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