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Plan Your Personalized Program For The Canadian Obesity Summit Now

Summit15appIf you are planning to attend the 4th Canadian Obesity Summit in Toronto next week (and anyone else, who is interested), you can now download the program app on your mobile, tablet, laptop, desktop, eReader, or anywhere else – the app works on all major platforms and operating systems, even works offline.

You can access and download the app here.

(To watch a brief video on how to install this app on your device click here)

You can then create an individual profile (including photo) and a personalised day-by-day schedule.

Obviously, you can also search by speakers, topics, categories, and other criteria.

Hoping to see you at the Summit next week – have a great weekend!

@DrSharma
Gurgaon, Haryana

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Type 1 Plus Type 2 diabetes Is Not Type 3 Diabetes?

sharma-obesity-brainLast week at the 8th Annual Obesity Symposium hosted by the European Surgery Institute in Norderstedt, one of the case presentations included an individual with type 1 diabetes (no insulin production), who had gained weight and subsequently also developed increasing insulin resistance, the hallmark of type 2 diabetes.

In my discussion, I referred to this as 1+2 diabetes, or in other words, type 3 diabetes.

Unfortunately, it turns out that the term type 3 diabetes has already been proposed for the type of neuronal insulin resistance found in patients with Alzheimer’s disease.

As discussed in a paper by Suzanne de la Monte and Jack Wands published in the Journal of Diabetes Science and Technology,

“Referring to Alzheimer’s disease as Type 3 diabetes (T3DM) is justified, because the fundamental molecular and biochemical abnormalities overlap with T1DM and T2DM rather than mimic the effects of either one.”

These findings have considerable implications for our understanding of Alzheimer’s disease as a largely neuroendocrine disorder, which may in part be amenable to treatment with drugs normally used to treat type 1 and/or type 2 diabetes.

In retrospect, I believe, whoever came up with the term type 3 diabetes for Alzheimer’s disease, should perhaps have called it type 4 diabetes, given that the 1+2 diabetes is now increasingly common (and well studied) in patients with type 1 diabetes, who go on to develop type 2 diabetes (which, as discussed at the symposium responds quite well to bariatric or “metabolic” surgery).

@DrSharma
Edmonton, AB

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Fear of Fat: Promoting Health In a Fat-Phobic Culture

Screen Shot 2015-03-11 at 10.45.43 PMToday I will be attending a Summit on Weight Bias at the University of Calgary, that will explore the the issue of weight-based discrimination and ways to address this – especially in health care settings.

It should come as no surprise that weight bias and discrimination are a major barrier to providing proper preventive and therapeutic health care due to the widespread attitudes and beliefs about obesity that exist amongst health professionals and decision makers.

The scientific summit, co-sponsored by the Canadian Obesity Network, Campus Alberta, and the Canadian Institutes of Health Research (CIHR), is complemented by a public Cafe Scientifique that will be held on Thursday, March 12, 7.00 at the Parkdale Community Association, 3512 – 5 Ave NW, in Calgary.

For more information and pre-registration for this free public event, which features

Leora Pinhas, MD
Child & Adolescent Psychiatrist, Physician Lead, Eating Disorders Unit, Ontario Shores Centre for Mental Health Sciences Assistant Professor, University of Toronto

Tavis Campbell, PhD
Professor, Department of Psychology and Oncology & Director, Behavioural Medicine Laboratory, University of Calgary

Yoni Freedhoff, MD, CCFP
Medical Director, Bariatric Medical Institute, Assistant Professor, University of Ottawa

 click here.

@DrSharma
Calgary, AB

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EOSS Features Prominently in The Lancet’s Obesity Management Recommendations

sharma-obesity-edmonton-obesity-staging-system1It would hardly come as a surprise to regular readers that I would be delighted to see the Edmonton Obesity Staging System featured quite prominently in the article on obesity management by Dietz and colleagues in the 2015 Lancet series on obesity.

Here is what the article has to say about EOSS:

“The Edmonton obesity staging system (EOSS) has been used to provide additional guidance for therapeutic interventions in individual patients (table 1). EOSS provides a practical method to address the treatment paradigm. In principle, EOSS stages 0 and 1 should be managed in a community and primary care setting. Recent data from the USA suggest that 8% of patients with severe obesity (BMI ≥35 kg/m²) account for 40% of the total costs of obesity, whereas the more prevalent grade 1 obesity accounts for a third of costs. These findings suggest that greater priority should be accorded to EOSS stages 3 and 4, resulting in greater focus on pharmacological and surgical management delivered in specialist centres.”

These recommendations are not surprising, as EOSS was specifically designed to provide a much better representation of how “sick” a patient is rather than just how “big” she is.

This is why EOSS has now found its way not just into the 5As of Obesity Management framework of the Canadian Obesity Network but also into the treatment algorithm of the American Society of Bariatric Physicians.

To download a slide presentation on how EOSS works click here.

@DrSharma
Edmonton, AB

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How To Tell If You May Be A Food Addict

sharma-obesity-fat-dietingFollowing the recent guest posts by Drs Vera Tarman and Pam Peeke on food addiction, many readers have left comments about how this notion rings true to them and how the ideas of treating their “eating disorder” as an addiction has helped them better control their diet and often lose substantial amount of weight.

Others have asked how to tell if they might be food addicts. For them, I am reproducing the following list of 20 questions taken from Food Addicts in Recovery Anonymous.

Although it is important to note that “food addiction” has yet to be officially recognized as a medical/psychiatric condition and the following questions are by no means “diagnostic”, I would still support the idea that the more of these questions you answer with yes, the more likely you may benefit from discussing this problem with someone who has expertise in addictions (rather than simply going of on another diet or exercise program).

1. Have you ever wanted to stop eating and found you just couldn’t?

2. Do you think about food or your weight constantly?

3. Do you find yourself attempting one diet or food plan after another, with no lasting success?

4. Do you binge and then “get rid of the binge” through vomiting, exercise, laxatives, or other forms of purging?

5. Do you eat differently in private than you do in front of other people?

6. Has a doctor or family member ever approached you with concern about your eating habits or weight?

7. Do you eat large quantities of food at one time (binge)?

8. Is your weight problem due to your “nibbling” all day long?

9. Do you eat to escape from your feelings?

10. Do you eat when you’re not hungry?

11. Have you ever discarded food, only to retrieve and eat it later?

12. Do you eat in secret?

13. Do you fast or severely restrict your food intake?

14. Have you ever stolen other people’s food?

15. Have you ever hidden food to make sure you have “enough?”

16. Do you feel driven to exercise excessively to control your weight?

17. Do you obsessively calculate the calories you’ve burned against the calories you’ve eaten?

18. Do you frequently feel guilty or ashamed about what you’ve eaten?

19. Are you waiting for your life to begin “when you lose the weight?”

20. Do you feel hopeless about your relationship with food?

@DrSharma
Burlington, ON

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