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Loel Solomon, PhD, MPP: Whole-community, whole-person, whole-ecosystem strategies needed for obesity treatment & prevention
TOS
Whole-community, whole-person, and whole-ecosystem strategies will be necessary to improve obesity treatment and prevention, Loel Solomon, PhD, MPP, said in the public health keynote address on Wednesday at ObesityWeek.

Most people spend only a few hours per year in a healthcare setting; in contrast, the majority of their time is spent in schools, neighborhoods, food environments, and media interactions. Solomon, Vice President of Community Health at Kaiser Permanente, said we are beginning to understand how to modify these "places" to drive healthy behavior changes.

In addition to these community initiatives, Solomon described a whole-person approach to obesity that emphasizes intrinsic motivation. Instead of focusing on financial rewards and other incentives, Solomon emphasized tapping into what matters most to each individual, as well the full range of influences on health, such as emotional, social, financial and career factors. Healthcare providers must also consider treatment strategies for toxic stress, such as traumatic childhood experiences, which have a dose-response relationship with obesity.

Finally, Solomon provided examples of whole-ecosystem strategies that have been successful at clinic-community integration. Nemours has given school nurses access to the electronic medical records of students with chronic conditions, while the Y has brought the Diabetes Prevention Program (DPP) to more than 38,000 participants in 43 states. In an example from his own organization, Solomon described how Kaiser Permanente has integrated food insecurity screening into all healthcare encounters in order to connect patients with available resources, in addition to advocating for policy changes that have expanded access to such services.
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#OW2015 Research Spotlight: One night of poor sleep could equal six months on a high-fat diet, study shows
TOS
New research finds that one night of sleep deprivation and six months on a high-fat diet could both impair insulin sensitivity to a similar degree, demonstrating the importance of a good night's sleep on health. This study, conducted by Josiane Broussard, PhD, and colleagues from Cedars-Sinai Medical Center in Los Angeles, CA, used a canine model to examine whether sleep deprivation and a high-fat diet affect insulin sensitivity in similar ways. The findings will be presented during a poster presentation this evening beginning at 6:00pm PT in the poster area of the Exhibit Hall.

When the body becomes less sensitive to insulin (i.e., "insulin resistant"), it needs to produce more insulin to keep blood sugar stable. This may eventually lead to Type 2 diabetes, a disease where the body’s insulin response doesn’t work properly and there is too much sugar in the blood. Diabetes is associated with a number of serious complications, including heart disease. Individuals with obesity are more likely to develop insulin resistance and subsequently, diabetes.

"Research has shown that sleep deficiency and a high-fat diet both lead to impaired insulin sensitivity, but it was previously unknown which leads to more severe insulin resistance," said Dr. Broussard. "Our study suggests that one night of total sleep deprivation may be as detrimental to insulin sensitivity as six months on a high-fat diet. This research demonstrates the importance of adequate sleep in maintaining blood sugar levels and reducing risk for metabolic diseases like obesity and diabetes."

Read more in the press release here.

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#OW2015 Research Spotlight: Research links genes to heightened brain reward responses to foods high in fat and sugar
TOS
For the first time, researchers have identified two genetic variants that interact to alter the brain responses to high-calorie foods, a tie that could aid in the development of targeted treatments for obesity and overweight. Researchers at Imperial College London led by Tony Goldstone, MD, PhD, of Consultant Endocrinologist and recipient of the ObesityWeek Foster-Schauer Award for his research found that two gene variants — FTO and DRD2 — influenced activity in the brain reward system when looking at pictures of high-calorie foods. The findings will be presented during an oral presentation on today from 3:45 – 5:15 in LACC-501ABC.

What does this mean for people with obesity?

"It means they may experience more cravings than the average person when presented with high-calorie foods — that is those high in fat and/or sugar — leading them to eat more of these foods," said Dr. Goldstone.

To conduct their study, researchers evaluated how two genetic variants near genes called FTO and DRD2 alter brain response in participants who were asked to look at pictures of either high-calorie or low-calorie foods and rate how appealing they found the pictures. This was done using a brain scanning technique called functional magnetic resonance imaging (fMRI). All cohort participants who had an fMRI scan and DNA taken were included in the study. Those participants with a variant near the FTO gene, which predisposes a person to obesity, had greater activation when looking at high-calorie foods in a part of the brain called the orbitofrontal cortex. They also found these foods more appealing, which was not seen for low-calorie foods. Read more in the press release here.

