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Excess Weight and Covid-19

Obesity Worsens Outcomes from COVID-19
Adults with excess weight are at even greater risk during the COVID-19 pandemic:

Having obesity increases the risk of severe illness from COVID-19. People who are overweight may also be at increased risk.

Having obesity may triple the risk of hospitalization due to a COVID-19 infection.
Remote Learning During Covid-19 Is Causing Children to Gain Weight, Doctors Warn
More snacking, less exercise puts them at greater risk for diabetes, other health concerns

Pediatricians are warning that the coronavirus pandemic’s protracted disruption of in-person schooling, sports and other activities is leading to weight gain that could have long-lasting impacts on children’s health.
Studies Begin to Untangle Obesity’s Role in Covid-19
In early April, Edna McCloud woke up to find her hands tied to her hospital bed. She had spent the past four days on a ventilator in a hospital in St. Louis County, Mo., thrashing and kicking under sedation as she battled a severe case of Covid-19.
Obese BME people at 'higher-risk' of contracting COVID-19
Source - EurekAlert
Obese people among black and minority ethnic communities (BME) are at around two times higher the risk of contracting COVID-19 than white Europeans, a study conducted by a team of Leicester researchers has found.

Benefits of Bariatric Surgery

Bariatric surgery cuts heart attack risk for years
Source - WebMD

Researchers looked at numerous heart (cardiac) risk factors before and after gastric bypass surgery and found all improved.

Improvements in heart risk factors included:

  • Total cholesterol declined from 184 before surgery to 174 after. (Below 200 is recommended.)
  • HDL or “good” cholesterol rose 40%.
  • LDL or “bad” cholesterol improved.
  • Triglycerides (blood fats) declined by about 55%.
Sleeve Gastrectomy Linked With Lower Fracture Risk
Source - medpagetoday
In severely obese patients who underwent bariatric surgery, sleeve gastrectomy, but not Roux-en-Y gastric bypass (RYGB), was associated with a lower risk for bone fractures, researchers reported.
Bariatric Surgery Slashes Spending on Diabetes and Hypertension Medications
Source - ASMBS
Patients with severe obesity who get weight-loss surgery cut their spending on diabetes medications by nearly 65 percent and spending on high blood pressure medications by more than a third three to six months after the operation, according to new research from Rush Medical College in Chicago presented here at an American Society for Metabolic and Bariatric Surgery (ASMBS) national clinical symposium on obesity prevention, treatment and research.
Association between Bariatric Surgery and Long-term Survival

Importance Accumulating evidence suggests that bariatric surgery improves survival among patients with severe obesity, but research among veterans has shown no evidence of benefit.

Objective To examine long-term survival in a large multisite cohort of patients who underwent bariatric surgery compared with matched control patients.

Bariatric Surgery Patients Exhibit Improved Memory Function 12 Months Postoperatively
Source - springer.com
137 patients were followed for 12 months after Bariatric Surgery to determine cognitive improvements. Patients Exhibited Improved Memory Function 12 Months Postoperatively.
Association Between Bariatric Surgery and Macrovascular Disease Outcomes in Patients With Type 2 Diabetes and Severe Obesity
Source - Jama Network
Macrovascular disease is a leading cause of morbidity and mortality for patients with type 2 diabetes, and medical management, including lifestyle changes, may not be successful at lowering risk.
Association Between Prepregnancy Body Mass Index and Severe Maternal Morbidity
Source - JAMA
Low and high prepregnancy BMI were associated with a statistically significant but small increase in the risk of severe maternal morbidity or mortality.
Weight loss surgery linked to lower risk of cancer
Source - Reuters
Severely obese people who undergo surgery to shed excess pounds may have lower odds of developing cancer than they would without the operations, a recent U.S. study suggests.
Change in Pain and Physical Function Following Bariatric Surgery for Severe Obesity
Source - JAMA
Importance: The variability and durability of improvements in pain and physical function following Roux-en-Y gastric bypass (RYGB) or laparoscopic adjustable gastric banding (LAGB) are not well described.
Bariatric Surgery Controls Blood Pressure
Source - JAMA
Bariatric surgery effectively controlled blood pressure in patients with obesity and hypertension, according to a trial published in Circulation.
Association Between Bariatric Surgery and Rates of Continuation, Discontinuation, or Initiation of Antidiabetes Treatment 6 Years Later
Source - JAMA
In this nationwide population-based cohort study of more than 30 000 adults, bariatric surgery was associated with a significantly higher 6-year postoperative antidiabetes treatment discontinuation rate compared with an obese control group, as well as with a low antidiabetes treatment initiation rate, with gastric bypass being the most effective procedure.

Safety of Bariatric Surgery

Surgical Skill and Complication Rates after Bariatric Surgery

Background

Clinical outcomes after many complex surgical procedures vary widely across hospitals and surgeons. Although it has been assumed that the proficiency of the operating surgeon is an important factor underlying such variation, empirical data are lacking on the relationships between technical skill and postoperative outcomes.

