Obesity Research

“Globesity” is the pandemic of the 21st century. Progress in understanding the full spectrum of obesity (s) is rapidly emerging via rigorous scientific global obesity research. Obesity research is one of the most dynamic areas of science. It is the nexus of physiology, psychology, neurobiology, biochemistry, genetics, nutrition and other scientific disciplines. An integrative understanding the biological mechanisms, psychological processes and social interactions has given rise to bariatric science.

AABC welcomes scholarship that will advance obesity research as well as obesity education and further the progress of bariatric science. If you would like to have AABC post your published articles and commentaries, please forward them to AABC research director Dr. Joseph Indelicato at joseph.indelicato@aabc-certification.org.

Weight Science: Evaluating the Evidence for a Paradigm Shift

Linda Bacon and Lucy Aphramor

Published January 24, 2011

Nutrition Journal (link to original article)

Abstract:

Current guidelines recommend that "overweight" and "obese" individuals lose weight through engaging in lifestyle modification involving diet, exercise and other behavior change. This approach reliably induces short term weight loss, but the majority of individuals are unable to maintain weight loss over the long term and do not achieve the putative benefits of improved morbidity and mortality. Concern has arisen that this weight focus is not only ineffective at producing thinner, healthier bodies, but may also have unintended consequences, contributing to food and body preoccupation, repeated cycles of weight loss and regain, distraction from other personal health goals and wider health determinants, reduced self-esteem, eating disorders, other health decrement, and weight stigmatization and discrimination. This concern has drawn increased attention to the ethical implications of recommending treatment that may be ineffective or damaging. A growing trans-disciplinary movement called Health at Every Size (HAES) challenges the value of promoting weight loss and dieting behavior and argues for a shift in focus to weight-neutral outcomes. Randomized controlled clinical trials indicate that a HAES approach is associated with statistically and clinically relevant improvements in physiological measures (e.g., blood pressure, blood lipids), health behaviors (e.g., eating and activity habits, dietary quality), and psychosocial outcomes (such as self-esteem and body image), and that HAES achieves these health outcomes more successfully than weight loss treatment and without the contraindications associated with a weight focus. This paper evaluates the evidence and rationale that justifies shifting the health care paradigm from a conventional weight focus to HAES.

© 2011 Bacon and Aphramor; licensee BioMed Central Ltd.

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Eating Disorders Skyrocket in Kids: What are the Signs?

By Neil Katz

Posted: November 29, 2010 10:27 AM

CBS News.com (link to original article)

(CBS) While millions of kids struggle with obesity, another dangerous trend has been hiding in their midst - young kids with eating disorders like anorexia and bulimia, which can stunt their growth and lead to early heart attacks.

That's according to a new report from the American Academy of Pediatric published in the journal Pediatrics.

The group says eating disorders in young children are rising at an alarming rate. Hospitalizations for kids younger than 12 were up 119 percent between 1999 and 2006, according to government data included in the report.

Kids with eating disorders may be malnourished, have organ damage and stunted growth. In some bulimia cases, the rapid change in electrolyte balance can cause heart attacks and sudden death. Or, their may be no obvious signs at all.

The profile for eating disorders is also rapidly changing, according to report author Dr. David Rosen, a professor of pediatrics, internal medicine and psychiatry at University of Michigan.

"The stereotype is these disorders affect teen girls from wealthy backgrounds," Rosen tells CBS News. "We are learning these are equal opportunity disorders. They affect boys, people of color and people from disadvantaged backgrounds. Health care providers need to suspect these disorders in patients where in they would not have in the past."

Males now represent 10 percent of the eating disorder population, according to the report, which also warned that young athletes of both genders, including gymnasts, wrestlers and dancers, are at risk for "partial-syndrome eating disorders," where they display some, but not all, of the behaviors.

Researchers don't really know why some kids are prone to eating disorders and others not. Media images of thin people and difficult family dynamics are no longer the full answer, Rosen told HealthDay.

Ironically, the obesity epidemic, may be making things worse. Pediatricians are increasingly counseling kids about nutrition. If not handled well, for some kids that can lead to obsession with controlling food intake.

"The key is to talk about body acceptance and healthy eating rather than numbers on a scale," says Marisa Sherry, a New York nutritionist who specializes in eating disorders. "If we teach kids that food is bad, they might feel judged all the time and can become obsessed with what they eat."

