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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Friday, August 1, 2014

The 5As of Healthy Pregnancy Weight Gain

5AsPregnancy_PractitionerGuide_rf-final_Page_01Yesterday, the Canadian Obesity Network released the 5As of Healthy Pregnancy Weight Gain.

This follows the release of the 5As of Obesity Management (adults) and the 5As of Pediatric Weight Management.

The 5As of Health Pregnancy Weight Gain, was developed by a working group of nurses, midwives, primary care physicians, obstetricians, researchers and policy makers convened by the Network.

It is based on the best available evidence on this topic and is intended to help primary care practitioners discuss and manage gestational weight with their patients.

The 5As of Healthy Pregnancy Weight Gain is based on the following 5 key principles:

  • Discussion about gestational weight gain should occur with every pregnant women and with every woman planning a pregnancy.

  • Achieving healthy gestational weight gain is about improving the health and well-being of both mothers and babies.

  • Early action means addressing root causes and removing roadblocks.

  • Pregnancy related health beliefs can be powerful influences on weight gain in pregnancy.

  • Achieving goals is different for every woman.

The 5As of Health Pregnancy Weight Gain can be downloaded here – pdfppt

@DrSharma
Edmonton, AB

p.s. if you did not receive the Obesity Network Newsletter with this announcement due to Canada’s new anti-spam legislation, please click here.

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Friday, July 18, 2014

Birth Control And Obesity

sharma-obesity-birth-control-pillAlthough obesity is a well-recognised factor for female infertility, the vast majority of women with excess weight are probably more interested in effective birth control.

That this is not as simple as it seems is evident from an article by Sheila Mody and Michelle Han from the University of California, San Diego, published in Clinical Obstetrics and Gynecaology.

The paper succinctly reviews a wide range of issues related to birth control and obesity.

To begin with, the authors points out that unintended pregnancies in obese women are often a problem simply because obese women are far less likely to use effective contraception than non-obese women. This non-use may in part be attributable to fear of weight gain, when most studies show that modern hormonal contraception is associated with almost no weight gain. The exception appears to be depot-medroxyprogesterone (DMPA), which may cause about 5 lb weight gain in the first year of use.

As for efficacy, the data show that unintended pregnancy rates among overweight women using oral contraceptives are similar or slightly higher than that among nonoverweight women. The reasons for these higher rates are not exactly clear.

Fortunately, the efficacy of intrauterine devices (IUD) appear no different between obese and non-obese women although the insertion of an IUD maybe more difficult in obese women because of poor visualization of the cervix and limited assessment of uterine position (a problem that can often be solved with the help of an ultrasound).

The paper also discusses the suitability of the vaginal vaginal contraceptive ring, which has been hypothesized to offer higher hormone levels for obese women than oral contraceptives because the hormones are absorbed directly into the vaginal mucosa and do not go through the first- pass liver metabolism.

Finally, the paper discusses issues around contraception for women who have undergone bariatric surgery (who have a particularly high rate of unintended pregnancies) as well as best practices for emergency contraception.

This is clearly information that all clinicians who counsel obese women should be aware of.

@DrSharma
Edmonton, AB

ResearchBlogging.orgMody SK, & Han M (2014). Obesity and Contraception. Clinical obstetrics and gynecology PMID: 25029338

 

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Thursday, July 17, 2014

Infant Antibiotic Exposure and Obesity Risk

sharma-obesity-gut-buts1With all the interest in the role of the gut bacteriome in the development of obesity, it was only a matter of time before someone examined the relationship between antibiotic use and obesity risk.

This is exactly what Anita Kozyrskyj and colleagues from the University of Alberta, Edmonton, Canada, explored in a paper now published in the International Journal of Obesity.

For their study they linked rovincial healthcare records to clinical and survey data from a Canadian longitudinal birth cohort study, whereby antibiotic exposure during the first year of life was documented from prescription records.

Overweight and central adiposity were determined from anthropometric measurements at ages 9 (n=616) and 12 (n=431) years.

According to this analysis, infants receiving antibiotics in the first year of life were about twice as likely to be overweight later in childhood compared to those who were unexposed.

However, after adjustment for birth weight, breastfeeding, maternal overweight and other potential confounders, this association persisted in boys but not in girls. The reason for this discrepancy is not clear.

Although these findings are in line with the notion that early use of antibiotics may predispose to obesity, it is important to not that these type of studies cannot prove causality.

It may well be that other non-measured factors could explain this association (e.g. overprotective or lower SES parents may be more likely to use antibiotics in their infants – both factors are independently associated with higher rates of obesity).

Nevertheless, given the rather high rates of antibiotic exposure in infants it appears that this may well be a promising area for further research not just in the context of obesity but also for many of the other conditions that are now believed to be influenced by intestinal flora.

@DrSharma
Edmonton, AB

ResearchBlogging.orgAzad MB, Bridgman SL, Becker AB, & Kozyrskyj AL (2014). Infant antibiotic exposure and the development of childhood overweight and central adiposity. International journal of obesity (2005) PMID: 25012772

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Friday, July 11, 2014

Is Weight Gain Typical in Atypical Depression?

sharma-obesity-depressionDepression or major depressive disorder (MDD) is not only one of the most common psychiatric problems, it also comes in many flavours.

While melancholic or “typical” depression is characterized by a loss of pleasure in most or all activities (anhedonia), a failure of reactivity to pleasurable stimuli, psychomotor retardation and a strong sense of guilt, “atypical” depression is characterized by mood reactivity (paradoxical anhedonia), excessive sleep or sleepiness (hypersomnia), a sensation of heaviness in limbs, and significant social impairment as a consequence of hypersensitivity to perceived interpersonal rejection.

An important further distinction is that “typical” depression is commonly associated with loss of appetite and weight loss, whereas “atypical” depression typically involves increased appetite (comfort eating), often with significant weight gain.

Now a study by Aurélie Lasserre and colleagues from Switzerland, published in JAMA Psychiatry, looks at the risk for weight gain in patients with different forms of depression.

The prospective population-based cohort study, included 3054 randomly selected residents of the City of Lausanne (mean age, 49.7 years; 53.1% were women) with 5.5 years of follow-up.

Depression subtypes according to the DSM-IV, as well as sociodemographic characteristics, lifestyle (alcohol and tobacco use and physical activity), and medication, were elicited using the semistructured diagnostic interviews.

As expected, only participants with the “atypical” subtype of MDD at baseline had a higher increase in adiposity and were about 3.75 times more likely to have developed obesity during follow-up than participants without MDD.

This association remained robust even after adjustment for a wide range of confounders.

Thus, as the authors note,

The atypical subtype of MDD is a strong predictor of obesity. This emphasizes the need to identify individuals with this subtype of MDD in both clinical and research settings. Therapeutic measures to diminish the consequences of increased appetite during depressive episodes with atypical features are advocated.

Although we should be wary of those antidepressants that can cause weight gain, an early diagnosis and treatment of atypical depression may well prevent further weight gain and perhaps facilitate weight loss in patients with atypical depression.

Clearly, screening for “atypical” depression must be an essential part of obesity assessment and management.

@DrSharma
Edmonton, AB

ResearchBlogging.orgLasserre AM, Glaus J, Vandeleur CL, Marques-Vidal P, Vaucher J, Bastardot F, Waeber G, Vollenweider P, & Preisig M (2014). Depression With Atypical Features and Increase in Obesity, Body Mass Index, Waist Circumference, and Fat Mass: A Prospective, Population-Based Study. JAMA psychiatry PMID: 24898270

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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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