23 August 2007

The average adult in the UK is drinking an extra day’s worth of calories every week through alcohol, according to a study by Standard Life.

The average adult is drinking enough lager, wine, cider and spirits to add almost 3,000 calories to their weekly calorific intake.

This is the equivalent to 500 calories above the average male recommended daily limit of 2,500 calories and 50% more than the advised maximum of 2,000 calories a day for a woman.

Annually UK adults are drinking around 155,000 calories through alcohol, adding to the country’s growing obesity problems. With 3,500 extra calories creating one pound of fat, adults are drinking enough alcohol each year to add 44lbs to their bodyweight, or just over three stone.

Men are downing the most calories through alcohol, just short of 200,000 calories annually. On a weekly basis men are consuming 3,836 calories through drink which equates to one and a half days of extra calories a week. Normal strength lager (3% proof) and Continental lager (around 5%) are men’s favourite alcoholic drinks, closely followed by wine and spirits.

But the study found that women are not far behind men in the alcohol adding calorie stakes. The average female is drinking more than 2,100 calories through drink each week which adds up to 110,000 each year. Small and large measures of red and white wine are the main source of alcohol calories for women followed by spirits, lager and alcopops.

Mick James, Protection Marketing Manager for Standard Life said: “These numbers paint a stark picture of how Britain is heading towards alcoholic induced obesity. With clear links to the incidence of diabetes, hypertension, heart attack and other cardiovascular conditions, obesity is of growing concern to public health. There is also a degree of evidence to suggest obesity has actually been reversing the improvements in mortality, made as a result of improvements to medicine. Society seems to be making choices to shorten its life expectancy.�

more  at http://www.easier.com/view/Lifestyle/Health_and_Fitness/Health/article-135300.html

There are two Metabolic Hormones Controlling Appetite, Leptin and Grehlin

Leptin:
Discovered in 1994, signals the brain that the body has had enough to eat.
The earliest-discovered of these hormones, and the first hormone ever shown to have a direct role in appetite and weight control. The hormone is secreted in fatty tissue and released into the bloodstream.  However, as the amount of fatty tissue in the body increases, the body begins to “resist� the leptin.  Obese people often have extremely high levels of leptin circulating in the blood.  However, the brain “ignores� the leptin because  it has become desensitized to it.  For this reason, injecting leptin into obese people to “curb� their appetite has been shown to be ineffective.  Also, if obese people reduce fatty tissue by losing weight, it is not clear whether the brain ever recovers its normal sensitivity to leptin.

Conclusion:
Once someone becomes obese and leptin-resistent,  automatic self-regulating appetite
control is no longer possible.

Grehlin:
Discovered in 1999, signals the brain to increase feelings of hunger.
Discussion:
Ghrelin is the only major metabolic hormone not secreted in fatty tissue– it is secreted in the lining of the stomach.  In obese people, Ghrelin levels tend to be high, increasing the apparent feeling of hunger.  Also, Ghrelin levels apparently fail to “cycle� up and down over a 24 hour period, as occurs with thinner people.

Gastric Bypass Surgery and Sleeve Gastrectomy: These types of surgery block part of the stomach, reducing the area of stomach lining being actually used.  Because there is less stomach lining, there is less ghrelin being secreted too, resulting in reduced hunger.

Anti-Obesity Vaccine– controlling ghrelin:  Scripps Research Institute reported in August 2006 that it had broken through with the first anti-obesity vaccine.  Still at a very early stage, Scripps scientists injected mature male rats with a vaccine which acted against ghrelin.  The vaccine stimulates the body to produce antibodies which attack or block the ghrelin being secreted.
This finding may be especially important to stop what is commonly known as “yo-yo dieting,� the cycle of repeated loss and regain of weight experienced by many dieters.

These findings may mark a turning point in the treatment of obesity by using the body’s own immune system to combat chronic obesity by the use of targeted antibodies.

No human trials have yet been reported.

After examining more than 2,700 men and women with an average age of 45, scientists at the University of Texas Southwestern Medical Centre in Dallas found that those with even a little fat around their waists were significantly more vulnerable to heart disease, even if their overall weight was normal.

Their findings, published in the Journal of the American College of Cardiology (JACC), may come as a shock to many who would not consider themselves fat. But they reinforce a growing belief among medical experts that waist-to-hip ratio (WHR) is a more accurate measure of healthy shape than the widely used body mass index (BMI).

BMI, which is calculated by dividing weight in kilograms by height in metres squared, gives an overall indication of heaviness compared with height. But according to BMI measurements, well-toned specimens from Brad Pitt to the rugby star Jonah Lomu would be classed as overweight, and increasing numbers of experts are now questioning BMI’s usefulness.