Methods

We conducted a study involving 20 bariatric surgeons in Michigan who participated in a statewide collaborative improvement program. Each surgeon submitted a single representative videotape of himself or herself performing a laparoscopic gastric bypass. Each videotape was rated in various domains of technical skill on a scale of 1 to 5 (with higher scores indicating more advanced skill) by at least 10 peer surgeons who were unaware of the identity of the operating surgeon. We then assessed relationships between these skill ratings and risk-adjusted complication rates, using data from a prospective, externally audited, clinical-outcomes registry involving 10,343 patients.

Results

Mean summary ratings of technical skill ranged from 2.6 to 4.8 across the 20 surgeons. The bottom quartile of surgical skill, as compared with the top quartile, was associated with higher complication rates (14.5% vs. 5.2%, P < 0.001) and higher mortality (0.26% vs. 0.05%, P=0.01). The lowest quartile of skill was also associated with longer operations (137 minutes vs. 98 minutes, P < 0.001) and higher rates of reoperation (3.4% vs. 1.6%, P=0.01) and readmission (6.3% vs. 2.7%) (P < 0.001).

Conclusions

The technical skill of practicing bariatric surgeons varied widely, and greater skill was associated with fewer postoperative complications and lower rates of reoperation, readmission, and visits to the emergency department. Although these findings are preliminary, they suggest that peer rating of operative skill may be an effective strategy for assessing a surgeon’s proficiency.

Comparing the Outcomes of Sleeve Gastrectomy and Roux-en-Y Gastric Bypass for Severe Obesity
Source - JAMA
Over the past decade there has been a rapid shift in bariatric procedure use worldwide, with the sleeve gastrectomy replacing the Roux-en-Y gastric bypass as the procedure of choice in most patients with severe obesity. The sleeve gastrectomy is less technically complex than the bypass procedure, and involves a 70% vertical gastric resection with no intestinal bypass.
Factors Associated With Achieving a Body Mass Index of Less Than 30 After Bariatric Surgery
Source - JAMA
Bariatric surgery is optimal in patients with a BMI of less than 40; delaying surgical treatment for obesity can lead to inferior results.

Excess weight and Public Health

Mayo Clinic Minute: Nearly half of US adults projected to be obese by 2030
Source - Mayo Clinic
For decades, obesity rates in the U.S. have been increasing. Now researchers predict that by 2030, nearly half of adults will be obese if the current trend continues.
Is Your State One of the 'Most Obese' in America?
Source - WebMD
The number of U.S. states with adult obesity rates above 35% reached an all-time high of nine in 2018, a new report says.
Health Effects of Overweight and Obesity in 195 Countries over 25 Years
Source - NEJM
Although the rising pandemic of obesity has received major attention in many countries, the effects of this attention on trends and the disease burden of obesity remain uncertain.
Genes found to increase childhood obesity risk
Source - CNN

Researchers have identified two genetic variations that appear to increase the risk of childhood obesity.

The study authors took data from North American, Australian and European meta-analysis of 14 studies consisting of 5,530 obese children and 8,318 non-obese kids. The team compared the genetic data.

Kidney cancers: Major rise ‘linked to obesity’
Source - BBCNews

Obesity is fuelling a major increase in the number of cases of kidney cancers diagnosed in Britain, experts say.

Obesity increases kidney cancer risk by about 70%, compared with smoking which increases it by about 50%.

The experts say that being overweight increases the risk of this cancer, as well as others including breast, bowel and womb cancer, because it causes the higher levels of certain hormones to be produced, compared with those seen in healthy people.

Disabled by weight: obese with arthritis
Source - Daily Rx

Being obese is just plain unhealthy. All that excess fat can make outcomes worse for patients with any of a number of diseases, including rheumatoid arthritis.

A recent study showed that morbidly obese patients with inflammatory polyarthritis – which includes diseases like rheumatoid arthritis – had higher levels of disability than arthritis patients who were not obese. Morbidly obese patients had about twice the odds of disability compared to those who were not obese.

Surprising misperceptions about weight status and obesity health risks
Source - Wlshelp

Although the majority of the American public views obesity as a serious public health issue, a surprising number tend to misperceive their own weight status and do not fully understand all the health consequences of being obese, according to results from The Associated Press-NORC Center for Public Affairs Research survey.

The results showed that nearly half of the overweight, but not obese, respondents misperceived their own weight status and thought their weight was about right. And while many of the respondents were aware of the link between obesity with heart disease and diabetes, most were less likely to mention other serious health impacts associated with being overweight or obese.

The Obesity-Inactivity-Cancer chain
Source - Daily Rx

The link between obesity and cancer is nothing new. Lack of regular exercise and cancer are also teammates. A new study has added some links to this chain of knowledge.

Researchers found that higher body mass index (BMI) was associated with a specific type of colorectal cancer. Physical activity decreased the risk of this cancer, which has a specific molecular signature.

Weight Loss Surgery May Affect Fat-Related Genes
Source - WebMD

Weight-loss surgery changes the levels of genes involved in burning and storing fat, a new study says.

