Blog | Tuesday, June 24, 2008

Obesity...of course


I'm looking through my notes from the Endo conference for any last tidbits that might be useful for blog readers. Everyone's interested in obesity, so I thought I'd share the observations of Daniel Besessen, MD, of the University of Colorado at Aurora, who led a session on "The Year in Clinical Obesity."

He started off by noting that the CDC data from 2001-2003 suggest the rise in obesity over the last several years in the U.S. is slowing... at least for adults.

"Maybe we have reached a plateau" for adults, Dr. Besessen said. "But obesity in children still grows and there will be health consequences as those kids get older. Even a modest increase in body weight leads to an increase in mortality."

The authors of a 2007 article in the New England Journal of Medicine (NEJM) used 2000 data on adolescent obesity for a computer simulation that found that, by 2020, 37%-40% of 35-year-olds will be obese, he noted.

On the treatment side, bariatric surgery and gastric banding have gotten more popular, he noted. That's good news, in a sense, since a 2007 NEJM study found that bariatric surgery decreased an obese person's risk of death by 30% compared to the use of conventional behavioral therapy.

A 2008 Journal of the American Medical Association study, meanwhile, found that gastric banding in diabetics led to remission for 73% of patients, compared to 13% remission in the conventional therapy group-- all of which came about from the weight lost, Dr. Besessen said.

"Bariatric surgery has been shown to have dramatic benefits, and people are moving toward banding," Dr. Besessen said. "The effectiveness and safety of these treatments really depends on the (skill of the) surgeons, however."

And at a session on Novel Factors Contributing to the Obeisty Epidemic, experts tossed out these interesting tidbits:

  • 7.5 hours of sleep is associated with the lowest BMI. More or less than this and the BMI starts creeping up, especially under 5 hours. In part, that's because inadequate sleep leads to an average increase of 24% in one's hunger level-- with people specifically craving fatty and starchy foods.

  • High fructose corn syrup is similar to fat in the way it is metabolized. Fructose consumption is up 30% since 1970, with the average person drinking 56 gallons a year of sweetened soda. Diets high in fructose may cause dyslipidemia and insulin sensitivity, and increase intra-abdominal fat.