Anxiety about Eating Disorders?
A study, performed by Nadia Micali at UCL and others, on almost six thousand 14 and 16 year olds in the Avon Longitudinal Study of Parents and Children (ALSPAC) found that all eating disorders (EDs) are predictive of later anxiety disorders. EDs are associated with high morbidity and mortality, and a previous study in America had shown them to be associated with depressive symptoms, drug use, binge drinking, and overweight or obesity. This study was conducted with the aim of finding out whether a range of eating disorders, including purging disorder, were prospectively associated with depression, anxiety disorders, substance abuse, and self-harm. It reported that all were associated with depression, and all but anorexia nervosa predicted drug use and self-harm. Those with anorexia nervosa were more likely to be underweight, but those with binge eating disorder and bulimia nervosa were more likely to be overweight or obese. Furthermore, the study found that the prevalence of eating disorders almost doubled between the ages of 14 and 16.
The study recommended improving identification of adolescents with eating disorders and behaviours in the community and delivering early intervention programmes, thereby identifying any risk of development into a full blown eating disorder and also limiting the chances of mental health problems in the future. It has highlighted how much of an effect eating disorders have on the general health of the public, whilst also showing that more needs to be done to curb adolescent eating disorders in order to protect their future.
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Is bariatric surgery justified for the super-obese elderly?
Ample evidence supports the safety and effectiveness of bariatric surgery in the general adult population, but more information is needed in patients age 60 years and older (elderly). In England, in 2012/13, the annual Health and Social Care Information Centre (HSCIC) statistics show over 8,000 bariatric surgery procedures were performed. Many more surgical procedures were carried out on women than men (in 2012/13, 6,080 for women and 1,944 for men).
There has been no data until now on the efficacy of bariatric surgery in the super-obese elderly. A new study from combined hospitals in London identified 50 consecutive patients undergoing bariatric surgery aged 60 years or over, and compared the outcomes of the super-obese (BMI≥50; n=26) with those of BMI<50. Mean follow-up was 33 months. It was found there were no significant differences between the groups in terms of comorbidities, operation-type or peri-operative complications.
Since life expectancy is naturally limited in elderly patients, quality of life is an important outcome measure. The study found quality of life outcomes were as good, if not better, for super-obese elderly patients as compared to morbidly obese. This trend is potentially counter intuitive since the super-obese patients were heavier at the end of the study period, with a greater proportion remaining obese.
Therefore, although super obese elderly patients may not lose as much weight during bariatric surgery compared to their lighter counterparts, their quality of life is enhanced, thus bariatric surgery may be justified more psychologically then physically in this group. This leads to the super obese elderly having a more positive attitude that may help them control their weight and exercise more frequently.
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Weight perceptions of English adolescents: cause for celebration or concern?
A new study has shown the greater part of normal-weight adolescents (84% of girls, 83% of boys) correctly acknowledge themselves as ‘about the right weight’. Overestimation of weight and overall size has become very uncommon, with only 7% of normal-weight teens (11% of girls, 4% of boys) identifying themselves as ‘too heavy’. This can be considered a celebration at a time when body image is often a cause for concern.
On the contrary, only 60% of obese adolescents (68% of girls, 53% of boys) correctly recognise themselves as ‘too heavy’, whilst 39% (32% of girls, 47% of boys) underestimate, identifying themselves as ‘too light’ or ‘about the right weight’. This lack of awareness however is a cause for concern, particularly for future health issues, but may be part of a wider acceptance, or normalisation, of obesity in society both of which need to be addressed to stem the obesity epidemic.
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Following in the father’s footsteps
Does the effect of the growing obesity epidemic only come from the mother? No! New research has shown conditions that can affect a father’s health can ultimately alter the genes he passes down to his children. This is a new and upcoming area of study that is receiving a lot more attention, alongside the influence of the father’s health after birth.
An observational study conducted by Emily Freeman and colleagues found that a father’s weight status was a better predictor of obesity risk than a mother’s. It was concluded: “father’s are a key influence in shaping the family environment that leads to the development of child obesity”. Interventions that are used to test the effectiveness of treating overweight fathers are a significant and novel strategy. The interventions can have a major impact on weight status in the childhood obesity epidemic and consequently should be a priority.
Fathers may ultimately be a strategic target for prevention and treatment of childhood obesity.
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From mice to humans, a new genetic form of obesity discovered!
Scientists have just discovered a new form of type 2 diabetes and obesity in humans. Researchers came across this discovery by sequencing the DNA of an exceptionally obese young woman and multiple members of her family. Besides an increase in appetite, which led to severe weight problems from a young age, she also had type 2 diabetes, reproductive problems and learning difficulties.
Researchers at Imperial College London found the lady had inherited two copies of a harmful genetic change that meant she could not make a protein called carboxypeptidase-E (CPE). Studies have previously shown that CPE deficiency causes diabetes, obesity, and impaired memory, but only in mice. No humans with this defect had been found until now as it is a very rare condition.
Professor Alex Blakemore from the Department of Medicine at Imperial College London, who led the study, said:
“These are serious disorders that affect the body’s ability to regulate hunger and fullness signals. They are inherited in the just same way as other genetic diseases and the sufferers should not be stigmatised for their condition. They should be offered genetic counseling and specialised lifelong support to allow them as healthy a life as possible.”
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Can mushrooms fight obesity in the gut?
mushroom that has been used for centuries in Chinese herbal medicine has been found to stave off obesity by altering the composition of bacteria in the gut, according to a study found in Nature Communications. The researchers from Chang Gung University measured the impact of giving extracts from the mushroom – called ‘Lingzhi’ – to mice on a high fat diet. True enough, they found that mice that were given the extract over two months gained less weight than their ‘placebo’ counterparts. The authors of the study are hopeful that Lingzhi can be used in the general population due to the good safety records and its similar composition to other mushrooms that we consume regularly.
The researchers confirmed that it was in fact the change in bacteria in the guts of the mice that affected the weight gain by transplanting the faeces of the mushroom-fed mice into the placebo mice and seeing a reduction in weight. They suggested that the mushroom acts as a ‘pre-biotic’, essentially acting as a fertiliser to promote beneficial bacterial growth in the gut. However, experts are warning that mice guts and human guts are vastly different, and that there is not going to be a simple ‘magic pill’ for obesity as it is much more complex than this.
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Generation X, Generation Y, Generation Inactive
UK active, a not-for-profit organisation – whose vision is to get more people, more active, more often – has released a report entitled ‘Generation Inactive’. According to UK Active, school children should not only be tested on academic subjects but also their fitness levels. The aim of the report was to explore how English Primary schools track and monitor the activity and fitness levels of their pupils; it found that less than half the schools surveyed knew how much time their children spent being physically active in lessons. Baroness Tanni Grey-Thompson, the former Paralympian and current chair of UK Active, has described these school children as ‘the most inactive generation of young people we’ve ever had’ and went on to explain how half of 7 year olds are not even getting the recommended 60 minutes of physical activity a day.
According to the report, inactivity costs the UK economy £8.2 billion pounds a year, and directly contributes to 1 in 6 deaths in the UK, making it twice as significant an indicator of premature death than BMI. The report outlines recommendations on how to get children more physically active, and also stresses the need for a better understanding of children’s activity. This involves extending the National Child Measurement Programme to measure fitness, extensively training teachers to deliver effective physical education, to ensure that children view physical activity as a behavioural norm throughout the day, and to support children in need of guidance and motivation. This will hopefully lead to a more targeted approach in improving children’s fitness as well as overall health.
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Weight loss and exercise improves fertility in women with PCOS
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