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NYC Health Department Treats Obesity as an Epidemic, Will Work Until it Ends
Best known for spearheading the effort to ban 16-ounce "sugary drinks," New York City Health Commissioner Thomas Farley, MD, MPH, gave the ObesityWeek Keynote Address Thursday to a packet room of nearly 4000 obesity researchers, bariatric surgeons, nutritionists and other allied health professionals.
"There are limits on a human's ability to refuse food," said Dr. Farley. "And since food is cheap and ubiquitous you can easily sneak in extra calories wherever you go.” And that's why, he said in his address, "Saving Gotham: New York City's Attempts to Reverse the Obesity Epidemic," that the obesity epidemic is the cholera of our day. "We in NYC are paid to respond to epidemics and will continue to work on it until it ends."
Although the sugary drink ban garnered the most media attention, New York's efforts to combat obesity are much broader. To encourage residents to be more physically engaged, the city is promoting active-design, incorporating more bike lanes on city streets and working to place a park within a 10-minute walk of every resident.
In regards to his thwarted efforts to pass laws to reduce sales of super-sized sugared beverages, Dr. Farley said that while there had been disagreements when the soda groups had met, he believes it's still possible to find common ground. His comments were met with a standing ovation by the crowd of health professionals committed to treating obesity as a disease.
Jing Hong contributed to this article.
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TOS Awards Session Recognizes Individual Contributions to Obesity Research, Education, and Policy
The 2013 TOS Awards Session honored five individuals yesterday for their contributions to the field of obesity.
The Mickey Stunkard Lifetime Achievement Award recipient was Steven N. Blair, PED, of the University of South Carolina, in recognition of his outstanding contribution to the field of obesity through scholarship, mentorship, and education. Dr. Blair presented research on the importance of physical activity and fitness in obesity research and highlighted the need incorporate physical activity in obesity research, funding, and public policy.
Sir Stephen O'Rahilly, MD, FRCIP, of the University of Cambridge, received the TOPS (Take Off Pounds Sensibly) Foundation Research Achievement Award, in recognition of a singular achievement and contribution to obesity research. Dr. O'Rahilly discussed his research identifying genetic mutations in humans that result in deficiencies in leptin and insulin signaling. He emphasized how the lessons from genetic discoveries increase our understanding of obesity.
The Atkinson-Stern Award for Distinguished Public Service recipient was Karen A. Donato, SM, of the National Institute of Health. The award is made possible by a gift from Thomas A. Wadden, PhD, and recognizes significant work to improve the lives of those affected by obesity through public policy.
George L. Blackburn, MD, PhD, of Harvard University, and George A. Bray, MD, of the Pennington Biomedical Research Center, were awarded the Masters of the American Board of Obesity Medicine, in recognition of their significant contributions to obesity treatment and medicine.
Earlier this week, during TOS's Opening Ceremony, Donna Ryan, MD, was honored with the prestigious George A. Bray Founders Award. This award recognizes Dr. Ryan for her significant contributions to advance the scientific and clinical basis for understanding and treating obesity, and for extensive involvement with the Society. She has demonstrated an outstanding ability to pull people together to solve large, difficult medical problems.
Live Surgery Telecast
Want a chance to see three expert Bariatric Surgeons performing live procedures? ASMBS is excited to bring a live broadcast of bariatric surgery to ObesityWeek for all scientific session attendees.
The Live Bariatric Surgery Telecast will be in the Thomas Murphy Ballroom Friday morning at 8a.m. Moderator Ninh Nguyen, MD, and panelists Luigi Angrisani, MD, and Michel Gagner, MD, will guide the room through three live surgical procedures, broadcast live on three dedicated high-quality video streams.
Titus Duncan, MD, will perform a gastric bypass for patient discharge within 23 hours. Nestor de la Cruz-Munoz, MD, will perform a revisional procedure. Drake Bellanger, MD, will perform a sleeve gastrectomy procedure for patient discharge within 23 hours.
This symposium is a great chance for all attendees to get an up-close look at several bariatric procedures.
Study Ties Surgical Weight Loss to Reduced Aging
Researchers have identified a connection between surgical weight loss and the aging biomarker, the telomere, a DNA sequence found on the end of chromosomes. According to a study presented today at the Oral Abstract, Surgery session, "Does Gastric Bypass Influence Aging?" (A404/405, 1:30 p.m.) by John Morton, MD, Director of Bariatric Surgery at Stanford School of Medicine, weight loss following bariatric surgery was associated with increased telomere length indicating decreased aging. The most significant changes in telomere length occurred in patients with higher levels of CRP (a marker of inflammation) and LDL cholesterol at baseline. Telomere lengthening was also correlated with weight loss and increases in HDL cholesterol.
