Friday, October 31, 2014

German TV Looks At Healthy Obesity

Arya Sharma on bike 3SATRegular readers will be familiar with the fact that not all people with excess weight necessarily have health problems. Now, the 3SAT television channel, which broadcasts in Germany, Austria and Switzerland has produced a 45 minute documentary on the science behind these findings.

Although the film is in German, I thought I would post the link anyway as many of my readers may well be able to grasp the story even if they are not entirely fluent.

To watch the documentary on line click here.

Incidentally, I am featured about 2.5 minutes into the film, discussing the Edmonton Obesity Staging System and related issues.

Appreciate all comments.

@DrSharma
Toronto, ON

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Thursday, October 30, 2014

Obesity Is Not About Lack Of Willpower

Yo-Yo Rubber Band Feb 2014As I prepare to spend the rest of this week educating health professionals in Ontario on how to better manage obesity in their practice, it is perhaps appropriate to remind ourselves that Canada is not alone in attempting to tackle this problem.

Indeed, we need to look no further than the Australian Clinical Practice Guidelines for the Management of Overweight and Obesity in Adults, Adolescents and Children for a succinct summary of reasons just why obesity management is so difficult:

- Regulation of body weight involves complicated feedback systems that result in changes in appetite, energy intake and energy expenditure. 

- While excess weight in individuals usually results from a prolonged period of energy imbalance, the causes of overweight and obesity are complex.

- Diet and physical activity are central to the energy balance equation, but are directly and indirectly influenced by a wide range of social, environmental, behavioural, genetic and physiological factors—the relationships between which are not yet fully understood.

- Individuals may be at greater risk of weight gain at particular stages in their lives.

The guidelines remind practitioners of the fact that body weight underlies tight regulation through a complex homeostatic system:

“While this system defends against weight gain as well as weight loss under normal circumstances, energy balance cannot be maintained when an energy surplus is sufficiently large and sustained. Weight gain will begin and usually continue until a new weight results in increased energy expenditure and energy balance is re-established. The same physiological mechanisms then seek to maintain energy balance at the higher weight, and will defend against weight loss by increasing appetite and reducing energy expenditure) if there is an energy deficit. As a result, most overweight and obesity results from upward resetting of the defended level of body weight, rather than the passive accumulation of excess body fat.”

This acknowledgement is a vast step forward from previous simplistic views of obesity which falsely view it as just a matter of “calories in” and “calories out”, which falsely imply that individuals should be able to achieve any desired weight simply by volitionally changing this balance through willpower alone.

Indeed, the reality is that the vast majority of individual attempting this “balance” approach to weight management will fail miserably only to gain the weight back.

Thus, the Australian guidelines are not shy about declaring a better need for pharmacological treatments and promoting the more extensive use of bariatric surgery for individuals with sever obesity related health problems.

A clear reminder to all of us that current treatments for obesity are insufficient and better, safer and more accessible treatments are urgently needed.

@DrSharma
Toronto, ON

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Friday, October 24, 2014

Social Network Analysis of the Obesity Research Boot Camp

bootcamp_pin_finalRegular readers may recall that for the past nine years, I have had the privilege and pleasure of serving as faculty of the Canadian Obesity Network’s annual Obesity Research Summer Bootcamp.

The camp is open to a select group of graduate and post-graduate trainees from a wide range of disciplines with an interest in obesity research. Over nine days, the trainees are mentored and have a chance to learn about obesity research in areas ranging from basic science to epidemiology and childhood obesity to health policy.

Now, a formal network analysis of bootcamp attendees, published by Jenny Godley and colleagues in the Journal of Interdisciplinary Healthcare, documents the substantial impact that this camp has on the careers of the trainees.

As the analysis of trainees who attended this camp over its first 5 years of operation (2006-2010) shows, camp attendance had a profound positive impact on their career development, particularly in terms of establishing contacts and professional relationships.

Thus, both the quantitative and the qualitative results demonstrate the importance of interdisciplinary training and relationships for career development in obesity researcher (and possibly beyond).

Personally, participation at this camp has been one of the most rewarding experiences of my career and I look forward to continuing this annual exercise for years to come.

To apply for the 2015 Bootcamp, which is also open to international trainees – click here.