The new study by James de Lemos and his team adds credibility to the theory that WHR is a more accurate means of measuring heart-disease risk because it identifies potentially dangerous “central obesity� even in those who are not overweight.

Laura Donnelly, Health Correspondent, Sunday Telegraph 12/08/07
Almost 700,000 people are so fat that they need drastic surgery to tackle their weight problems, the Government’s health watchdog has found.

Despite the scale of the obesity crisis, primary care trusts (PCTs), fearful that the £3 billion cost of the operations would cripple the NHS, are restricting surgery to the most desperate cases. Last year, fewer than 5,000 such operations were performed.

Analysis of the guidance drawn up by the National Institute for Health and Clinical Excellence (Nice) reveals that 688,000 people in England, classified as “morbidly obese”, are entitled to be fitted with gastric bands or to have stomach stapling operations to reduce the amount of food they consume.

Nice says that anyone with a body mass index (BMI) above 40 should be offered surgery if other attempts to lose weight fail after six months, and those with a BMI above 50 should go under the knife immediately. A BMI of 40 equates to a man of 5ft 9in weighing 19 stone and a woman of 5ft 4in weighing almost 17 stone.

However, obesity experts claim that PCTs are ignoring the guidelines and, because they cannot afford to pay for thousands of operations – which cost about £6,000 each – are imposing stricter restrictions of their own.

Critics said the figures were an indictment of the Government’s failure to tackle Britain’s obesity epidemic, which has seen the number of obese people soar by 40 per cent in the past decade. One Briton in four is now classed as obese.

Andrew Lansley, the shadow health secretary, said: “This is an illustration of the Government’s failure to tackle the problem. It shouldn’t be about waiting until someone becomes a hopeless case.”

Obesity experts said that cash-strapped PCTs were desperate to avoid the costs of operating on the obese.

David Hewin, a surgeon at Gloucestershire Royal Hospital, said: “The numbers involved are huge, so PCTs are coming up with much more stringent criteria and moving the goalposts. Some are only offering surgery to patients who have other medical problems, such as type two diabetes, and some only to patients with a BMI over 50.”

Janet Edmond, director of the British Obesity Surgery Patient Association, said budgetary concerns were being exacerbated by a shortage of the specialists required to perform the procedures. “At the moment this is being funded in small numbers,” she said. “I would love to see a lot more patients getting access to surgery but realistically it cannot be done overnight. The resources are just not there.”
 

By Gregory Lopes – Washington Times – August 13, 2007
Companies seeking to cut rising health care costs are starting to dock the pay of overweight and unhealthy workers.

Clarian Health, an Indiana hospital chain, will require workers who smoke to pay $5 out of each paycheck starting in 2009. For workers deemed obese, as much as $30 will be taken out each paycheck until they meet certain weight, cholesterol and blood pressure standards.

Clarian employees will also be required to take part in a health risk appraisal that will inform the company which employees smoke.

Such appraisals are becoming a popular tool for businesses to determine the health of their work force. The type of health benefit program Clarian is setting up could become a model for businesses in coming years, analysts say.

Article at http://www.medgadget.com/archives/2007/08/eat_away_just_dont_digest.html

News 14 of North Carolina is reporting that the Carolinas Medical Center has implanted its first Endobarrier Gastrointestinal Liner as an experiment in treating morbid obesity, especially in type 2 diabetics. Similar in function to gastrointestinal bypass surgery, in that it limits digestion, the device is implanted non-invasively through the esophagus. Though information is almost non-existent about the device online, including who the manufacturer is, it is also being experimented with at Academisch Ziekenhuis Maastricht (Maastricth Academic Hospital, Holland).
“This is again performed endoscopically with a device that goes down the esophagus into the stomach where the device is deployed. The theory is food goes on the inside of this endobarrier. The digestive enzymes are on the outside of the endobarrier and the food and digestive enzymes don’t mix until two feet further down stream in the smaller bowel.”
While it is similar to the gastric bypass, it’s not a replacement for those who need the surgery just yet.

“For now, it’s not instead of, it’s prior too gastric bypass. Whether or not this becomes a procedure instead of gastric bypass remains to be seen,” said Gersin.

At 2-3 months, the average weight loss is 20-30 pounds.

Lipostabil, also known as the Flab Jab, is currently yet to receive a licence for cosmetic purposes in the UK due to a lack of clinical testing and concerns over its safety.

