Steady Snacking Ranks as a Major Cause

These findings, which were published in the journal Health Affairs, show that U.S. children eat an average of three snacks a day in addition to three regular meals. Known as “constant eating,” this steady snacking may showcase why our nation’s childhood obesity levels have increased by more than 16%. The researchers, led by Carmen Piernas and Barry Popkin of the University of North Carolina, focused on 31,337 children between the ages of 2 and18.

The researchers found that more than 27% of calories that American kids take in are consumed as snacks (specifically, food eaten outside regular meals). In addition, it was shown that the largest increases were from those of salty snacks and candy, including desserts and sweetened beverages. The researchers also noted that between 1977 and 2006, children increased their caloric intake by 113 calories per day.

The Financial Toll of Obesity Continually Growing

The sky-rocketing obesity levels, whether for adults or children, are taking a huge financial toll on the U.S. healthcare system. Many are calling for financial incentives to combat these mounting health threats. Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention (CDC), has written a commentary discussing various financial issues. Among these are: taxing sugary drinks and junk food, zoning restrictions on fast-food outlets around schools, and banning advertising that targets unhealthy food for children. “Government at national, state, and local levels, spearheaded by public health agencies, must take action,” Frieden stated.

A second study conducted at the Oregon Health and Science University in Portland involved the data from the 2007 National Survey of Children’s Health. This study showed that for children between 10 and 17 years old, obesity rates increased from 14.8% in 2003 to 16.4% in 2007. The study also found that overweight children levels remained at about 15%. “While combined overweight and obesity rates appear to be leveling off, our findings suggest a possible increase in the severity of the national childhood obesity epidemic,” said researcher Christina Bethell.

The U.S. Government Taking Action

These findings, while depressing, may help First Lady Michelle Obama in her efforts to educate the nation about the childhood obesity health threat. Speaking at the School Nutrition Association conference in Washington, Obama stressed that many are responsible for childhood obesity, including parents, educators and policymakers. “Our kids didn’t do this to themselves,” she stated. “From fast food, to vending machines packed with chips and candy, to a la carte lines, we tempt our kids with all kinds of unhealthy choices every day.”

In addition, research suggests that obese children and teenagers are more likely to remain obese as adults, while also developing related conditions at younger ages. The study’s findings also showed that overweight or obese children were 32% more likely to have to repeat a grade in school, while 59% were more likely than normal weight kids to miss more than two weeks of school.

If you live in South Carolina and are considering a bariatric procedure, 2011 is shaping up to be a very good year. The state’s government workers will qualify for a pilot program beginning in January 2011. Specifically, those enrolled in the state’s employee insurance plan will be able to receive coverage for either a gastric-bypass or Lap-Band surgery. Stephen VanCamp, director of the employee insurance program, said that this paid coverage will be issued to 100 people statewide, on a first-come, first-serve basis.

Confronting the State’s Obesity Issues

Typically, these two procedures cost about $24,000 each. However, South Carolina’s obesity rates have doubled since 1990. The Centers for Disease Control and Prevention (CDC) now classifies almost 2/3 of all of the state’s adults as being overweight or obese. As such, the weight loss surgery coverage was added to the state’s 2010-11 budget to address the obesity problem. An additional $19 million was also funded for 2011, due the new federal health care law.

Under this new coverage plan, patients’ results will be tracked for 18 months, both to track complications, and to determine the overall health savings. To qualify for surgery, workers or their spouses must have a BMI of at least 40, which is considered “morbidly obese.” These future patients must also have a positive psychological exam, and post-surgical nutrition and support plans.

Opposition within the State Government

As you’d expect, not all members of the state’s government are happy about this new program. For instance, some, such as State Comptroller General Richard Eckstrom, feel that while steps are necessary to combat obesity, bariatric surgery may be too extreme. He believes that it would be better for the state to focus on preventing people from becoming so large that they qualify in the first place. And others feel that this program shouldn’t be funded by the state during a recession.