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Bench to Bedside and Beyond Early Career Travel Grant
TOS
Addressing obesity requires an integrated, multipronged approach from all areas — including clinical, public health, policy and research. With that in mind, TOS Secretary-Treasurer Martin Binks, PhD, FTOS, created a new path to fund travel for early career members to The Obesity Society Annual Meeting at ObesityWeek with the creation of the Bench to Bedside & Beyond travel grants in 2014. These two annual travel grants in the amount of $1000 each recognize and provide opportunities for any TOS early career member in attendance at ObesityWeek. Recipients are chosen on-site based on a simple lottery.

Congratulations to the following recipients:
  • Justin Malek, student at the University of Alabama at Birmingham
  • Elizabeth Ruzicka, student at Kent State University

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From Los Angeles, across the nation
TOS
In the last two days, promising researchers, entrepreneurs and healthcare professionals have shared exciting developments poised to take obesity medicine into the next era. As we reach the halfway point of ObesityWeek, consider how we can ensure these developments reach patients in tangible ways for a comprehensive obesity treatment approach.

A study published last week found that severe obesity cost California $9.1 billion in 2013, especially because many health plans simply do not cover evidence-based strategies. Individuals affected by obesity often do not get the support they need from healthcare professionals or the medical system. From bias and stigma that prevent fruitful conversations to institutional barriers that prevent care, it’s time to make a change for better obesity care.

Los Angeles Mayor Eric Garcetti underscored the seriousness of the disease of obesity by declaring Nov. 1 – 7 as Obesity Care Week in the City of Los Angeles. "It will take a long-term collaborative effort, involving partners from across all fields taking an active role, to ignite the betterment of obesity care and treatment," he wrote. This is only the beginning.

Next year, let's follow LA's lead to New Orleans, Houston, Cleveland, Chicago, New York. Learn more about National Obesity Care Week and see how you can join us. Visit us in the South Lobby today through Friday!

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Celebrate the final days of ObesityWeek at the AfterDark
TOS
The Belasco Theatre, Thurs, Nov. 5, 9:00 – 11:59pm
Relax, unwind and celebrate all that you learned at the conference with your friends and colleagues at the AfterDark Reception. This evening ballroom event offers live music and dancing to wrap up the final night of the meeting.

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Two emerging therapies reviewed at Pharmacotherapy Forum
TOS
Two temporary, capsule-delivered weight loss products now in development were presented during Tuesday's Pharmacotherapy Forum at ObesityWeek.

The PlenSat digestible balloon autoinflates in the acidic environment of the stomach to a diameter of 4 cm and eventually falls apart and passes through the intestines. Fred Voss, PhD, described the patient-delivered product as affordable and scalable to many more patients than current weight loss devices. Multiple capsules can be taken to achieve the correct dose for each patient, and a low maintenance dose can be given for long-term treatment effects. While the PlenSat balloon has been tested only in dogs thus far, the company is now raising money for a feasibility study.

In another presentation, Hassan Heshmati, MD, described Gelesis 100, a food-grade hydragel that absorbs water and expands in the stomach to delay emptying and increase satiety. After each meal, particles are degraded in the colon and the water is reabsorbed. In addition to the gastric effects, it is hypothesized that the particles act as a diffusion barrier in the intestines to prevent the absorption of substances including glucose. In a 3-month randomized, double-blind, placebo-controlled trial of 128 subjects, those taking the low dose (2.25 g twice daily) had 6.1% total weight loss compared to 2.0% with placebo (microcrystalline cellulose). A significant correlation was found between baseline fasting plasma glucose and the degree of weight change. Based on these results, the FDA has accepted Gelesis 100 as a nonsignificant risk device, and it is currently being tested in a 6-month trial of 460 subjects, with results expected in the first quarter of 2017.

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Obesity care seen through fresh eyes
Contributed by ConscienHealth
In the ObesityWeek advocacy forum Tuesday, three speakers challenged advocates for obesity care to look at the issue of access to obesity care through fresh eyes.

