Good sleep routines and sleeping the right amount is the best healthy proposition,” lead author David Gozal said.
Parents should watch for symptoms that indicate their children need to sleep more. Being cranky or less alert are just two of these. Consequences seen during school would probably be behavior problems, poorer execution of cognitive tests and physical injuries.
Catching up on sleep over the weekend is believed to help to a certain extent but those children who were obese already had shorter and more irregular patterns of sleep. These are also the ones who had higher insulin levels — which can lead to type 2 diabetes over a prolonged period — higher levels of “bad” (LDL) cholesterol and higher levels of C-reactive protein, which has been linked to heart disease in later life.
Obesity is defined as an excessively high amount of body fat (or adipose tissue) in relation to lean body mass. The amount of body fat includes concern for both the distribution of fat throughout the body and the size of adipose tissue deposits. Weight standards can be measured in many different ways. The most common is body mass index.
BMI represents weight levels associated with the lowest overall risk to health. BMI is a mathematical formula in which a person’s body weight in kilograms is divided by the square of his or her height in meters. BMI is more highly correlated with body fat than any other indicator of height and weight. Desirable BMI levels may vary with age. According to the National Institutes of Health clinical guidelines on the identification, evaluation and treatment of overweight and obese adults, all adults (aged 18 years or older) who have a BMI of 25 or more are considered at risk for premature death and disability. Individuals with a BMI of 30 or more are considered obese. Health risks increase as severity of the person’s obesity increases.
Other weight tables have been created by the Metropolitan Life Insurance Company. Theirs is based on their client population.
Factors that contribute to child, adolescent and adult obesity include:
Modifiable (things that can be changed) causes such as:
• Physical activity: lack of regular exercise
• Sedentary behavior: high frequency of television viewing, computer usage and similar behavior that takes up time that could be used for physical activity
• Socioeconomic status: low family incomes and non-working parents
• Eating habits: over-consumption of high-calorie foods and eating patterns such as eating when not hungry, eating while watching TV or doing homework
• Environment: factors include over-exposure to advertising of foods that promote high-calorie foods and lack of recreational facilities
Non-changeable causes include:
• Genetics: children of obese and overweight parents are at greater risk of obesity
Obese people are at risk of developing one or more serious medical conditions, which can cause poor health and premature death. Obesity is associated with more than 30 medical conditions and scientific evidence has established strong relationships with increases in deaths from all causes due to obesity. Preliminary data also shows the impact of obesity on various other conditions. Weight loss of about 10 percent of body weight, for people who are overweight or obese, can improve some obesity-related medical conditions including diabetes and hypertension.
Just a few facts on obesity-related medical conditions:
• More than 75 percent of hypertension cases are reported to be directly linked to obesity.
• Obesity contributes to the main cause of gout — the deposit of uric acid crystals in joints and tissue.
• As many as 90 percent of individuals with type 2 diabetes are reported to be overweight or obese. Obesity has been found to be the largest environmental factor on the prevalence of diabetes in a population.
• Postmenopausal women with obesity have a higher risk of developing breast cancer. In addition, weight gain after menopause may also increase breast cancer risk. Women who gain nearly 45 pounds or more after age 18 are twice as likely to develop breast cancer after menopause than those who remain at a stable weight.
• Women with obesity have three to four times the risk of endometrial cancer than women with lower BMI.
• The effects of obesity on cardiovascular health can begin in childhood, which increases the risk of developing cardiovascular disease as an adult.
• Obesity has been found to decrease the body’s resistance to harmful organisms. A decrease in the activity of scavenger cells, which destroy bacteria and foreign organisms in the body, has been observed in patients with obesity.
If losing weight is high on your list of New Year’s resolutions for your child or yourself, check out “The Top 10 Habits That Can Help You Lose Weight” by Kathleen M. Zelman on WEBMD.

Obesity, Legacy of Smoking Leave Americans Behind in Life Expectancy

America lags many other nations in life expectancy, largely because of obesity and, in years past, lots of smoking. That, at least, is the conclusion of a new study from the National Research Council, the main operating arm of the National Academy of Sciences and the National Academy of Engineering.

The report mainly blames the nation’s once-prevalent smoking habit. While only 20 percent of the adult population smokes today, the figure was 40 percent in 1960, and many 1960 smokers are still suffering the effects.

“Fifty years ago, smoking was much more widespread in the United States than in Europe or Japan: a greater proportion of Americans smoked and smoked more intensively than was the case in other countries,” the authors wrote, as Reuters reports.

“Other factors, such as obesity, diet, exercise, and economic inequality, also have likely played a role in the current gap and divergence between the United States and other countries,” the study said.