It should be mentioned that South Carolina is not alone in requiring insurance companies to cover morbid obesity treatments, such as gastric bypass surgery. Georgia, Illinois, Indiana, Maryland, New Hampshire and Virginia all have similar programs in place.

Even as the United States struggles with sky-rocketing obesity rates for all ages, the state of Oregon has the honor of having the lowest amount of obese children. In 2007, a ground-breaking government study, the Healthy People 2010 initiative, found that over 16% of American children ages between the ages of 10 and 17 years were considered “obese.” These results mean that the children possess a body mass index (BMI) in the 95th percentile or above. This level represents a 10% increase from 2003.

Oregon, the leader, was shown to have a childhood obesity level at just under 10%. In addition, the state was the only one to record significant childhood obesity decreases between 2003 and 2007. Meanwhile, in Mississippi, the worst state, more than 20% of all children were shown to be obese!

Depressing Weight Loss News Nationwide

The initiative had the goal of improving childhood obesity levels by 5% nationwide. And truthfully, the news was pretty bad, as even the lowest expectations of Healthy People 2010 were not met. This study, which involved a telephone survey of parents about their children, involved about 47,000 children in 2003 and 44,000 in 2007. In analyzing multiple categories, the results showed that only Wyoming girls even came close to the goal. The results of the study were published in the Archives of Pediatrics and Adolescent Medicine.

So why did Oregon score so much better than the other 49 states? Healthcare experts believe that it may be due to finances, family history, race, or all three. The study results illustrated that the Black and Hispanic children and adolescents involved in the study had twice the likelihood of being overweight or obese as whites — Oregon is 90% Caucasian. Oregon has laws that ensure nutrition standards in schools, while also requiring chain restaurants to provide nutritional information on request. The state also has high rates of breast-feeding, which may offer defense against obesity.

Certain Factors May Influence Obesity Rates

The researchers also took into account such factors as poverty and inactivity, but the same results were found. According to Gopal Singh, the study’s lead author, and an epidemiologist with the U.S. Health Resources and Services Administration, children living in a neighborhood with unsafe surroundings, poor housing and no access to sidewalks, parks and recreation centers had 20-60% higher odds of being obese or overweight.

Dr. Joe Thompson, director of the Robert Wood Johnson Foundation Center to Prevent Childhood Obesity, suggests that rising childhood obesity levels may be due to one or more factors. Among these are: fast food, neighborhoods without sidewalks, television, video games, schools neglecting physical education, and multiple societal changes. Dr. Thompson adds that it’s now up to lawmakers to reduce obesity, especially to save future medical costs.

On Monday, May 24th, US Agriculture Secretary Tom Vilsack appealed to Congress that billions of additional dollars would have to be poured into programs dedicated to child obesity and hunger. And it appears that his words are echoed by the rest of the government, as President Barack Obama, in his 2011 budget proposal set aside an additional one billion dollars a year over 10 years for the child nutrition bill, which Congress will re-authorize this year.

Impacts for Healthcare, the Economy & National Security
Speaking at the launch of a report on child hunger at the Center for American Progress, Vilsack stated that both childhood hunger and obesity should be made national priorities. He said that it was morally wrong for so many children to be going hungry in the world’s richest nation. He then added that these health threats had major impacts on our national healthcare system, as well as the nation’s economy and national security.

“Research shows that youngsters who are either obese or who are hungry simply do not learn as well as they ought to, he said. “Youngsters who are obese take chronic disease into adulthood which substantially reduces their productivity as individuals and causes our health care costs to escalate.”

In regard to the nation’s national security, the high number of childhood obesity means that there may not be future candidates to serve in the military. As for the economy, Vilsack said that child hunger costs the US economy at least 28 billion dollars per year “because poorly nourished children perform less well in school and require far more long-term health care spending. Further, food insufficiency severely hampers children’s emotional, intellectual, and physical development, and it strongly hinders the upward mobility of their parents.”

