Clinicians not seeing obesity through the eyes of the patient
There is a deep disconnect between the way patients perceive obesity, and their healthcare providers. This is based on a recent qualitative study, due to be released in 2016; it suggests that clinicians are far too scientific in their understanding, and look at obesity with thoughts of health and disease, whilst the people they are treating see it more through the lens of lifestyle and social relationships. The findings from the small study, which was supported by the Obesity Society, show that many people face harsh challenges over their weight because of the view that obesity is a lifestyle issue that can be overcome simply, by eating less and being more active. What many healthcare providers fail to realise is that obesity is a complex disease, and requires a holistic and complete care approach in order to tackle it effectively.
The study also found that 75% of people with obesity regarded themselves as ‘healthy’, showing a clear disconnect between them and their clinicians. Overall these results highlight the fact that a lack of understanding and empathy between the two parties leads to a lack of effective communication. This prolongs treatment and reduces its efficacy. Further studies into this issue are due to be conducted, and on a larger scale.
Read MoreBariatric surgery has lasting health benefits for teens
A study published in the New England Journal of Medicine found that bariatric surgery can drastically reduce weight-related health problems in teens. The study is the first report from the Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) study that collects longitudinal, prospective, clinical and laboratory data on teenagers undergoing bariatric surgery at five centres in the United States. It followed participants for 3 years post-surgery and concluded that surgery has a lasting effect, and significant impact on health, for those aged 12-19. The researchers studied data from 228 participants with severe obesity and found that, after surgery, 66% of patients no longer had unhealthy levels of fat in their blood; 75% of them reduced their blood pressure to normal; and, perhaps most impressively, type 2 diabetes disappeared in 90% of the patients who had it.
Whilst many of the patients found it difficult to keep the weight off, it was particularly encouraging to see that the complications that can arise from being obese were reduced. However, the authors did point out that the benefits must be viewed in the context of the risks of micronutrient deficiencies, and the need for further abdominal procedures in some patients. As there are not many effective treatments for obesity in teenagers, bariatric surgery, although controversial, may be a safe and effective solution. The researchers are hoping to continue the study in order to fully assess the lasting effects of bariatric surgery on teens.
Read MoreWe just can’t STAND this obesity problem anymore!
A study led by the American Cancer society has found that standing for one quarter of your day, while performing your normal daily activities, is linked to a reduced likelihood of obesity. It is widely known that sedentary behaviours are not conducive to a healthy weight and lifestyle, however little research has been performed in the way of standing habits. This study analysed data from more than 7,000 adults over 5 years. It found that, amongst men, a 32% reduction in obesity risk was seen, whilst standing for half the day resulted in a 59% reduction. Standing for more than 75% of the day was not associated with a lower risk. In women these figures were 35% and 47% respectively.
The researchers also combined the study with one about physical activity, confirming the generally accepted view that increased physical activity results in a decreased risk of obesity. Whilst it is interesting to see the benefits of standing, standing itself may be no more beneficial than sitting. The effects are likely to be due to standing and movement activities rather than standing alone. The study authors emphasise that the study limitations should be taken into account. This was a cross-sectional study, meaning it only captures a snapshot in time, and it is therefore unclear whether standing less increases your risk of obesity, or obese people are less likely to stand. Furthermore, standing and physical activity was self-reported, so additional research should be undertaken to fully assess the effects of standing on weight, as opposed to physical activity.
Read MoreAre junk food and fizzy drinks really to blame for obesity?
Whilst junk food and fizzy drinks have often been portrayed as the villains in the fight against obesity, they may not be the leading causes of obesity according to a new study published in Obesity Science & Practice. Researchers reviewed a nationally (according to the USA) representative group of adults and found that consumption of fast food, fizzy drinks and sweets was not linked to BMI for 95% of the population. The study used data from the Centers for Disease Control’s National Health and Nutrition Examination Survey for 2007-08, which contained over 5,000 participants. They looked at anthropometric body measurements, including height and weight, and then combined these findings with questionnaires about diet. There was no significant difference in consumption of these foods between overweight and normal weight individuals. However they did not take into account differences between those with increased waist circumferences and normal weights
These findings led the team to believe that, whilst it is not recommended to over-indulge in these foods, they are not the overwhelming contributors to obesity. Dr David Just, a co-author for the study, suggested that campaigns that demonise certain foods may not be doing as much good as we’d thought, and it is behaviours and overall diet that need to be targeted in order to effectively curb obesity.
Read MoreIs abdominal fat more dangerous than overall BMI?
Central obesity in normal weight individuals means they are at a greater risk of complications than those that are overweight without excess abdominal fat. This is a conclusion from a study conducted in Minnesota, USA. The study looked at 14 years of data from over 15,000 participants in the Third National Health Nutrition Examination Survey which ran from 1988-1994. Central obesity was defined as a waist-hip ratio of ≥0.85 in women and ≥0.9 in men (this is according to the WHO criteria). They found that normal-weight participants with central obesity had worse long-term survival rates than their counterparts with normal fat distribution, regardless of the latters’ BMI. This was mostly due to increased risks for cardiovascular disease and diabetes, and an overall increased risk of total mortality.
Dr Lopez-Jimenez, lead author of the study explained that, with these results, measurements of waist-hip ratio should be included as part of general medical examinations, to ensure that the possible increased risk was not overlooked. This advice goes against current obesity management guidelines from the American Heart Association and the Obesity Society, who both say that waist measurements should only be taken in those who are obese. It will be interesting to see if changes are made to these guidelines as a result of this study.
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