Why I Blog
In 2007 I moved to Edmonton to become the medical director of the Edmonton ‘Weight Wise’ Program (since February 2012 I am now the medical co-chair of Alberta Health Services’ Provincial Obesity Program). Within a few days of taking the new job, I realised just how many people were directly or indirectly involved in this program. Not only was there the clinic staff but there were also the staff working in the community, offering classes on healthy eating and physical activity. Then, there were the many administrators and managers throughout the system, who had a say in what was being delivered in the clinic and in the community. And of course, I had my own ideas about what an obesity program needed to look like. This is what my first blogs were about. Blogging was simply the easiest means for me to communicate with my colleagues and staff as to where I thought we should be going – the vision for the program. Many of my first posts were about who I met and what I did. They included brief commentaries and pointers to obesity publications that I thought were important to consider as we changed and built the program. They also included random thoughts that emerged from my dealings with patients, staff, colleagues, and administrators. Almost five years and well over 1,000 posts later, I continue to post daily – now for a much wider, world-wide readership. Every day, when I click the ‘publish’ button, 1,000’s of emails go out to readers across the globe – colleagues and health care professionals (for whom I primarily write) but also people struggling with obesity, their families, and anyone else interested in this subject. My audience even includes journalists looking for new stories and new angles on old ones. For me, blogging continues to be invaluable. This is where most of my ideas on obesity first found the light of day – the issue of weight bias, the inadequacy of BMI, the etiological framework for obesity, the importance of mental health, the need for accommodation, the Edmonton Obesity Staging System, the 4Ms of obesity, the 5As of obesity management – all of these ideas originated from postings (or thinking about postings) – and were remarkably shaped by my readers, who are never stingy or shy with their comments. As my readership continues to grow, so does my sense of responsibility to them.… Read More »
Hot Topics Conference on Obesity and Mental Health, Toronto, June 26-28, 2012
Following a most successful 3rd Canadian Obesity Student Meeting in Edmonton last week, tomorrow sees the start of the Canadian Obesity Network’s Hot Topics Conference on Obesity and Mental Health, organised in partnership with the International Association for the Study of Obesity (IASO) and the Centre for Mental Health and Addiction (CAMH). Attendees will learn about: • Clinical assessment and management of patients with obesity and mental illness • Current evidence and best practices in psychological and behavioural interventions • Current evidence on emerging pharmacological treatments for obesity and mental illness • Current understanding the neuropsychobiology of ingestive behaviour and mental health disorders • Bias and stigma associated with obesity and mental illness • Research priorities in the emerging field of obesity and mental illness. The list of distinguished speakers include: Day 1 (Tuesday, June 26, 13.00-18.00): Opening and Welcome David S. Goldbloom, Chair, Mental Health Commission of Canada Etiological Assessment of obesity and the Role of Mental Health Arya m Sharma, Edmonton, Canada The Neurobiology of Appetite: Hunger as Addiction Alain Dagher, Montreal, Canada Neural Integration of Metabolic, Cognitive, and Emotional Signals in the Control of Ingestive Behavior Hans-Rudolf Berthoud, Baton Rouge, USA A Psychogenetic Analysis of Appetite and Overeating Caroline Davis, Toronto, Canada The Effect of Obesity in Mood Disorders Roger McIntyre, Toronto, Canada ADHD and Obesity Caroline Davis, Toronto, Canada Borderline Personality Disorder and Obesity Randy Sansone, Dayton, USA Binge Eating and Bulimia Allan Kaplan, Toronto, Canada Day 2 (Wednesday, June 27, 8.00-17.30) Stress and Obesity Zul Merali, Ottawa, Canada Gut Hormones for Treating Obesity Nick Finer, London, UK An overview of Current Surgical Treatments for Obesity Teodor Grantcharov, Toronto, Canada Pregnancy and the Post-Partum Period: A Vulnerable Window for Obesity and Mental Illness Valerie Taylor, Toronto, Canada Motivational Interviewing in Bariatric Patients Michael Vallis, Halifax, Canada Psychological and Psychiatric Predictors of Response and Failure to Bariatric Surgery Anthony N Fabricatore, Pennsylvania, USA Behaviour Change for Weight Loss: State of the Science Rohan Ganguli, Toronto, Canada Body Image Across Weight Status Shelly Russell-Mayhew, Calgary, Canada Changing Social Standards Associated with Weight and Body Image Fannie Dagnais, Montreal, Canada Assessing Quality of Life in Obesity Ronette Kolotkin, Durham, USA Perspectives of Persons Living with Obesity: Quality of Life and Engagement in Everyday Life Mary Forhan, Hamilton, Canada Day 3 (Thursday, June 28, 8.00-12.30) Disorders of Consumption: Learnings from Smoking Cessation Peter Selby, Toronto, Canada Preventing Obesity Through Mental… Read More »