About one-third of US children is now considered “obese,” or is becoming obese. At the same time, an estimated 17 million children now live in households forced to occasionally skip meals to make their finances stretch further.

In particular, researchers have uncovered potential risks for liver damage for one specific ingredient found in the majority of weight loss drugs. Known as “orlistat,” this drug is flying off the shelves under the over-the-counter brand name “Alli.” In addition, orlistat is also available as a prescription drug called “Xenical.” And while rare, the U.S. Food and Drug Administration (FDA) received 13 separate reports of consumers developing severe liver damage after taking the drug. However, it should be noted that 12 of these cases were reported to have occurred overseas.

Rare, But Serious Health Risks Reported
But while there have been few US-based cases, the agency still wants to get the warning out to consumers. It’s estimated that about 40 million people worldwide are currently taking orlistat in some form. And while the risk is low, the FDA wants to spread the word about any potential drug-related side effects.

The agency has not determined if orlistat is actually responsible for liver damage. They do suspect that any side effects may be related to how patients metabolize the drug, as well as their health risks (if any). According to Dr. Eugene Schiff, director of the Center for Liver Diseases at the University of Miami Miller School of Medicine, the drugs may have been exposed to some contamination.

“We are telling consumers and health-care providers to be vigilant should [patients] develop symptoms suggestive of liver impairment,” stated FDA spokeswoman Elaine Gansz Bobo. “We are not advising routine monitoring of liver enzymes as that will not help predict who may develop hepatic impairment on the drug. We were unable to identify any particular group that may be at increased risk.”

For these 13 most recent orlistat-related cases reported to the FDA, they “were cases that, on review and categorization by the agency, received severity scores of 4 or 5 using the Drug Induced Liver Injury Network scoring system,” stated Gansz Bobo. “Basically, a ‘5’ means resulting in death or liver transplantation, and a ‘4’ means it was severe and required hospitalization.” In addition, Gansz Bobo said that in regard to these “cases of significance,” the FDA determined that they were either “likely” or “possibly” related to the use of orlistat.

A History of FDA Research
In 1999, orlistat was first approved by the FDA as a prescription medicine. Then, in 2007, the drug became the first non-prescription drug approved to treat adult obesity in the United States. In August 2009, the agency began a review of orlistat in regard to possible liver damage incidents.

This announcement came after 32 cases of serious liver injury were reported between 1999 and October 2008; two of these occurred in the United States. The majority of these patients reported cases involving typical signs of liver damage, such as jaundice, weakness and abdominal pain. Twenty-seven patients had symptoms severe enough to require hospitalization. Today, orlistat is approved in about 100 countries.

So what should be done if you’re taking orlistat? Above all else, patients should see their healthcare professional if and when they develop dark urine, itching or yellow skin or eyes.

Studies show that the number of bariatric surgeries being performed in the U.S. continues to increase. However, these procedures’ quality and safety vary widely from one hospital to another. HealthGrades, a Golden, Colorado-based, independent healthcare ratings organization, has released the findings of its fifth annual study of bariatric surgery. For this recent study, more than 190,000 patients who had undergone bariatric surgery from 2006-2008 were involved. These patients had been discharged from 684 hospitals in 19 states.

Surgical Complications Falling Nationwide
For the purposes of the study, the researchers assigned hospitals one of three ratings, indicating “best-performing,” “average-performing” and “poor-performing” facilities. And the good news? The ratings showed that the overall rates of risk-adjusted, in-hospital complications and mortality related to obesity surgery are decreasing!

Specifically, the researchers found that those patients at top hospitals experienced a 66.55% lower chance of experiencing complications than those patients who underwent bariatric surgery at a bottom-ranked hospital. In addition, the patients at top hospitals reported shorter lengths of stay. The researchers concluded that if all bariatric patients had surgery at levels similar to top-ranked hospitals, 5,046 patients could avoid major in-hospital complications during this three-year period.

