Thursday, August 28, 2014

Call For Abstracts: Canadian Obesity Summit, Toronto, April 28-May 2, 2015

COS2015 toronto callBuilding on the resounding success of Kananaskis, Montreal and Vancouver, the biennial Canadian Obesity Summit is now setting its sights on Toronto.

If you have a professional interest in obesity, it’s your #1 destination for learning, sharing and networking with experts from across Canada around the world.

In 2015, the Canadian Obesity Network (CON-RCO) and the Canadian Association of Bariatric Physicians and Surgeons (CABPS) are combining resources to hold their scientific meetings under one roof.

The 4th Canadian Obesity Summit (#COS2015) will provide the latest information on obesity research, prevention and management to scientists, health care practitioners, policy makers, partner organizations and industry stakeholders working to reduce the social, mental and physical burden of obesity on Canadians.

The COS 2015 program will include plenary presentations, original scientific oral and poster presentations, interactive workshops and a large exhibit hall. Most importantly, COS 2015 will provide ample opportunity for networking and knowledge exchange for anyone with a professional interest in this field.

Abstract submission is now open – click here

Key Dates

  • Abstract submission deadline: October 23, 2014
  • Notification of abstract review: January 8, 2014
  • Early registration deadline: March 5, 2015

For exhibitor and sponsorship information – click here

To join the Canadian Obesity Network – click here

I look forward to seeing you in Toronto next year!

@DrSharma
Montreal, QC

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Wednesday, June 25, 2014

Social Anxiety As A Deterrent To Physical Activity

sharma-obesity-distored-body-image1Social anxiety, defined as persistent fears of one or more social situations in which the person is exposed to others and expects to be scrutinized, has been reported in as many as one in ten individuals with overweight or obesity.

Now, a paper by Abbas Abdollahi and Mansor Abu Talib, published in Psychology, Health and Medicine, examines the relationship between social anxiety and sedentary behaviour in this population.

The researchers surveyed 207 overweight and obese students (measured heights and weights) using a number of validated instruments to assess social anxiety, sedentariness and body esteem.

As one might expect, social anxiety was associated with lower body esteem and higher sedentary behaviour.

The key mediator in this relationship was body dissatisfaction and poor body esteem.

Thus,

“…obese individuals with poor body esteem are more likely to report social anxiety, because they are concerned about negative evaluation by others; therefore, obese individuals indicate avoidance behaviour, which, ultimately, leads to social anxiety.”

The implications of these findings are obvious,

“First, when assessing the social anxiety in individuals, it is important to account for the presence of sedentary behaviour in addition to other psychological risk factors. Second, reducing sedentary behaviour can alter the effect of social anxiety factors; this may be a significant factor to incorporate into social anxiety treatment programmes. Reducing social anxiety in individuals is a main part of any clinical intervention. Third, the findings of the current study suggest that health professionals should encourage obese individuals with social anxiety to reassure their value and abilities regardless of their weight or body shape, and assist them to recognize that everybody is unique and that differences between individuals are valuable.”

This will take more than simply telling people with overweight to be more active. It will certainly require targeted and professional help to overcome body dissatisfaction and low self esteem.

Or, even better, we need to do all we can to help people gain more confidence and be accepting about their own bodies in the first place.

@DrSharma
Vancouver, BC

ResearchBlogging.orgAbdollahi A, & Talib MA (2014). Sedentary behaviour and social anxiety in obese individuals: the mediating role of body esteem. Psychology, health & medicine, 1-5 PMID: 24922119

 

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Monday, June 23, 2014

Does More Energy In And Out Make It Easier To Maintain Energy Balance?

sharma-obesity-caloric_balance_scaleFrom every thing we know about obesity, the simplistic model of energy-in-energy-out (or Eat-Less-Move-More) approach to managing weight has not led us to any meaningful advances in obesity management. The number of people who can successfully manage their weight by this approach in the long-term is so minuscule, that every “success story” is considered “newsworthy”.

Now, a provocative paper by Gregory Hand and Steven Blair, published in US Endocrinology, suggests that what matters for good health is the amount of energy flowing through the system rather than the state of energy balance.

Thus,

“Recent findings suggest that a high energy flux, maintained by increasing energy expenditure, can improve an individual’s metabolic profile without changing weight.”

This, essentially, is a fancy way of saying, that simply moving more calories through your body by burning more calories (even if you instantly eat them back) benefits the organism irrespective of any impact this may have on body weight – or that exercise is good for you even if you do not lose weight.
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Anyone familiar with Steven Blair’s work (fat and fit is better than skinny and unfit) – will recognize the theme – but couching it in a concept of energy flux is a novel and interesting spin to this idea.