"This unique study demonstrates that surgically induced weight loss is able to reverse a marker of aging, telomere length," said Dr. Morton. "Past research has shown a tie between telomere length following weight loss through diet and exercise, but not through bariatric surgery."
New England Journal of Medicine Perspective Underscores Potential of Early Obesity Prevention
In a Perspective published in the November 13, 2013 issue of the New England Journal of Medicine, Drs. Matthew W. Gillman and David S. Ludwig argue that interventions during the prenatal and postnatal periods may be especially effective in preventing obesity.
Potential strategies identified by epidemiologic studies include smoking cessation before pregnancy, reduction of excessive gestational weight gain, treatment of gestational diabetes, avoiding unnecessary cesarean delivery, establishing infants' healthful sleep habits, and introduction of solid foods no earlier than 4-6 months. The authors hypothesize that obesity prevention efforts focusing on multiple risk factors will be the most effective. However, they cautioned that definitive conclusions await intervention trials, many of which are now underway.
"Mothers appear especially willing to modify their behavior to benefit their children during pregnancy and infancy," said Dr. Gillman. "This willingness, coupled with knowledge that these periods are critical for setting children on lifelong trajectories of healthful biology and behavior, highlight the importance of anti-obesity efforts during early human development."
Dr. Gillman is from Harvard Pilgrim Health Care Institute and Dr. Ludwig is from Boston Children's Hospital. Both are professors at Harvard Medical School, Boston.
Experts Examine if Low- and No-Calorie Sweeteners Help — or Hinder — Weight Management
During a breakfast symposium Wednesday morning titled, "Setting the Record Straight: Making Sense of the Data on Low- and No-Calorie Sweeteners in Weight Management," three leading experts — James O. Hill, PhD, Suzanne Phelan, PhD, and Christine Rosenbloom PhD, RD, CSSD — examined the research on low-and-no-calorie sweeteners found in a wide range of foods and beverages, from low- and no-calorie beverages to yogurt.
On the goal of session, Dr. Hill noted, "This is an emotionally charged issue. What we're trying to do today is show where the data is."
The experts provided a thorough review of the science and regulations, and voiced support for low- and no-calorie sweeteners as an effective tool for weight loss and weight management, based on extensive review of the data. They also debunked some of the common myths associated with these ingredients.
Dr. Phelan concluded by saying, "low- and no-calorie sweeteners can be part of healthy weight loss and a healthy diet." Dr. Hill agreed, saying, "We have to take a strong stand in what we know right now, and I urge people to look at the data because we see so many people who are being helped by these." Dr. Rosenbloom added, "I always go back to the whole idea of calories count and [on safety] I point to the data around the world."
School Policy Not Rooted in Reality
School policies that target obesity are easy to make — but policies that actually work and apply equally to everyone are harder to create.
Sheila Fleishhacker, PhD, at the National Institutes of Health introduced the "School and Local Policy" session Wednesday afternoon. Policies that ban the construction of fast-food restaurants near schools or libraries, for example, may actually increase fast-food consumption by young people. Additionally, wellness policies often fail to attend to cultural specifics for minority groups such as Native Americans and people with disabilities, said Dr. Fleishhacker.
One study found that students without access to vending machines at school actually consumed more soda, said Daniel Taber, PhD, from the University of Texas. But this only held true in states with no soda bans or taxes. The bottom line, he said, is that isolated changes to school policy will likely have a small impact on student wellness.
Some schools have also introduced programs that serve breakfast in the classroom (BIC) instead of in a cafeteria. Compared with other schools, students in those with BIC were more likely to eat breakfast every morning — but at least 9% of the students still ate nothing before classes, reported Gary Foster, PhD, of Temple University. Those who skipped breakfast were more likely to be overweight, said Dr. Foster.
During a panel discussion at the end, Dr. Taber criticized research methods predicated on the "let's-pretend-that-we-live-in-a-vacuum" approach. He advocated incorporating "real-world" factors that influence how children really eat.
Lee Adcock contributed to this article.
Full house for stress, sleep deprivation, and eating
Hundreds of participants packed the room for the Wednesday afternoon Symposium on stress, sleep deprivation and eating behavior.
Yale psychiatrist Rajita Sinha, PhD, said that accidents, illnesses, a loved one's death, and other traumatic events can be stressors that trigger overeating. Stress can decrease neuronal connections to prefrontal brain regions. Additionally, facing a larger number of stressful events correlates with weight gain.
In one of Dr. Sinha's experiments, obese participants presented with highly palatable foods, such as pizza, cakes or chicken wings, ate significantly more than lean participants.
Minor daily annoyances such as an argument with a family member or co-workers can also lead to stress-related overeating, said psychologist Janice Kiecolt-Glaser, PhD, of Ohio State University's College of Medicine.
