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5th Canadian Obesity Summit – Four More Days To Submit Your Abstracts!

banff-springs-hotelEvery two years the Canadian Obesity Network holds its National Obesity Summit – the only national obesity meeting in Canada covering all aspects of obesity – from basic and population science to prevention and health promotion to clinical management and health policy.

Anyone who has been to one of the past four Summits has experienced the cross-disciplinary networking and breaking down of silos (the Network takes networking very seriously).

Of all the scientific meetings I go to around the world, none has quite the informal and personal feel of the Canadian Obesity Summit – despite all differences in interests and backgrounds, everyone who attends is part of the same community – working on different pieces of the puzzle that only makes sense when it all fits together in the end.

The 5th Canadian Obesity Summit will be held at the Banff Springs Hotel in Banff National Park, a UNESCO World Heritage Site, located in the heart of the Canadian Rockies (which in itself should make it worth attending the summit), April 25-29, 2017.

Yesterday, the call went out for abstracts and workshops – the latter an opportunity for a wide range of special interest groups to meet and discuss their findings (the last Summit featured over 20 separate workshops – perhaps a tad too many, which is why the program committee will be far more selective this time around).

So here is what the program committee is looking for:

  • Basic science – cellular, molecular, physiological or neuronal related aspects of obesity
  • Epidemiology – epidemiological techniques/methods to address obesity related questions in populations studies
  • Prevention of obesity and health promotion interventions – research targeting different populations, settings, and intervention levels (e.g. community-based, school, workplace, health systems, and policy)
  • Weight bias and weight-based discrimination – including prevalence studies as well as interventions to reduce weight bias and weight-based discrimination; both qualitative and quantitative studies
  • Pregnancy and maternal health – studies across clinical, health services and population health themes
  • Childhood and adolescent obesity – research conducted with children and or adolescents and reports on the correlates, causes and consequences of pediatric obesity as well as interventions for treatment and prevention.
  • Obesity in adults and older adults – prevalence studies and interventions to address obesity in these populations
  • Health services and policy research – reaserch addressing issues related to obesity management services which idenitfy the most effective ways to organize, manage, finance, and deliver high quality are, reduce medical errors or improve patient safety
  • Bariatric surgery – issues that are relevant to metabolic or weight loss surgery
  • Clinical management – clinical management of overweight and obesity across the life span (infants through to older adults) including interventions for prevention and treatment of obesity and weight-related comorbidities
  • Rehabilitation –  investigations that explore opportunities for engagement in meaningful and health-building occupations for people with obesity
  • Diversity – studies that are relevant to diverse or underrepresented populations
  • eHealth/mHealth – research that incorporates social media, internet and/or mobile devices in prevention and treatment
  • Cancer – research relevant to obesity and cancer

…..and of course anything else related to obesity.

Deadline for submission is October 24, 2016

To submit an abstract or workshop – click here

For more information on the 5th Canadian Obesity Summit – click here

For sponsorship opportunities – click here

Looking forward to seeing you in Banff next year!

@DrSharma
Edmonton, AB

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My Critical Review Of Critical Fat Studies: Obesity In Canada

obesity-in-canada-coverA few weeks ago, I was invited by the Editor of The Lancet Diabetes & Endocrinology to review Obesity in Canada, a collection of articles by Canadian and Australian authors, who identify themselves as “fat scholars” engaging in “critical fat studies”. (Edited by Jenny Ellison, Deborah McPhail, and Wendy Mitchinson).

Obviously, I have had multiple interactions with “fat scholars” over the years and have certainly always learnt a lot.

Indeed, I would be the first to admit that many of my own ideas about obesity, including the issue of whether or not obesity is a disease and, if so, how to define the clinical problem of obesity in a manner that does not automatically label a quarter of the population as “diseased”, has been shaped by this discourse.

Similarly, my own notions about obesity management, with a primary goal to improve health and well-being rather than simply moving numbers on the scale, are clearly influenced by ideas that first emerged from the “fat acceptance camp” (not exactly the same, but close enough).

Thus, there was certainly much in this compendium that I was already quite familiar with – which certainly made the reading of this 500 page volume most enjoyable.