Which Facility You Choose Plays A Large Part
But there is some bad news - The researchers did observe that there were large performance gaps among the different facilities. As an example, bariatric surgery mortality, which is rare, was found to occur four times more at bottom-performing hospitals than top-performing hospitals.

“Bariatric surgery has been proven to reduce caloric intake and control obesity, but the HealthGrades study demonstrates that where patients have this type of surgery matters-a great deal,” said Rick May, HealthGrades’ vice president of clinical consulting. “There is a subset of U.S. hospitals whose patients, the data show, have fewer complications and leave the hospital earlier.”

Source: Modernhealthcare.com/article/20100526/NEWS/305259974

There’s no denying it that childhood obesity is a growing concern. The Centers for Disease Control and Prevention (CDC) has determined that the levels have more than tripled over the past 30 years! For children between the ages of 6 and 11, obesity rates have increased from 6.5% in 1980 to 19.6% in 2008. Even worse, one in five American teenagers has been shown to have abnormal cholesterol levels, and therefore, higher risks for heart disease. Plus, children and teenagers are consistently being diagnosed with obesity-related conditions, such as high blood pressure, diabetes, and arthritis.

The First Lady Takes the Cause to the People

As such, it’s understandable that Michelle Obama would choose childhood obesity as her cause. In her efforts to spotlight obesity, she has embarked on a tour to discuss this healthcare situation, and her personal issues related to the situation. For instance, she mentions that while her children were diagnosed as being overweight, and later body mass index (BMI) scores confirmed these findings. So, Michelle made effective changes to her children’s diets and exercise regimes, resulting in healthy weight loss.

However, while the First lady’s efforts were ultimately successful, she did experience some criticism. Some people mistakenly believed that the children were put on calorie-restrictive “starvation” diets; this was proven to be untrue. Rather, she ensured that her daughters followed physician-approved guidelines, such as consuming healthy food in moderate portions, reducing their intake of sugary drinks, and eating more fruits and vegetables. The children also watched less television and exercised more.

Many felt that the First Lady overlooked such weight-related health issues as anorexia nervosa and bulimia. But it was pointed out that these conditions typically target normal-weight individuals, and not the obese; they’re usually diagnosed in only about 1-2% of the population. Obesity and its related conditions are far more prevalent than anorexia at all ages, and represent a much bigger threat for children and teenagers.

As a result, healthcare professionals — and the First Lady — believe that it’s much more dangerous and misguided to avoid telling children and teenagers that they’re overweight and/or obese, for fear of hurting their feelings. There’s even research to back this up: it’s been shown that about 90% of teens feel good about themselves. Meanwhile, less than 25% of Americans are dieting at any given time, while two-thirds are overweight or obese.

Greek researchers found that repeated bariatric weight loss surgeries may result in higher risks of complications than undergoing one procedure. These procedures have been shown to be the only effective method for long-term weight loss in severely obese people.

The study’s findings, which were published in the journal Archives of Surgery, focused on 56 patients who had repeat bariatric surgery between 1995 and 2008. The patients’ average age was 39.6, while the average body mass index (BMI), the measurement of weight and height, was 46.9. A BMI score of more than 30 is considered “obese.”

The Potential Risks of Multiple Bariatric Procedures
The results showed that the rates of patients having multiple (or “revisional”) bariatric surgery range from 5-56%. In the study, the patients were followed-up for an average of 102 months after their revisional surgery. It was found that while no patient died, 19 (33.9%) experienced serious complications within 1-3 months after surgery, including: internal leakage from the surgical site, acute kidney failure and pneumonia. As for late complications, which occur more than 90 days after surgery, these were reported in 13 patients (23.2%). These complications included: hernia at the incision site and narrowing of the passageway between the stomach and intestine.