Access to care has been typically framed as a health issue. But Jennifer Shinall of the Vanderbilt University Law School explained that a more productive approach might be to frame obesity as a women's issue. This approach might be more productive, she explained, because obesity has a disproportionately negative effect on the health, economic, and social status of women. And by approaching obesity as a women's issue, advocates could advance the cause of access to care through established legal solutions that protect women from discrimination under the 1964 Civil Rights Act and the Affordable Care Act. Shinall explained that this is true because discrimination based on weight is perfectly legal under current law. Discrimination based on gender is not legal and much more easily challenged under Federal law.

Likewise, Lloyd Stegemann challenged advocates to stop relying upon legislative and regulatory action to improve access to care, and instead to begin organizing behind a social movement to demand better access to care.

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Explore a sub-specialty at TOS Section events at ObesityWeek
TOS
Each Section of TOS holds various meetings and networking events at ObesityWeek. Check out the Section event schedule below so you don't miss out — they are open to all!
  • Meet the Professor Breakfast, Thursday, November 5, 7:00am-8:00am
  • Latin American Affairs Section Meeting, Thursday, November 5, 12:00pm-1:30pm
  • Bariatric Surgery Section Meeting, Thursday, November 5, 12:00pm-1:30pm
  • Pediatric Obesity Section Meeting, Thursday, November 5, 12:00pm-1:30pm
  • Bio-Behavioral Research Section Meeting, Thursday, November 5, 7:30pm-9:00pm
  • TOS ABOM Reception (CMO & LAA Sections), Thursday, November 5, 7:30pm-9:00pm
  • Obesity and Cancer Section Meeting, Thursday, November 5, 7:30pm-9:00pm
  • Epidemiology & Population Health Section Meeting, Friday, November 6, 7:00am-8:00am

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    Treat Obesity Seriously™ & Sign the Obesity Pledge at TOS Member Services Booth
    TOS
    Do you treat obesity seriously? By signing the Obesity Pledge you can demonstrate your commitment to the cause and encourage your friends and colleagues to do the same. Add your voice to the many others who have signed on by saying:

    "I believe obesity isn't just a problem. It's a disease that warrants serious evidence-based treatments. Nutritional and physical activity guidance. Intensive behavioral counseling. Drug therapy. And surgery. Agree to learn more and help more. I treat obesity seriously."

    It's simple. Stop by TOS Member Services Booth, sign the pledge on the iPad and pick up your free lapel pin.

    Not able to make it to the booth? Sign the pledge online with your mouse. Print your certificate and hang it on your office or practice wall. Share the pledge with your family, friends and colleagues. And, send a letter to your member of Congress expressing your support for legislation that improves access to treatment for obesity.

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    A night of music & comedy
    TOS
    Take a break and join us for some great music and fantastic comedy by The Lap Band featuring Caroline Apovian and Richard Bergman with special guest Arya Sharma. The event will be held tonight — Thursday, Nov. 5 from 8:00pm – 11:00pm at the Hotel Figueroa Rabat Room at 939 South Figueroa Street, which is only a short walk from the Convention Center.

    Presented by Medscape and co-sponsored by Diabetes/Obesity Research Institute of Cedars-Sinai. RSVP to james.mccarthy@bmc.org.

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    Look ahead at tomorrow
    TOS
  • TOS Awards (Ethan Sims, Lilly, Wadden), 8:00 – 10:15am, LACC-Concourse 150/151
  • Basic Science Keynote Speaker, Jan Nedergaard, PhD, 11:00am – 12:00pm, LACC-Hall G
  • TOS Oral Abstracts: Bariatric Surgery, 1:30 – 3:00pm, LACC-502A
  • California Bubbly: The Consequences and Public Debate Around Soda Taxes, 3:45-5:15pm, LACC-511ABC
  • OAC Your Weight Matters Event for the Public (Saturday), 8:00am – 12:00pm, LACC-Concourse 152