"Parents are vital here," she says. "Kids learn everything from them. If parents are always talking about dieting and weight obsession, kids pick up on that. Parents should focus more on health eating and exercise rather than constantly fretting over fitting into a pair of jeans or calling oneself 'fat.' That's a judgment. What we want is body acceptance and healthy lifestyle."

The good news is that eating disorders caught in childhood have a better rate of treatment success than for adults.

"If you are waiting to make the diagnosis of eating disorders in a kid that has lost a lot of weight and seems sick, you are missing the boat," says Rosen. "We need to get to this when kids are starting to diet, starting to obsess over weight. That's when we need to be suspicious. We can do a much better job intervening before kids have gotten to the malnourished state."

So what should parents look for? Read our 12 secret signs of Anorexia to learn more.

The Stigma of Obesity

By Karen Kataline

Posted: 03/28/2010 01:00:00 AM MDT

The Denver Post (link to original article)

In 1965, I was named Denver County's Little Miss. I never thought it terribly sinister to be in child beauty pageants. In retrospect, I have come to believe that the pageants themselves were not as troubling as the kind of parents who would put their children there in the first place.

My mother was "Ethel Merman on steroids," a stage mother who lived vicariously through her daughter, just as her mother had lived vicariously through her. In her youth, she (like thousands of other little girls) had been expected to be the next Shirley Temple.

Like my mother, I was put on the stage at age 3. As a natural extrovert, I took to it rather well, but it required decades to understand some of the more disturbing aspects of my early years.

Most pervasive was my mother's obsession with my weight. The fact that the most important beauty pageant of my life, when I was 9, took place on a makeshift stage in the parking lot of a McDonald's was a delicious irony.

In second grade, my mother put me on a 500 calorie-a-day diet. Not only was this seriously unhealthy, but my 7-year-old mind concluded that she wanted to starve me to death. Since I was not about to die quietly, I mastered the art of stealing food in the middle of the night.

Weight had become the battleground on which to effect separation between my mother and me. At the age of 16, I was 5 feet tall and weighed 285 pounds.

I made sure there would be no more beauty pageants.

I have watched as many core issues of my childhood have replayed themselves on a grand scale in the popular culture, from sexualized baby beauty queens to the growing obsession with "childhood obesity."

When I hear Michelle Obama making this issue her new "cause," I wince at the potential repercussions. Apart from a general debate about whether this should be the business of the federal government, there is another question: Particularly in the case of children, could the alarm be exacerbating and, in some cases, causing the problem?

It's a complex issue with a multitude of variables, all the more reason that blanket pronouncements are absurd. When those pronouncements are received by already overzealous parents or those who live through their children, the results can easily backfire, sometimes with tragic consequences.

The secret that some professionals know (but few have found a way to treat or talk about) is that obesity can express the need for protection.

In an appearance- and thin-obsessed culture and despite great pain, it is a defense that works surprisingly well. It keeps others at a distance and allows the body to say what the mouth cannot: "I'm scared of too much sexuality," "Stop displaying me!" or, perhaps, "Accept me for who I am or leave me alone."

When such a person attempts to lose weight, they may discover, as I did, an actual "fear of thin." If this is true, is it wise to exacerbate a cultural obsession into an acceptable national cause?

In such a politically correct climate, where it is a great sin to offend someone, why is it now acceptable to stigmatize fat people — and especially children — more than ever?

As you may imagine, I've had to do a lot of therapy to overcome these very personal issues. One of the most valuable benefits has been to recognize and respect boundaries — foremost those between me and my mother.

I am responsible for what I put in my mouth, for my own body and my own self-acceptance. I hope the government learns about respecting boundaries, too. Not to do so creates a kind of collective co-dependence — which is much more frightening to me than my own childhood.

Karen Kataline of Denver (karen@gutspah.com) is an entertainer and trainer in assertiveness and communications.

Modern Science Versus the Stigma of Obesity

By Jeffrey M Friedman

Research Paper from the Molecular, Cellular and Developmental Biology (MCDB) Department at the University of Colorado in Boulder

Obese people, who are already subject to adverse health effects, are additionally victimized by a social stigma predicated on the Hippocratic nostrum that weight can be controlled by ‘deciding’ to eat less and exercise more. This simplistic notion is at odds with substantial scientific evidence illuminating a precise and powerful biologic system that maintains body weight within a relatively narrow range. Voluntary efforts to reduce weight are resisted by potent compensatory biologic responses. This article will review some of this evidence, together with promising avenues of research. Further progress in understanding and treating obesity will come not from repetition of anachronistic preconceptions but rather from the rigorous scientific approach that has driven advances in so many other areas of medicine.

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