For the study, 39 patients underwent revisional surgery due to inadequate weight loss after their initial procedure. These patients achieved a significant decline in BMI, declining from an average of 55.4 to 35; this represents an average loss of nearly 69% of excess body weight. In addition, these revisional procedures imparted benefits for those experiencing nutritional complications and intolerable side effects after their initial procedure. Patients are classified as having revisional bariatric surgeries for three reasons:

1. Unsatisfactory weight loss after the initial procedure
2. Severe nutritional complications such as protein malnutrition, and
3. Intolerable side effects such as blocking or narrowing of the digestive tract.

The study’s authors believe that as these procedures are continually improved, and their benefits for weight loss are publicized, revisional surgeries may become more common.

Researchers at Monash University and the Royal Children’s Hospital in Melbourne show that one specific procedure — lap-band surgery — may lead to a loss of up to 80% of excess fat in patients!  In fact, the surgery’s outcomes, which were published in the Journal of the American Medical Association, were shown to be much more effective for adolescents than just following severe dieting and exercise programs.

The Lap-Band Vs. “Lifestyle” Changes
For the government-funded study, the researchers observed 50 severely obese teens between the ages of 14 and 18 from May 2005 to September 2008. Half of the patients underwent gastric banding surgery, in which a silicon clamp is implanted that shrinks the stomach and reduces appetite. These patients were told to eat only three small meals and exercise for 30 minutes each day. Meanwhile, the other 25 patients remained on a strictly supervised diet and exercise regime.

It was found that those receiving the surgery lost an average of 77 pounds, which was more than 10 times the weight of the other group. Overall, after two years, those teens undergoing surgery lost an average of 79% of their excess weight, while those following just the lifestyle changes lost just 13%. It should be mentioned that six of the lifestyle group withdrew from the study after gaining weight, even though they had access to a personal trainer, physician, dietician and regular guidance.

Weight Loss Benefits, But NOT A “Quick Fix”
The bottom line? Lap-band weight loss surgery may offer remarkable benefits for weight loss for teenage patients. “While this study confirms that some adolescents can achieve substantial weight loss and health improvements through diet and exercise, gastric banding should be considered for those severely obese adolescents who find primary weight loss methods unsuccessful,” stated study author Professor Paul O’Brien.

However, healthcare professionals caution that this and other procedures are not a “quick-fix” solution for weight loss, especially for younger patients.

In a new meta-study (group of studies) published in the Archives of General Psychiatry, Dutch researchers focused on the connection between depression and obesity. The 15 studies, which focused on almost 59,000 subjects, showcased the strong ties between weight gain and negative mental and emotional health. In particular, they found that this association was stronger among Americans than Europeans. Also, there were stronger ties for those actually diagnosed with depression, rather than those with only the symptoms.

According to Dr. Floriana S. Luppino, of Leiden University Medical Center in the Netherlands: “We found bidirectional associations between depression and obesity: obese persons had a 55 percent increased risk of developing depression over time, whereas depressed persons had a 58 percent increased risk of becoming obese.”

The Science Behind Depression & Weight Gain
But what is the reasoning behind this association? Scientists feel that as obesity is thought to be an inflammatory condition, it may be linked with depression risks. And in both the United States and Europe, being thin is the ideal beauty factor.

This may explain why the overweight and obese suffer from both body dissatisfaction and low self-esteem, thereby increasing depression risks. It’s also thought that antidepressant drugs may contribute to weight gain, which then increases depression risks. And, this depression may actually impact the body’s endocrine system, which may lead to weight gain.

But the researchers believe that these findings may help to improve the health and well-being of patients. “Because weight gain appears to be a late consequence of depression, care providers should be aware that within depressive patients weight should be monitored. In overweight or obese patients, mood should be monitored. This awareness could lead to prevention, early detection and co-treatment for the ones at risk, which could ultimately reduce the burden of both conditions.”

Source:
http://news.yahoo.com/s/hsn/20100302/hl_hsn/obesityanddepressionaviciouscircle