Lipostabil is licensed in Germany as a treatment for fat embolisms, where blood vessels become blocked by fat particles. However, it has been discovered that when injected directly into problem areas, such as a double chin or fat behind the knees, fat can be broken down and lost in those specific places.

 The treatment has even been demonstrated live on television on Channel 4’s Richard and Judy show. A guest was given two injections of Lipostabil two months apart and showed a marked improvement.

 However, the Flab Jab has already been banned in Brazil, the country where its usage as a cosmetic treatment was pioneered, due to links to skin infection and nerve damage.

In fact, Lipostabil’s manufacturer Sanofi-Aventis has warned that the drug is not designed to be administered subcutaneously, under the skin, and is not safe to be used for cosmetic purposes.

The Medical Defence Union and the Medical Practitioners Society, the UK’s two main medical insurers are currently refusing insurance to any doctors who continue to supply the treatment. Also, the MHRA, Medicine and Healthcare products Regulatory Authority, who license drugs in the UK, have contacted over fifty clinics to order them not to advertise the treatment and doctors who don’t comply could face unlimited fines and potentially prison sentences. So it may be some time if ever that Lipostabil is offered in the UK as a fat loss solution.

By EMMA MORTON -The SUN
August 03, 2007
 
FAT Brits who want to lose weight should just eat less, a top doctor claimed last night.                                                                                        Obesity is now “over-medicalisedâ€�, said British Medical Association chief, Dr Hamish Meldrum. He said too many adults use pills and surgery to try to slim – instead of cutting out junk food.

Dr Meldrum said: “People use fancy labels that suggest things are a medical problem. It is preferable for people to change their eating habits.�

Weight-loss surgery — like gastric bands — has risen six-fold in ten years, with 1,000 Brits having the op each year.

Slimming pill sales are also up with more than £48million a year spent on tablets.

COSMETIC BLISS WOULD WELCOME COMMENTS ON THIS ITEM

Here is some information from NICE (National Institute for Clinical Excellence) which puts the above comment into perspective, we think.  If the morbid obesity epidemic was able to be solved by the simple expedient of eating less, there would be no problem:

According to NICE, in 1998, an estimated 0.6% of men and 1.9% of women in England and Wales had a BMI of 40 or more. This represents 124,000 men and 412,700 women or 2500 people for a typical primary care trust population of 200,000. The prevalence of obesity is rising as the average BMI increases. Between 1994 and 1998 the average BMI increased by 0.44 for men and 0.57 for women.

“ NICE recommend that weight loss surgery may be offered if the patient fulfils all the following criteria:

Obesity surgery should be considered only for people who have been receiving intensive management in a specialised hospital obesity clinic .
individuals should be aged 18 years or over.
there should be evidence that all appropriate and available non-surgical measures have been adequately tried but have failed to maintain weight loss.
there should be no specific clinical or psychological contra-indications to this type of surgery.
individuals should be generally fit for anaesthesia and surgery.
individuals should understand the need for long-term follow-up.
Surgery should normally be reserved for those with a BMI of 40 or more but NICE accept that it may be offered to those with a BMI in excess of 35 if they have associated morbidities that may benefit from weight reduction.”

Because of underfunding care for the obese in the NHS, we wonder if there are sufficient resources available to treat EVEN A FRACTION OF THOSE PATIENTS WHO MEET THESE CRITERIA

Source: Blackwell Publishing Ltd.  Date: July 31, 2007
Science Daily — Only one in seven UK doctors’ surgeries provide well-developed support programmes for obese patients, according to a survey of primary care nurses published in the latest Journal of Advanced Nursing.
Sheffield-based researchers surveyed just under 400 nurses in the north of England in mid 2006, including district nurses, practice nurses and health visitors.

Their aim was to ask the nurses about their clinical practice, views and support for patients with obesity.

The researchers discovered that 89 per cent of nurses recognise the need for more effective primary care services to tackle obesity and see obesity advice and support as part of their role.

However, one in five nurses also admitted that they felt awkward or embarrassed about talking to patients about obesity and only a fifth felt they were effective when it came to helping patients to lose weight.

Half said that they found providing care and support for obese patients particularly rewarding, but some also expressed negative attitudes and beliefs.

It’s estimated that one in five adults in the survey area — which covered four primary care trusts in the north of England – are obese, reflecting national UK trends.

Many of the nurses in the current survey also had weight problems – 14 per cent were obese and 29 per cent were overweight.

“Primary care nurses have an important role when it comes to helping patients to tackle obesity, which can lead to diseases like coronary heart disease and diabetes” says lead researcher Dr Ian Brown from Sheffield Hallam University.