At 78.3 years, U.S. life expectancy at birth ranks 36th in the world, behind most of Europe, parts of Asia and even Cuba, according to the United Nations. Japan’s life expectancy of 83 years is the world’s highest.

The report had some good news for Americans, however. The authors said that the nation’s declining smoking numbers will result in higher life expectancies in the coming decades.

Turn down the thermostat, your heater may be making you fat

Linda Carroll writes: Lowering your thermostat may reduce not only your spending, but also your weight, a new study suggests.

Researchers suspect that rising indoor temperatures in British and American homes may have contributed to the obesity epidemic. The theory is that we burn fewer calories when our bodies don’t have to work as hard to stay warm, according to a report published in Obesity Reviews.
“Research into the environmental drivers behind obesity, rather than the genetic ones, has tended to focus on diet and exercise – which are undoubtedly the major contributors,” said the study’s lead author, Dr. Fiona Johnson, of the UK Health Behavior Research Centre at University College, London. “However, it is possible that other environmental factors, such as winter indoor temperatures, may also have a contributing role.”

Johnson and her colleagues scrutinized data on indoor temperatures in both the United Kingdom and the United States. They found that both British and American households have bumped up their thermostats several degrees over the last few decades.

For example, bedrooms in the U.S. were heated to an average of 66.7 degrees in the late 1980s, versus 68.4 degrees in 2005. The differences were more striking in British bedrooms, where the average temperature climbed from 59.4 degrees in 1978 to 65.3 degrees in 1996.

Studies have shown that slightly chillier temperatures can lead to increased energy expenditures, Johnson noted. And that’s true even when people bundle up.

“Increased time spent indoors, widespread access to central heating and air conditioning, and increased expectations of thermal comfort all contribute to restricting the range of temperatures we experience in daily life and reduce the time our bodies spend under mild thermal stress – meaning we’re burning less energy,” Johnson said.

Weight Loss Today

Biggest Loser Ashley Johnston promotes Rite Aid weight plan

She set the record for the most weight loss by a woman on the NBC-TV show “The Biggest Loser.” Now Ashley Johnston, the runner-up on season 9, is teaming with Rite Aid to promote the drugstore chain’s Rite Weight Plan.

One appealing feature is the cost: It’s free.

Here’s what it includes: a 12-page guide containing weight-loss tips and techniques; access to a medical weight-control program called Lindora for help losing up to 10 percent of your body weight in 10 weeks; online seminars, weight tracking tools and supportive daily e-mails. The website also includes recipes, healthy snack suggestions, a body mass index calculator and tools to decipher food labels.

In addition, pharmacists at the stores can answer questions about diet trends, drug therapy for weight loss, myths and medications used to control weight-related diseases, including heart disease, diabetes, arthritis and stroke.

Pharmacist Shauna Morat, of the Rite Aid at 1820 Teall Ave. in Syracuse, says some people who resolve to lose weight this time of year struggle with popular myths about dieting.

One of the most popular: The less you eat, the better.

While portion control is important, Morat says, “that doesn’t mean if you skip a whole meal that you are controlling your portions.” That can backfire, she says, by messing up your body’s metabolism, which can cause you to gain weight.

Another popular myth: Low-fat means it’s good for you.

Morat cautions to read food labels closely. “Many that are marked ‘low-fat’ may be high in sugars, and calories.”

She reminds us that the average woman needs about 1,200 calories per day; the average man, about 1,500.

Through Jan. 22, enter a sweepstakes at www.riteaid.com/weight for a chance to win a trip for two to The Biggest Loser Ranch in Los Angeles, where the reality show is filmed. Johnston lost 183 pounds on the show last year, dropping 48.93 percent of her weight. She placed second behind a man who lost 50.19 percent of his body weight, going from 526 pounds to 262 pounds.

100-pound weight loss

Adam Reitz, a teacher at Liberty High School, gets ready for his evening run on the steps of the school. Adam has lost over 100 pounds in the last three years simply by running and watching his eating habits. He runs every day, mornings before work and evenings, no matter what the weather conditions. (Douglas Kilpatrick, SPECIAL TO THE MORNING CALL / December 20, 2010)

When Adam Reitz doesn’t feel like waking up at 3:30 a.m. for his daily run, he reaches out for his phone and looks at the picture that changed his life.

Most days he doesn’t need to reach for the phone. The image of himself 100 pounds heavier is engraved in his mind, as are the feelings associated with that picture.