Nevertheless, it is important to realise that “fat scholars” do not just see themselves as “scientists” – rather, they see the practice of “fat studies” as a political work, tightly (some might say dogmatically) bound to a frame of reference that is reminiscent of political “activism” rather than “science”.

Fat scholars (at least the ones represented in this volume) are not just critical of, but also appear most happy to discard the entire biomedical and population health discourse around obesity, as nothing more than (I paraphrase), “a thinly-veiled conspiracy by the biomedical establishment to create a moral panic that justifies the reassertion of normative identities pertaining to gender, race, class, and sexuality.

Accordingly, some fat scholars appear to be of the rather strong opinion that there is in fact no “global obesity epidemic” and even if there are perhaps a few more fat people around today than ever before, the health consequences of obesity are vastly overblown, and any recommendations or attempts to lose weight are not only ineffective but actually harmful.

Now, before you simply roll your eyes and decide to file away the whole exercise in the drawer that you reserve for global-warming deniers and anti-vaxxers, let me assure you that there is indeed a lot to be learnt from the discourse (at least I did).

For one, there are absolutely fascinating chapters on the history of fat activism in Canada (which apparently dates back to the early 70s), enlightening perspectives on Indigenous People’s encounters with obesity, the issue of “mother blaming”, and even a chapter on fat authenticity and the pursuit of hetero-romantic love in Vancouver.

There are stories about how kids and families experience childhood obesity intervention programs and how primary school teachers themselves struggle with being thrust into a role of being role models while struggling with their own personal response to the pervasive obesity messages.

Obviously, there are some ideas that may be harder to swallow than others.

Take for e.g, the notion that the “root cause” of fat phobia (at least according to fat scholars who rely on postmodern feminism, psychoanalysis, and queer theories), is simply a reflection of the femininity ascribed to body fat: because women need fat to menstruate, body fat can be seen as female reproductive material that, in patriarchy, must be contained, restrained, and ultimately eliminated.

Personally, I can no doubt think of a wide range of other “root causes” that would result in “fat phobia” and “weight stigma” without having to quite delve into feminism or queer theories – but that’s another story.

Or the notion that there is in fact no link between body fat and diabetes – something that is easily refuted by a host of experimental animal studies and clinical observations  (which, in the world of “fat scholars” do not appear to exist or are for some opaque reason deemed entirely irrelevant for the discourse).

Nevertheless, these “peculiarities” aside, I do admit that I found the book a very timely, relevant and enlightening read for anyone who is seriously interested in the issue of obesity and bold enough to step out beyond the typical biomedical discourse.

I would most certainly recommend this volume to people working in health policy and public health but also to clinicians, who seek to better understand some of the social aspects of the obesity discourse as it relates to their patients.

There is much in the volume that I perhaps disagree with or rather, see from a different perspective (I am after all a clinician) – however, openness to entertaining alternative views and ideas, and willingness to shift your own opinion and beliefs when new evidence emerges, is the defining characteristic of good scholarship – and I certainly remain a lifelong student.

@DrSharma
Edmonton, AB

Disclaimer: I was given a complimentary copy of Obesity in Canada to review by the Lancet Diabetes & Endocrinology

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The Social Function Of Fat Talk

sharma-obesity-distored-body-image1Comments about body shape, size or weight are so common that we often don’t pay attention to them. However, even a simple comment about someone’s weight or appearance, as in, “You look great – have you lost weight?”, has been shown to have significant negative consequences for the folks involved, as it endorses a thin-ideal.

Often fat talk is presented as a self-degrading comment, as in, “I feel fat” or “My thighs look too big” – not seldom from people with perfectly “normal” weight, which again endorses the negative connotations associated with fatness.

Now a study by Tegan Cruwys and colleagues published in Eating Disorders purports to demonstrate a causal link between fat talk and the correlates of disordered eating (thin-ideal internalization, body dissatisfaction, negative affect, and dieting intentions) by experimentally manipulating fat talk in existing friendship groups and measuring naturalistic expression of fat talk and its effects.

The study involved 85 women aged 17–25 who participated in friendship pairs that were randomly assigned to a condition in which their friend expressed fat talk, positive body talk, or neutral talk.

