Monday, June 26, 2017            

The following is a summary/brief analysis of the obesity and surgery stories making news this week:

Long-Term Weight Loss After Bariatric Surgery in Teens… Weight Loss Improves Gout in Patient with Obesity… U.S. Preventive Services Task Force Recommends All Kids Be Screened for Obesity… Visceral Fat and Brain Health in Elementary-Age Children… Harvard Researchers Say Evidence Supporting Role of Leptin in Metabolism Lacking… More Playtime with Dad Linked to Lower Obesity Risk for Kids... Patterns that Lead to Childhood Obesity Risk

Metabolic and Bariatric Surgery in the News…

Poster Pearls From ADA 2017: 13 New Things You'll Be Glad You Know (Medscape)

In a review of results from studies featured in the posters section of the recent American Diabetes Association's 77th Annual Scientific in San Diego, Medscape reports on a research showing approximately one half of the teens who had bariatric surgery maintained their weight within 20% of their nadir, and weight-loss outcomes were superior to those of patients receiving treatment at a medical weight management clinic. Researchers from University of Minnesota followed 50 teens who had gastric bypass surgery, collecting anthropometric data and questionnaires to assess diet, activity, and quality of life at least 5 years (mean, 8 ± 2 years) after surgery. No behavioral factors, such as eating behavior or physical activity, were strongly associated with maintenance of weight loss. However, self-reported improvement in quality of life was shown to be strongly associated with success.

Weight Loss May Improve Condition of Overweight Obese Patients with Gout (Healio/Rheumatology)

Weight loss may benefit gout patient who are overweight or have obesity, according to findings presented at the EULAR Annual Congress. Researchers conducted a review of databases and other published literature for longitudinal analyses in which weight loss was quantified. The studies also included factors such as joint pain, physical function and health-related quality of life. The analysis included a total of 907 patients from 10 studies. Several weight management strategies were observed in the studies, from diet with or without physical activity, bariatric surgery, diuretics, metformin or no intervention. Six studies showed a beneficial impact on gout attacks and almost all studies reported beneficial effects of weight loss. Positive impacts were also reported with bariatric surgery.

Obesity in the News…

All Kids Should Be Screened for Obesity (Kaiser Health News)

An statement published in JAMA Internal Medicine from the U.S. Preventive Services Task Force affirmed that children age 6 and older should be screened for obesity and referred to intensive treatment when necessary. While the Affordable Care Act requires that nearly all plans cover such treatment, most kids don’t have access to programs featuring exercise, nutrition and counseling, the authors note. The authors evaluated the evidence related to screening and treating children and adolescents for obesity. Based on that analysis, the group affirmed its 2010 recommendation. Under the ACA, preventive care recommended by the task force must be covered by nearly all health plans without making consumers pay for it out-of-pocket. But despite the task force’s recommendation, insurance coverage is spotty, said Dr. Jason Block, associate director of the Division of Chronic Disease Research Across the Lifecourse at Harvard Medical School, who co-authored an editorial about the new guidelines. Even when plans cover obesity treatment, they may not pay for a range of services. In addition, many obesity programs don’t offer the minimum 26 hours of personal contact that the task force determined is necessary for effective treatment.

Losing Fat, Gaining Brain Power, on the Playground (New York Times)

A new study of elementary-age children shows that those who were not part of an after-school exercise program tended to have more visceral fat relative to their weight, which has deleterious impacts on brain health and thinking. Researchers from Northeastern University in Boston and the University of Illinois at Urbana-Champaign tracked hundreds of 8-to-10-year-old children in a nine-month after-school exercise program in Urbana. Every day, one group of children played tag and other active games for about 70 minutes. The subjects in a control group continued with their normal lives, with the promise that they could join the program the following year. All the children completed tests of fitness, body composition and cognitive skills at the start and end of the program. The researchers did not ask the children to change their diets. After the trial, the exercising children who had obesity at the study’s onset had less visceral fat relative to their starting weight, even if they remained overweight. They also showed significant improvements in their scores on a computerized test that measures how well children pay attention, process information and avoid being impulsive. Notably, a similar effect was observed in children whose weight was normal at the start. Across the board, the more visceral fat a child shed during the nine months of play, the better he or she performed on the test. The children in the control group, in contrast, had generally added to their visceral fat; this was particularly true among those who were already obese. They gained, on average, four times as much visceral fat as the normal-weight children in the control group, and also did not perform as well on the subsequent test.

Decades After the Discovery of Anti-Obesity Hormone, Scant Evidence that Leptin Keeps Lean People Lean, Scientists Say (Science Daily)

Researchers from Harvard Medical School published a commentary in the journal Cell Metabolism highlighting what the authors say is a "startling lack of experimental evidence detailing the biologic roles of leptin in metabolism." According to the authors, who call for a renewed effort to characterize the action of the hormone, the pivotal experiments that probe the function of this protein and unravel the precise mechanism of its action as a guardian against obesity are largely missing.

Dads' Caregiving Tied to Kids' Obesity Risk (Medpage Today)

Children of dads who more frequently performed caregiving tasks, such as helping them to brush their teeth, get dressed, or go to bed, are 33% less likely to have obesity at ages 2-4, according to survey data from a longitudinal cohort study published in the journal Obesity from researchers at the Johns Hopkins School of Public Health in Baltimore. Every one-category increase in the frequency fathers took their kids out for walks or play reduced their obesity risk by 30%. The study included data on approximately 3,900 children from the Early Child Longitudinal Study-Birth Cohort (ECLS-B), a nationally representative cohort of more than 10,000 children born in 2001. The cohort was designed to collect information on home and family influences on child development during the first 6 years of life.

Genes and the Environment? Factors, Patterns that Lead to Childhood Obesity Risk (ScienceDaily)

When a child is overweight, parents tend to use more controlling, restrictive feeding practices, and parent-child communication about weight and restrictive feeding is often negative, another factor that increases obesity risk. A new study from the University of Illinois shows that a child's genetics, related to emotion and cognition, may also play a role in this pattern. Using data from the STRONG Kids cohort, researchers examined information about parent feeding styles, and how parents of preschool-age children (2.5 to 3 years) typically react to their children's negative emotions. The researchers looked at these factors combined with child genetic data. Data was collected from a group of 126 children. Parents filled out questionnaires, rating how they typically respond to their children in common situations, such as a child becoming upset at a birthday party. Saliva samples provided the genetic information. Parents most likely to use restrictive feeding were those who reported more frequent use of unresponsive stress-regulating strategies with their children -- punishing or dismissive -- and had children who were higher weight status.