Weekend Roundup, June 22, 2012
As not everyone may have a chance during the week to read every post, here’s a roundup of last week’s posts: Beverage Consumption and Obesity in Canadian Kids Preventing Type 2 Diabetes in Youth 3rd National Obesity Student Meeting, Edmonton, June 20-23, 2012 Unhealthy Waits? 2010/11 Canadian Initiatives to Promote Healthy Active Living Have a great Sunday! (or what is left of it) AMS Edmonton, Alberta
Hindsight: Bound Leptin and Sympathetic Activity
As readers are probably well aware, leptin is one of the key hormones (secreted by fat cells), that regulate energy balance – not just by affecting food intake but also energy output. The latter happens in part through stimulation of the sympathetic nervous system. In a paper we published in the Journal of Clinical Endocrinology and Metabolism in 2003, we examined the relationship between both free and protein-bound plasma leptin levels and sympathetic activity as assessed by microneurography. Study participants included 25 healthy normal weight men, 8 individuals with central (multiple system atrophy) and 4 individuals with peripheral (pure) autonomic failure. Baroreflex sensitivity was measured using phenylephrine and nitroprusside infusions. MSNA was consistently correlated with protein-bound leptin concentrations but not with free leptin levels. MSNA at baseline was about 15 bursts per minute in subjects with lower and about 24 bursts per minute in subjects with higher bound leptin concentrations. We concluded that protein-bound rather than free leptin levels are correlated with basal sympathetic outflow, a relationship that was difficult to explain through a direct central nervous effect of protein-bound leptin. Rather, we suggested that protein-bound leptin may increase sympathetic vasomotor tone indirectly via a baroreflex mechanism. According to Google Scholar, this paper has been cited 26 times. AMS Edmonton, Alberta
Preventing Type 2 Diabetes in Youth
This week the CON-SNPs are hosting the 3rd Canadian Obesity Student Meeting (COSM) here at the University of Alberta. Following a rather tight morning of oral presentations and posters, the noon Key Note talk was given by Jon McGavock, Robert Wallace Cameron Chair in Child Health Research and CIHR New Investigator at the University of Manitoba’s Institute of Child Health. His talk on “Understanding and Preventing Type 2 Diabetes in Youth” portrayed his ‘journey’ as a young researcher. He took care to begin his talk by warning the audience that his presentation was likely to be biased heavily towards the benefits of exercise (as an avid exerciser and runner himself) and to the Jets. McGavock remembers that not all too long ago, he was simply a ‘lonely exercise physiology student’ at the University of Alberta, when he fortunately managed to get support from the TORCH program, which helped kickstart his research career, taking him now to the University of Manitoba, where he is now focusses on type 2 diabetes in kids. Manitoba, it turns out has the highest incidence of type 2 diabetes in kids in all of Canada with about 75 new cases diagnosed in 2010 (i.e. more than one new case per week). In 2007 he studied 841 youth form eight Alberta middle and high schools who were assessed with accelerometers and various lifestyle and risk factors. Individuals in the lowest tertile of waist circumference, had no significant difference in light to moderate physical activity but about eight minutes a day more of vigorous physical activity. During a post-doctoral fellowship at the University of Texas, Southwestern Medical Centre in Dallas, he performed MRI spectroscopy studies in lipodystrophic individuals focussing on the deposition and health effects of ectopic fat. In a CIRCULATION paper he published in 2007, he showed a clear relationship between the risk for diabetes and the amount of liver and myocardial fat in adults. In a subsequent paper just published in OBESITY, he showed that prediabetic and type 2 diabetic kids also had more fat in their livers as well as lower fitness levels. In fact, in a paper just out in DIABETES CARE, he showed that hepatic steatosis is indeed associated with type 2 diabetes risk factors independent of cardiorespiratory fitness, whole-body adiposity, and visceral fat mass. Currently he is doing the POWER trial, a randomized controlled trial of high-intensity exercise (to stimulate mitochondrial oxidation capacity),… Read More »
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