@DrSharma
Toronto, ON

ResearchBlogging.orgGodley J, Glenn NM, Sharma AM, & Spence JC (2014). Networks of trainees: examining the effects of attending an interdisciplinary research training camp on the careers of new obesity scholars. Journal of multidisciplinary healthcare, 7, 459-70 PMID: 25336965

 

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Thursday, October 23, 2014

Guest Post: My Weight Is Not Measured In Pounds

Fitness Header ColorToday’s guest post comes from Andrea Matthes, a Certified Personal Trainer and blogger, who I met at the annual meeting of the Obesity Action Coalition in Orlando – the post speaks for itself.

I recently attended the Obesity Action Coalition’s annual Your Weight Matters Convention and got the opportunity to hear Dr. Sharma’s keynote presentation titled, “Health is Not Measured in Pounds.” I found myself sitting in my chair, agreeing so emphatically that I was full-body nodding at the waist. By the end of his speech, I couldn’t contain myself– I jumped out of my chair making the first, very loud clap that echoed through the room, only to be followed by hundreds of other claps and a full-house standing ovation. Dr. Sharma’s message was something I needed to hear. Not because it was a new theory to me, but because up until that hour, his theory was what I was experiencing first-hand.

I am 5 feet, one inch tall and weigh 165lbs (when slightly dehydrated). At my current height/weight my BMI is 31.2, also known as: OBESE. A word that is often associated with laziness, overeating, diabetes, high blood pressure, bad cholesterol and overall ill health. According to this number, I need to lose at least 35lbs if I want to reach the “normal” range in order to be considered “healthy”.

Can I just tell you how frustrating that is?

I am living an exceptionally healthy, full and active lifestyle. My blood pressure is perfect, my cholesterol levels are great, and my A1C is consistently normal. My daily life consists of running, jumping, lifting heavy objects, and eating a diet that most people would consider ideal. I am extremely proud of the lifestyle I live. I am able to climb mountains, run races, surf, ski, and flip a perfectly executed cartwheel at the drop of a hat. Yet, I am told that in order to be healthy, I need to lose weight!

How ridiculous is that?

It’s extremely ridiculous and unfair that I have to live with a label that is based on a fancy formula for size; a label that says I need to lose weight in order to avoid potential misdiagnoses, higher insurance premiums, and social stigma. It’s unfair that my TRUE health has very little to do with pounds and everything to do with how I live my life. This is what my obesity looks like:

I am a running, swimming, cycling, heavy-lifting, nutrient-eating, LIFE-LOVING, 5-foot-one-inch-tall, 37-year-old woman who also weighs 165lbs which leaves me with a label that misrepresents the life I live and my health!

I may be obese according to BMI but that does not mean I am unhealthy.

My obese body is strong, it is capable, it is HEALTHY. In fact, my obese body is healthy enough to do things that many skinny people can’t do. So weigh me all you want, but please, do not measure my HEALTH in pounds.

ABOUT ANDREA

Andrea has lost 164 pounds with a jumpstart from gastric bypass surgery followed by a complete lifestyle overhaul. She is now a Certified Personal Trainer, Level One CrossFit Coach and has completed over 25 races since March of 2013. Andrea blogs about her REAL FOOD, REAL FITNESS, REAL LIFE approach at www.imperfectlife.net where she strives to inspire others to let go of perfection and learn to love their one and only I’mperfect Life.

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Monday, October 20, 2014

Obesity In Pet Dogs

household petsIf anyone is concerned about humans getting fatter – let us not forget our household pets.

Thus, according to a report published in the official journal of the British Veterinary Association, a survey of 1000 dogs attending as outpatients in a veterinary clinic found 28% (or 1 in 3) to be obese.

Notable, the prevalence of obesity in female dogs was higher than in males (32% vs. 28%) and higher in middle-aged than younger dogs (12% vs 21% in males and 21 vs 41% in females).

Dogs getting table scraps or other home-prepared food as the main part of their diet showed a higher incidence of obesity than those fed on canned dog meat.

Also, the incidence was higher (44%) among dogs owned by people with obesity than among dogs owned by people of normal physique (25%) and was higher (34 to 37%) among dogs of people in middle and elderly age groups than among dogs owned by people under 40 years of age (20%).

Of note, the owners of 31% of the dogs classified as obese considered their dogs to be of normal weight.

Now, for any reader, who wonders what is remarkable about any of these findings – here is the surprising little detail: this paper was published in 1971!

Indeed, it is the first paper in a series of coming posts on obesity research that was published almost 5 decades ago but could have well been published last week.

It is surprising how little has changed.

@DrSharma
Edmonton, Alberta

ResearchBlogging.orgMason E (1970). Obesity in pet dogs. The Veterinary record, 86 (21), 612-6 PMID: 5465678

 

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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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