Kiecolt-Glaser also found that depression and obesity have a reciprocal connection: people who are depressed are more likely to become obese, and vice versa.
Sleep expert Yang Wang, MD, PhD, closed the session by presenting his research on the association between sleep apnea and metabolic dysfunction. Sleep apnea and obesity are intertwined; each can lead to the other, creating a hard-to-break cycle.
The speakers agreed that stress, sleep loss, and eating behaviors are intimately connected. Breaking those links remains a challenge.
Alyssa Purser contributed to this article.
Wrap up your ObesityWeek with AfterDark Event
The famous AfterDark Event has come to ObesityWeek! Close out an exciting, educational week by joining us for a night of cocktails, casinos and dancing. AfterDark will begin at 9:00 p.m. in the Marriot Marquis Atrium Ballroom. Wear your favorite "After Five" cocktail attire and celebrate one final night with your colleagues, friends, and partners in the fight against obesity.
All registered attendees are invited to join this event — one ticket to AfterDark is included with your Scientific Sessions registration. Please note that, due to the nature of the ASMBS AfterDark party, this event is for adults only. Children under the age of 18 will not be admitted.
TOS Sessions not to Miss Today
TOS Poster Award Recipients
Stop by to see TOS Section Poster Award Recipients presenting today. Find a list here.
ASMBS Sessions not to Miss Today
- Live Bariatric Surgery Telecast — three surgeries will be performed simultaneously and broadcast into the Thomas Murphy Ballroom, at 8:00 a.m. Interactive session with moderators, panelists, and live questions.
- Edward E. Mason Founder's Lecture: "Bariatric Surgery and the NIH" by Bruce M. Wolfe, MD. — 10:30 a.m., Thomas Murphy Ballroom
- ASMBS Presidential Address by outgoing President Jaime Ponce, MD — "30 Years of Accomplishments…Where Do We Go From Here?," 11:15 a.m., Thomas Murphy Ballroom
Study: As cost of sugary drinks go up, sales go down
Raising the cost of high-calorie beverages by a few cents — and highlighting calorie content in places where they are sold — decreases sales, a new study shows.
This research comes after much discussion in recent years about trying to combat the nation's obesity crisis by adding extra taxes to the cost of sugar-sweetened beverages, sometimes called a "soda tax."
Studies: Weight-loss surgery yields lasting improvement in health
Los Angeles Times
Fifteen years after they have weight-loss surgery, almost a third of patients who had Type 2 diabetes at the time they were operated on remain free of the metabolic disorder, a new study says. And six years following such surgery, patients had shaved their probability of suffering a heart attack over the next 10 years by 40 percent, their stroke risk by 42 percent, and their likelihood of dying over the next five years by 18 percent, additional research has concluded.
'Food addiction' may be at root of some obesity
Although it's not technically an addictive disorder by psychiatric standards, behaviors associated with "food addiction" are closely tied to obesity, researchers reported here.
In an analysis of data from the Canadian province of Newfoundland, about 5% of people there exhibited symptoms of "food addiction," as classified by the Yale Food Addiction Scale, Pardis Pedram, MD, MSc, of Memorial University in Newfoundland, and colleagues reported at Obesity Week here.
Bingeing boosts diabetes risk
Women who binge eat may be at greater risk of developing type 2 diabetes, regardless of how heavy they are, researchers reported here.
In a cohort study of about 4,300 girls, those who binged frequently — without "purging," or using laxatives or vomiting after a big meal — had nearly a four-fold increased risk of developing type 2 diabetes, even after controlling for body mass index, Alison Field, ScD, of Boston Children's Hospital, and colleagues, reported at Obesity Week.
Diabetes cure lasts long term after bariatric surgery
Bariatric surgery significantly increased the rate of type 2 diabetes remission over both the short and long term in obese individuals, and also helped prevent complications of diabetes, researchers found.
At 2 years, 71.8 percent of patients who underwent the weight-loss surgery were in diabetes remission compared with only 16.4 percent of controls, for an adjusted odds ratio of 13, reported Lena M. Carlsson, MD, PhD, of the Institution of Internal Medicine in Helsinki, Finland.
Protein-rich breakfast curbs appetite, overeating
Food Product Design
Eating high-protein breakfasts curbed hunger throughout the morning, compared with a low-protein breakfast or skipping breakfast, in women ages 18 to 55 years, according to new research presented at Obesity Society’s Obesity Week, Nov. 11-16.
Employer wellness programs limit access to evidence-based obesity treatment
Health-related goals are often implemented by employers that require participation in wellness programs to receive full health benefits, but plans seldom cover evidence-based obesity treatments, according to data presented at ObesityWeek 2013.
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