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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Monday, September 15, 2014

Update on New Medications for Obesity

sharma-obesity-fda4Last week, while I was off on a brief holiday, two important events took place in the US with regard to obesity medications.

On September 10, the US-FDA granted approval for Contrave, a fixed combination of bupropion and naltrexone, two centrally active compounds, also used in the treatment of addictions.

Then, on September 11, an advisory panel appointed by the FDA, voted strongly in favour of approving the GLP-1 agonist liraglutide at the 3.mg dose for the treatment of obesity.

These two new entities would bring the currently approved prescription medications for the treatment of obesity in the US to six – a dramatic change from just a couple of years ago.

This is still a long shot away from the many effective treatments we have for treating other common conditions (e.g. there are more than 20 prescription medications approved for treating diabetes and almost 100 compounds for the treatment of hypertension).

Why would we need this many different medications for obesity? For the simple reason that not everyone will respond favourably or tolerate all of these compounds.

Given that obesity is a remarkably heterogeneous disorder and that these drugs have distinctly different modes of action, I would not expect all of these medications to work in all individuals.

It is also important to note that all of these drugs work best when combined with intense behaviour modification – no pill will ever serve as a substitute for a healthy diet and a daily dose of moderate to vigorous physical activity. But we also know that the latter alone, will rarely produce sustainable weight loss in the long-term.

Obviously, given the chronic nature of obesity, medications for obesity will need to be used long-term in the same manner that we use medications to treat other chronic conditions (e.g. diabetes, hypertension, etc.).

This means that we will need more long-term data on the efficacy and safety of these compounds.

Nevertheless, there is reason to hope that for many people with obesity related health problems, these new obesity medications will provide much-needed therapeutic options.

@DrSharma
Vienna, Austria

Disclaimer: I have served as a paid consultant and/or speaker for the makers of Contrave and liraglutide.

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Wednesday, September 3, 2014

Can Targeting Estrogen Receptors Alleviate Binge Eating Disorder?

sharma-obesity-mouse-eatingBinge eating disorder, a loss of control of food intake accompanied by dysphoric mood alterations, is more common in women than in men and may account for as much as 40% of severe obesity seen at bariatric centres.

Strangely enough, a new study by Xuehong Cao and colleagues from Baylor College of Medicine, Houston, Texas, published in the Journal of Clinical Investigation, shows that targeting estrogen receptors in the serotonergic neurons of brain centres involved in appetite regulation may alleviate this behaviour, at least in mice.

Previous observations in humans that women with binge eating often suffer from menstrual irregularity, presumably due to impaired functions of ovarian hormones (e.g. estrogens) and that circulating 17β-estradiol levels are inversely associated with binge eating, prompted these investigators to study the role of estrogen in binge eating behaviours in ovarectomised mice.

While estrogen administration resulted in markedly reduced binge eating behaviour in these mice, this effect was absent in genetically modified mice that lacked the estrogen receptor-α (ERα) in the dorsal raphe nuclei (DRN), an area particularly rich in serotonin (5-HT) neurons known to be important in appetite regulation (and sleep).

The researchers also showed that a conjugate that combines GLP-1 and estrogen into one molecule is far more effective in reducing binge eating behaviour than GLP-1 alone (again, this effect was much reduced in ERα KO mice) suggesting that such a conjugate may be used to specifically target GLP-1 receptor neurons, thereby perhaps avoiding any potential adverse effects of estrogen administration.

Obviously, there is a long way from such initial observations in mice to safe and effective treatments in humans.

Nevertheless, these observations should open a new field of interest in finding more effective pharmacological treatments for binge eating disorders or perhaps even more “common-garden-variety” obesity in humans.

@DrSharma
Gambach, Germany

ResearchBlogging.orgCao X, Xu P, Oyola MG, Xia Y, Yan X, Saito K, Zou F, Wang C, Yang Y, Hinton A Jr, Yan C, Ding H, Zhu L, Yu L, Yang B, Feng Y, Clegg DJ, Khan S, DiMarchi R, Mani SK, Tong Q, & Xu Y (2014). Estrogens stimulate serotonin neurons to inhibit binge-like eating in mice. The Journal of clinical investigation PMID: 25157819

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Tuesday, September 2, 2014

Can Weight Loss Supplements Promote Weight Gain?

sharma-obesity-weight-loss-supplementsApart from the fact that there are indeed no weight-loss supplements that will help you lose more than the weight of the money in your back pocket (a fact that even Dr. Oz had to admit to at a recent senate inquiry into the rubbish he promotes on his shows), there may be reason to suspect that the use of such supplements may in fact do the opposite.

Thus, a rather simple experiment by Yevvon Chang and Wen-Bin Chiou from Tunghai University, Taichung, Taiwan, published in Nutrition, suggests that taking a (supposed) weight-loss supplement may actually lead to greater caloric intake.

This field study was conducted in 70 volunteers, who were randomised to taking a either placebo or a weight-loss supplement (the same placebo) and were then exposed to a buffet meal.

On average, participants presumably taking weight loss supplements ate a greater number of food items than did control subjects (overall about 30% more food). They also tended to chose less healthy items than the control group.

This effect tended to be strongest in those subjects who had a more positive attitude towards taking supplements for weight loss (those with the most positive attitude eating almost 3 times more food items).

Or, as the authors summarise,

“…the results supported our hypothesis that taking weight loss supplements was associated with an inclination to eat more food. This link was driven by perceived progress toward the goal of weight reduction. The liberating effect of taking weight loss supplements on food consumption became more prominent as attitudes toward this kind of supplement became more positive.”

Obviously, it is hard to extrapolate from such a short-term experiment to what happens over time – especially when people do follow the lifestyle recommendations that come with most supplements (eat-less-move-more).

This study certainly is in line with the recent observation that people who take statins to lower their blood cholesterol levels tend to eat unhealthier diets and may in fact end up gaining more weight than people who don’t.

Thus, it may be time to study the “fattening” effect of weight-loss supplements. Perhaps the only reason that we have not yet observed this effect in larger studies is because very few people stay on these nonsensical agents for more than a few weeks.

@DrSharma
Gambach, Germany

ResearchBlogging.orgChang YY, & Chiou WB (2014). The liberating effect of weight loss supplements on dietary control: A field experiment. Nutrition (Burbank, Los Angeles County, Calif.), 30 (9), 1007-10 PMID: 24976417

 

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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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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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