“But they clearly need further training and organisational support to provide the help that obese people need to lose weight, in line with new UK health guidelines.

“Any training programmes should also address nurses’ beliefs and attitudes. While outright negatives stereotypes were rare, a number of nurses displayed potentially negative beliefs and attitudes relating to obesity and obese people. However, they were much less likely to do this if they were obese themselves”
Full Story:  http://www.sciencedaily.com/releases/2007/07/070730100245.htm

31 July 2007  By Craig Mcqueen DAILY RECORD SCOTLAND

DEPRESSED MUM DIANNE TOOK DRASTIC ACTION WITH A GASTRIC BAND..AND IT CHANGED HER LIFE
AS Dianne Giannandrea spent years struggling with her weight, she began to wonder if her obsession with food would kill her.

The 41-year-old would have visions of becoming trapped in her own bed as she just couldn’t keep her weight down, and no amount of dieting seemed to help.

Severe post-natal depression had sent the 5ft 1in mum-of-three’s weight ballooning to a dangerous 17-and-a-half stone.

So when Dianne saw a TV programme called Supersize Surgery, she wondered if going under the knife was the answer.

And after visiting Glasgow’s BMI Ross Hall Hospital, she decided a gastric band was the key to regaining her health.

Now, nearly a year after surgery, she’s lost five-and-half stone and admits the decision has transformed her life.
Dianne said: “It wasn’t until I had Sarah, my second child, that the problems started as I got severe post-natal depression.
“For years after that my weight rocketed and although I would be on all sorts of diets and lose weight, I’d put it back on again.
“Because of the post-natal depression I became reclusive and ended up hating myself.
“I ate constantly, mostly takeaways. I believe I was addicted to food, just like an alcoholic or a smoker.
“When your full day is spent obsessing about food and what you’ll eat, how much you’re going to eat and when you’re going to eat, it does become an addiction.
“I would eat anything that was in the fridge. It was like it was calling my name, and it would always be the bad things like chips, chocolate or ice cream.”
By the start of last year, Dianne was at the end of her tether. But then she saw the ITV series Supersize Surgery, based at the Dolan Park private hospital in Bromsgrove, which focused on patients undergoing surgery to tackle morbid obesity.
With the support of husband Paul and kids William, 25, Sarah, 16, and seven-year-old Ben, she contacted the show’s producers and spoke to a consultant featured on the programme.
But then a friend suggested she contact BMI Ross Hall in Glasgow, a private hospital offering both the gastric band and the more complex gastric bypass procedures.
A gastric band is an inflatable belt placed around the stomach, dividing it in two and creating a smaller pouch at the top of the stomach so you feel full quicker.
Food passes slowly through the opening left by the band before continuing through your system, and the size of the opening is controlled by inflating or deflating the band with saline solution.
Adjustments are made by injecting fluid through a thin tube.
A gastric bypass is a bigger operation normally used for patients with more severe weight problems, so Dianne opted for the gastric band procedure.
Having already lost a stone before deciding she wanted surgery, Dianne lost another stone on the pre-op diet devised by the hospital’s dieticians.
She then had the operation last August. The one-hour procedure, which cost £8000, uses keyhole surgery and involves making around five small incisions to insert the band.
Dianne said: ” You’re on a liquid diet for about six weeks after the op, then you can start to eat more solid food.
“But I have to stay away from things like bread and rice as your stomach needs to work harder to process them which can cause the band to slip.
“And you can’t overeat or you end up being sick. In the six-week period I think I lost about two stones, which is quite dramatic, and I was taking supplements to make sure I was getting the vitamins I needed.”
Nearly a year later, Dianne says the band has transformed her life.
Her weight has fallen to 12 stone, she’s overhauled her diet and started getting regular exercise through walking.
She said: “It’s completely changed me. I was always miserable and although I got treatment for the depression, it never goes completely.
“Now I shake that off through things like exercise.
“Some people might think having an operation like that is an awful thing to do, but it’s given me my health and my life back. It’s the best thing I’ve ever done.”
Dianne’s surgeon, Mr Robert Stuart, said: “The noticeable thing about Dianne is that she now feels back in control of the decisions that are important to her in terms of what food she eats and what exercise she takes.”
Dianne also admits she could have never have done it without the help of husband Paul and her three children.
She said: “Paul’s been 100 per cent behind me. The kids are amazed as well. Ben’s delighted he can get his arms around me now, so there’s definitely no going back.”
‘People might think that this operation is an awful thing to do, but it gave me my health and life back’