Here is how the researchers describe the experiment:

“Participants in all conditions viewed the same 20 images of female celebrities, which were diverse in terms of age, race, body shape and size. Each comment that participants read from “Friend A” was generated from a predetermined script. In the neutral talk condition, none of the 20 comments were about appearance, for example, “Such a great actress”. Eight of the neutral comments were retained in the other conditions, with the remaining 12 comments referencing appearance. In the fat talk condition, these comments explicitly valued thinness, and/or expressed body dissatisfaction. For example, “She looks great after losing all that weight” and “I should really watch what I eat more”. In the positive body talk condition, the comments emphasized body acceptance and satisfaction. For example, “It’s so great to see that she doesn’t care about her photo being taken right after having a baby”, and “Love that skirt, would look amazing on me!”. The simulated “conversation” ran for ∼10 min, following which participants immediately completed a computer-based questionnaire.”

The broad range of outcome measures included the

Body Image States Scale, the Positive and Negative Affect Scale (PANAS), the Internalization-General subscale (nine items) of the Sociocultural Attitudes Towards Appearance Scale-3 (SATAQ-3), the Dieting Intentions Scale (DIS) and a five-item questionnaire that assessed how participants felt about their friendship subsequent to the messenger task.

Existing friendship group norms for fat talk were measured using the Descriptive Norms for Pursuit of Thinness Scale.

Not only did the study show that listening to friends fat talk increased correlates of disordered eating but also that these negative effects of listening to fat talk were fully mediated by fat talk expression.

Furthermore, the study also revealed a social function of fat talk, whereby participants rated their friends more positively when they were perceived to behave consistently with group norms, either pro- or anti-fat talk.

In contrast positive body talk showed none of the negative effects of fat talk, and was considered socially acceptable regardless of existing friendship group norms.

As the authors note,

“These findings indicate that fat talk is a mechanism through which the thin ideal is transmitted between individuals. Interventions at the level of the friendship group to challenge norms and communication styles may break the link between societal risk factors and individual risk of eating disorders.”

To learn more about fat talk and its negative consequences click here

@DrSharma
Berlin, Germany

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2015 Weight Bias Summit: Full Report

Screen Shot 2015-03-11 at 10.45.43 PMEarlier this year I participated in a two-day workshop on weight bias hosted by researchers at the University of Calgary. The over 40 participants included researchers, clinicians, health administrators and a number of other stakeholders, who discussed all aspects of weight bias and discrimination.

A particular focus of the workshop, supported by the Canadian Institutes of Health Research (INMD) and co-hosted by the Canadian Obesity Network was to explore a research agenda towards finding effective ways to reduce weight bias and its negative consequences for the health and well-being of those living with obesity.

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Obesity In UK Show Dogs

13_walkingTheDogAs readers may be well aware, the obesity epidemic is by no means limited to humans – our pets are also affected (as, incidentally, are zoo animals).

A paper by Such and German, published in Veterinary Record, shows that a significant proportion of show dogs in the UK would be considered to have overweight or obesity.

The researchers did internet searches to identify 40 pictures per breed of 14 obese-prone dog breeds and 14 matched non-obese-probe breeds that had appeared at a major national UK show (Crufts). Of 1120 photographs initially identified, 960 were suitable for assessing body condition using a previously validated method, with all unsuitable images being from longhaired breeds.

None of the dogs (0%) were underweight, 708 (74%) were in ideal condition and 252 (26%) were overweight with pugs, basset hounds and Labrador retrievers were most likely to be in the latter category.

In contrast, standard poodles, Rhodesian ridgebacks, Hungarian vizslas and Dobermanns were least likely to be overweight.

In the discussion, the authors wonder whether or not breed standards should be redefined to be consistent with a dog in optimal body condition (read – body weight).

As someone, who could not really care less about breed standards and pedigrees (having shown dogs at dog shows myself as a kid), I find this paper of interest, as it reflects our thinking about appearances, that is by no means limited to animals.

The mental health and physical benefits of owning a dog are well-documented – whether they meet show standards or not, is probably not what determines their usefulness as (wo)man’s best friend.

@DrSharma
Edmonton, AB

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