Apart from providing a theoretical model for how exercise may benefit you even if you don’t lose any weight doing it, the model may also have implications for weight management.

Thus,

“The significance of the model of energy regulation is twofold: First, the model suggests that energy balance, and maintaining a stable weight is more easily achieved at a high energy flux. Second, a high energy flux can be achieved by matching a high energy intake with equivalent high energy expenditure, or by increasing energy stores (gaining weight). Of note is that these two characteristics of the model suggest that the biological system was designed to maintain a high energy flux, and increasing energy stores is a quite viable mechanism to achieve this level of energetics. An extensive body of research indicates that multiple and redundant mechanisms regulate the ‘drive’ for energy intake. The high energy flux is attained by matching the intake with expenditure and/or a change in energy storage. Weight gain is consistent with high energy flux combined with low energy expenditure, and it follows that attempting to achieve energy balance at a low energy flux (sedentary behavior combined with food restriction) is not a long-term strategy for weight maintenance.”

The biological question that pops into my mind of course is as to how exactly the body would sense this “flux”. While it is easy to see how the body would sense energy stores (e.g. through hormonal signals such as leptin), it is not clear how the body would monitor flux (after all, to regulate something, it needs to be measured).

This is not something that the authors delve into, thus leaving a somewhat unsatisfying gap in what otherwise makes for an interesting hypothesis.

@DrSharma
Toronto, ON

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Tuesday, June 3, 2014

Why Promoting Exercise May Make Us Fatter

sharma-obesity-exerciseDon’t get me wrong – I am all about physical activity – the more the better. If physical activity was a pill, I’d be all about putting it in the drinking water.

But here is the problem – a new study by Carolina Werle, Brian Wansink and Collin Payne, published in Marketing Letters, provides rather convincing evidence that simply calling physical activity “exercise” may actually increase food intake (which we know will often exceed any calories burnt during that activity).

The researchers present the results of three studies – two field experiments showing that when physical activity was perceived as fun (e.g., when it is labeled as a scenic walk rather than an exercise walk), people subsequently consume less dessert at mealtime and consume fewer hedonic snacks. Incidentally, the participants also reported enjoying the fun walk way more than the exercise walk, despite both walks covering exactly the same ground.

An interesting aspect of the post-walk ad libitum food intake was that the extra calories consumed by the exercise group was entirely attributable to increased servings of desserts and choice of sugary beverages – not by consumption of the main meal – clearly suggesting the “reward” nature of the compensatory response.

A third observational field study during a competitive race showed that the more fun people rated the race as being, the less likely they were to compensate with a hedonic snack afterwards.

Thus, the authors conclude that,

Engaging in a physical activity seems to trigger the search for reward when individuals perceive it as exercise but not when they perceive it as fun.

Long-distance runners have a variety of ways they can frame their experience in a race. If competitive, they can view their race as a serious effort to win a medal or achieve a personal best time. Alternatively, some other runners could view the race as a form of a workout or exercise, but still others could see it as a form of adventure or as a “fun run.” How they view their 30–60 min experience relates to what they chose to eat following the race.

The article concludes with the advice to the fitness industry to warn participants about compensatory overconsumption of snacks – to which I say, good luck with that. Most sports facilities that I know off actually rely on their in house snack bars for a rather substantial part of their revenue. I have also yet to see the activity event that is not routinely paired with some form of culinary reward for participants (and often even for those, who just stood around watching the event).

My advice to both health professionals and policy makers is to simply drop the “E-Word” from their vocabulary – but then again, what fun is that?

@DrSharma
Edmonton, Alberta

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Tuesday, May 27, 2014

What’s Europe Doing About Obesity?

ECO2014 logoAs I head out to attend the 21st European Congress on Obesity in Sophia, Bulgaria, I came across this interactive site that allows interested readers to checkout obesity interventions across Europe.

The atlas of European projects and interventions for obesity prevention in adults is part of the SPOTLIGHT project which udertook a Europe-wide survey to provide an overview of projects and interventions to prevent adult obesity through improving diet and physical activity.

While the atlas may not include every single intervention that is currently happening, it does provide a sense of the scope and range of these activities.

For each project or intervention the atlas considers the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) aspects and presents these data where available.

I am sure I will have plenty more to report on based on what I hear at the conference.

@DrSharma
Munich, Germany

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In The News

Diabetics in most need of bariatric surgery, university study finds

Oct. 18, 2013 – Ottawa Citizen: "Encouraging more men to consider bariatric surgery is also important, since it's the best treatment and can stop diabetic patients from needing insulin, said Dr. Arya Sharma, chair in obesity research and management at the University of Alberta." Read article

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