Tuesday, July 29, 2014

5th Conference on Childhood and Adolescent Obesity, Winnipeg, Sept 23-26, 2014

Jonathan McGavock, PhD, Assoc. Professor, Manitoba Institute of Child Health, Winnipeg, MB

Jonathan McGavock, PhD, Assoc. Professor, Manitoba Institute of Child Health, Winnipeg, MB

For readers interested in the prevention and management of childhood and adolescent obesity, there is still time to submit your abstract (deadline Aug 5) and to register for this event in Winnipeg.

Those of you, who have been to previous meetings in this series, will know that this meeting (interspersed biennially with the Canadian Obesity Summit) brings together clinicians, researchers, policy makers and other stakeholders for 4 days of intense networking and knowledge exchange.

This year’s conference is being organised by Jon McGavock from the Manitoba Institute of Child Health and is sure to be a blast.

Given Jon’s interest in this area, this year’s conference will include a strong focus on the burden of obesity among Indigenous Youth and showcase examples of the best and promising practices within Indigenous communities across Canada and the US.

This special theme will include presentations from Indigenous youth living in communities with a high burden of obesity, sharing circles with Indigenous leaders and stakeholders and will explore interventions designed to promote these strengths and enhance resiliency among children and adolescents.

Of course, the conference will also cover a wide range of other topics related to childhood obesity across the age and care continuum.

View CE Credits HERE.

Brochure is available HERE.

Register for the conference HERE.

Registration for the pre-conference only HERE.

Submit your abstract HERE.

Incidentally, I will be having the privilege of giving a keynote at the opening of the pre-conference.

While in Winnipeg, I will also be performing my “Stop Being a Yo-Yo” show at the Colin Jackson Studio Theatre on Sept. 24, Show time: 7:00 p.m. (click HERE for online tickets).

See you in Winnipeg!

@DrSharma
Edmonton, AB

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Monday, July 14, 2014

How To Prevent Gallstones During Weight Loss

GallstonesOne of the best recognised complications of weight loss – especially if this occurs too rapidly – are the development of gallstones, which can result in acute symptoms and often require surgery.

Now Caroline Stokes and colleagues from the Saarland University Medical Center, Homburg, Germany, publish a systematic review of strategies to prevent weight-loss associate gallbladder stones in Clinical Gastroenterology and Hepatology.

Their analysis includes 13 randomised-controlled trials, comprising 1836 participants undergoing weight loss through dieting (8 trials) or bariatric surgery (5 trials).

Ursodeoxycholic acid (UDCA) reduced the risk of ultrasound-verified gallstones compared with control interventions with a risk ratio of 0.33 and a number-needed-to-treat (NNT) of only 9.

They also found a significant risk reduction with high-fat weight loss diets (risk ration 0.09).

No adverse effects were noted for either intervention.

Thus, it is evident that UDCA and/or higher dietary fat content prevent the formation of gallstones during weight loss and these treatments should likely be initiated particularly in patients, who are undergoing rapid weight loss (particularly those at high risk of gallbladder stones).

@DrSharma
Edmonton, AB

ResearchBlogging.orgStokes CS, Gluud LL, Casper M, & Lammert F (2014). Ursodeoxycholic Acid and Diets Higher in Fat Prevent Gallbladder Stones During Weight Loss: A Meta-analysis of Randomized Controlled Trials. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 12 (7), 1090-110000 PMID: 24321208

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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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Thursday, June 26, 2014

Guidelines for Managing Overweight and Obesity in Adults

the obesity societyRegular readers may recall a previous post on guidelines on obesity management released by The Obesity Society (TOS) together with other organisations, including the American Heart Association and the American College of Cardiology, at Obesity Week in Atlanta last year (2013).

The bottom line, as I have blogged before, was the revelation of just how little we actually know about obesity.

For what it is worth, the complete guidelines are now published as a supplement to its July issue of the Obesity journal (Guidelines (2013) for Managing Overweight and Obesity in Adults: Full Report).

According to The Obesity Society’s press release,

TOS is investing in the improved treatment of obesity by making the full guidelines available in print so they can serve as a go-to resource for health practitioners around the world. Whether you are a physician, nurse, nutritionist or fitness trainer, every professional interacting with individuals with obesity can find value in this insightful treatment guide.

No doubt, a tremendous amount of work went into developing these guidelines – whether they will substantially change practice remains to be seen.

@DrSharma
Vancouver, BC

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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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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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