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    OBESITY IN THE NEWS


    Could electrical stimulation to the brain help with weight loss? A new study shows promise
    Los Angeles Times
    Giving a region of the brain that's key to self-control and motivation a zetz of electrical stimulation may help the obese to eat less and lose more weight, says a new study. Research suggests that the brains of people who are obese differ in a key respect from those of normal-weight people: The left dorsolateral prefrontal cortex — a structure just above the right eye that plays a role in behavior related to planning and reward-seeking — is less active in the obese.
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    Children of stressed parents may be prone to obesity
    HealthDay News
    Hispanic children are more likely to be obese if their parents have high levels of stress, a new study suggests. Researchers compared obesity rates of Hispanic children in Chicago, Miami, New York City and San Diego with their parents' levels of stress at home and at work. The children's obesity rates rose according to the amount of stress their parents faced — from 20 percent among kids whose parents had no stress to 34 percent among those whose parents had three or more stress factors. Stress factors included difficulties at work or in a relationship, among others.
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    Weight-loss surgery often brings less joint pain
    HealthDay News via WebMD
    Aching knee and hip joints may hurt less after successful weight-loss surgery, a new study suggests. "In particular, walking is easier, which impacts patients' ability to adopt a more physically active lifestyle," lead researcher Wendy King said in a news release from the ObesityWeek meeting. Weight-loss surgery isn't a "magic bullet" for joint pain for every patient, however.
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    Better sex life may be a weight-loss surgery bonus
    HealthDay News via WebMD
    Following weight-loss surgery, activity in the bedroom may pick up as the pounds fall away, a new study finds. The research suggests the effect may be long-term, and similar for both men and women. "Improvements in sex life are an additional benefit that goes beyond weight loss," said Dr. John Morton, president of the American Society for Metabolic and Bariatric Surgery. He was not involved in the new study.
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    Sleep well to avoid insulin resistance
    Medical News Today
    One night of sleep deprivation and six months on a high-fat diet could both impair insulin sensitivity to a similar degree, according to research presented at the Obesity Society Annual Meeting in Los Angeles. This demonstrates the importance of a good night's sleep on health. Sleep deficiency and a high-fat diet are known to lead to impaired insulin sensitivity, but it was previously unknown which leads to more severe insulin resistance.
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    Brain stimulation limits calories consumed in adults with obesity
    National Institutes of Health
    A National Institutes of Health study found that non-invasive brain stimulation decreased calorie consumption and increased weight loss in adults who are obese. The findings suggest a possible intervention for obesity, when combined with healthy eating and exercise. Results were published in Obesity concurrent with a presentation at the 2015 Obesity Society meeting.
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    City of Los Angeles proclamation on obesity care
    Dr. Sharma's Obesity Notes
    WHEREAS: The disease of obesity is a major source of concern across the nation. In California, the adult obesity rate is nearing a quarter of the population (24.7 percent) and in Los Angeles County, the percentage of adults affected by obesity continues its steady rise from 13.6percent in 1997 to 24.3percent in 2013.
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    Obesity Care Advocacy Network launched to help address the nation's growing obesity epidemic
    Obesity Action Coalition
    During the 2015 ObesityWeek, leading healthcare organizations announced the formation of a new advocacy network, the Obesity Care Advocacy Network. The Founding members, the Academy of Nutrition and Dietetics, the American Association of Clinical Endocrinologists, the American Society for Metabolic and Bariatric Surgery, the Endocrine Society, Novo Nordisk, the Obesity Action Coalition, the Obesity Medicine Association and The Obesity Society, aim to partner with other medical societies and organizations to change how the nation perceives and approaches the U.S. obesity epidemic by educating and advocating for public policies and increased funding for obesity education, research, treatment and care.
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    More Americans than ever use prescription drugs
    NBC News
    More Americans than ever are taking prescription drugs — close to 60 percent of U.S. adults, according to new research. And most seem to be related to obesity, with cholesterol and blood pressure drugs leading the pack, researchers report in the Journal of the American Medical Association. The single most popular drug is Zocor, a cholesterol-lowering drug in a class called statins, said Elizabeth Kantor, formerly of the Harvard T.H. Chan School of Public Health in Boston, and now at Memorial Sloan Kettering Cancer Center in New York.
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    Data presented at ObesityWeek showed Saxenda treatment demonstrated significant and sustained weight loss over 3 years compared with placebo
    SYS-CON
    New data from the phase 3a SCALE™ (Satiety and Clinical Adiposity: Liraglutide Evidence in Non-Diabetic and Diabetic adults) Obesity and Pre-diabetes three-year trial extension were presented at ObesityWeek 2015, the 3rd annual combined congress of the American Society for Metabolic and Bariatric Surgery and The Obesity Society.
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