It was three years ago and two months before his wedding. He had just returned from a trip to Hawaii with his students and colleagues from Liberty High School in Bethlehem. The school nurse had taken the picture and left it in his mailbox for him to remember their trip. It was a pleasant image of him posing with his now-wife, Tara, who is also a teacher at Liberty.

Wayne L. Westcott: How do TV weight-loss shows work?

You may have watched television shows that feature people who have lost large amounts of weight in relatively short periods of time. For example, contestants are frequently reported to lose about 60 pounds of body weight in 12 weeks.

Let’s take a look at the math and physiological changes necessary to attain such a huge weight loss, at a rate of 5 pounds per week.

Most Americans have enough stored fat to lose 1 to 2 pounds per week, which requires cutting 3,500 to 7,000 calories per week. Some very heavy adults may be able to lose 3 to 4 pounds of fat per week, which requires cutting 10,500 to 14,000 calories per week. But it would be almost impossible for someone to lose 5 pounds of fat per week, which requires slashing 17,500 calories.

What would it take for someone to achieve a 17,500-calorie deficit within a week? If a person normally eats 2,500 calories a day, a total food fast would produce a 17,500 weekly calorie deficit. Or, if a person continued to eat normally, he or she could burn 17,500 extra calories by running 175 miles a week (25 miles each day). Obviously, both scenarios are unlikely.

If a person loses 5 pounds a week, then the weight isn’t totally fat. A significant percentage of the weight loss is muscle, composed of about 75 percent water and 25 percent protein.

Losing muscle, which is always unwise and unhealthy, inevitably results in metabolic rate reduction and a rapid regain of fat weight. Research confirms that those who lose body weight rapidly will regain the lost weight almost as quickly. In fact, physiologically, there is no alternative. Ask veteran dieters how many times they have lost and then regained large amounts of weight. Almost all of the people who participate in our weight-loss program have previously succeeded and failed with at least a half of a dozen diet plans.

So what is the secret to losing fat and keeping it off? The same secret that makes you look better, feel better and function better. Namely, a purposeful exercise program that restores muscle, recharges the resting metabolic rate and reduces fat.

It is essential to understand that as we age, we lose about 6 pounds of muscle every decade, unless we do strength training. As a result, our resting metabolism decreases about 3 percent per decade. Unless we eat less food, our lower metabolism leads to increased fat stores, averaging about 16 pounds per decade.

The 6-pound muscle loss combined with the 16-pound fat gain shows up as a 10-pound-per-decade weight gain on the bathroom scale. However, it really represents a 22-pound-per-decade, undesirable change in body composition, personal appearance and physical function because of 6 pounds less muscle and 16 pounds more fat.

The solution to this problem is not just dieting. Dieting can reduce fat, but it routinely results in muscle loss and metabolic rate reduction. Likewise, the solution is not endurance exercise alone. Endurance exercise like walking, jogging, cycling and stepping can reduce fat, but it does not replace muscle or recharge resting metabolism. The solution is a sensible combination of strength exercise, endurance exercise and nutrition, with or without calorie restriction.

Consider the results of almost 3,000 participants in our fitness research program. After 10 weeks of performing 20 minutes of strength exercise and 20 minutes of endurance exercise two or three days a week, the participants averaged a 3-pound muscle gain and a 4-pound fat loss, along with reductions in systolic and diastolic blood pressure.

In another study, we divided about 100 overweight women into two groups for the purpose of fat loss and cellulite reduction. Both groups performed our basic exercise program, but one group followed a modestly reduced calorie plan of 1,600 calories per day.

After eight weeks of training, all of the women made excellent improvements in body composition and personal appearance. However, those who combined exercise and diet lost twice as much fat weight (11 pounds versus 5 pounds) and twice as many inches off their hip measurement (2 inches versus 1 inch) than those who only exercised.

My first recommendation to reverse the negative effects of the aging process is a basic fitness program that includes both strength training and endurance exercises. In addition to improving musculoskeletal fitness, strength training replaces muscle, recharges metabolism and reduces fat by burning extra calories during the exercise session and throughout the day. In addition to improving cardiovascular fitness, endurance exercise reduces fat by burning extra calories during the exercise session.

My second recommendation is a sound nutrition program that includes enough protein for muscle and bone building and a reasonable reduction in caloric intake. That is, a diet that provides enough energy for your activity sessions and keeps your metabolism from slowing, which is always counterproductive.

Wayne L. Westcott, Ph.D., teaches exercise science at Quincy College in Massachusetts and consults for the South Shore YMCA. He has written 24 books on physical fitness, and has been a featured speaker at Harvard Medical School’s International Conference on Practical Approaches to the Treatment of Obesity.