The findings may help lead to the development of new drugs that mimic this weight-loss-associated control of gene regulation, said the authors of the study published online April 11 in the journal Cell Reports.

Lifestyle and Excess Weight

Exercise can lead to weight loss if you do it for 300 minutes a week, a study suggests
Source - INSIDER
Exercise alone often doesn't cause significant weight loss because it can increase appetite, causing you to eat back the calories you just burned.
What Difference Do Calorie Counts on Menus Make?
Source - WebMD
Calorie labeling requirements for menus in U.S. restaurant chains could save tens of thousands of lives and billions of dollars in health care and other costs, a new study claims.
Eating an Early Dinner Can Help You Burn Fat, Lower Your Blood Sugar
Source - Healthline
Conventional wisdom is that a calorie is a calorie, no matter when you eat it, and that weight gain is caused by eating more calories than you use. Nutritionists call this the calories in, calories out theory of weight control.But it might not be as simple as that. New research discovers that what time you eat may play a significant role in gaining weight.
Intermittent Fasting: Foods to Eat and Avoid
Source - US News
Intermittent fasting involves cycling between periods of eating and fasting.Proponents say intermittent fasting is a safe and effective way to lose weight and improve your health.
Obesity, drinking and unhealthy diet add to gout risk
Source - Reuters
Based on data from more than 14,000 people, researchers calculated how much factors like being overweight, following a diet that isn’t heart-healthy, drinking alcohol or taking water pills known as diuretics contribute to high levels of uric acid, known as hyperuricemia, which is a precursor to gout.
The Downside of Having a Sweet Tooth
Regular consumption of sugary drinks heightens the risk not only of tooth decay, obesity, fatty liver disease and Type 2 diabetes, but also of heart disease and premature death.
Morning Exercise May Offer the Most Weight Loss Benefits
In a study, people who worked out before noon lost more weight, on average, than those who typically exercised after 3 p.m.
Are Fruit Juices Just as Unhealthy as Sugar-Sweetened Beverages?
Source - JAMA
Fruit juices are still widely perceived as a healthier option than SSBs. However, they often contain as much sugar and as many calories as SSBs. Although the sugar in 100% fruit juices is naturally occurring rather than added, once metabolized, the biological response is essentially the same.
Learning to eat again: Man drops 130 pounds after surgery
Source - CNN
Debbie Benzine lost her first husband to heart disease when he was 44. His death left her to raise a young child alone. For 16 years, she stayed single because, “going through it once was enough for me.”
Cutting 300 Calories a Day Shows Health Benefits
Calorie restriction led to weight loss, lower cholesterol and less inflammation. Whether it extends life span and wards off disease long-term remains unproven.
A Probiotic for Obesity?
People with metabolic disorders may benefit from supplements of a common gut bacterium, a small pilot study suggests.
Are Fruit Juices Just as Unhealthy as Sugar-Sweetened Beverages?
Source - JAMA
Fruit juices are still widely perceived as a healthier option than SSBs. However, they often contain as much sugar and as many calories as SSBs. Although the sugar in 100% fruit juices is naturally occurring rather than added, once metabolized, the biological response is essentially the same.
Sleeping With the Lights on Tied to Weight Gain
The mechanism is unclear, but the researchers suggest that light may disrupt sleep enough to change levels of appetite-regulating hormones or cause daytime sleepiness that reduces physical activity.
A Possible Weight Loss Strategy: Skip Breakfast Before Exercise

A new study finds that the choice to eat or omit a meal before an early workout could affect our relationship to food for the rest of the day.

Skipping breakfast before exercise might reduce how much we eat during the remainder of the day, according to a small but intriguing new study of fit young men.

The study finds that the choice to eat or omit a meal before an early workout could affect our relationship to food for the rest of the day, in complicated and sometimes unexpected ways.

Are your friendships giving you a boost or bringing you down?

Are you spending time with the right people for your health and happiness?

While many of us focus primarily on diet and exercise to achieve better health, science suggests that our well-being also is influenced by the company we keep. Researchers have found that certain health behaviors appear to be contagious and that our social networks — in person and online — can influence obesity, anxiety and overall happiness.

Seriously, Juice Is Not Healthy
Obesity affects 40 percent of adults and 19 percent of children in the United States and accounts for more than $168 billion in health care spending each year. Sugary beverages are thought to be one of the major drivers of the obesity epidemic. These drinks (think soda and sports drinks) are the largest single source of added sugars for Americans and contribute, on average, 145 added calories a day to our diets. For these reasons, reducing sugary beverage consumption has been a significant focus of public health intervention. Most efforts have focused on sodas.
Do Fathers Who Exercise Have Smarter Babies?

Exercise changes the brains and sperm of male animals in ways that later affect the brains and thinking skills of their offspring, according to a fascinating new study involving mice.

The findings indicate that some of the brain benefits of physical activity may be passed along to children, even if a father does not begin to exercise until adulthood.

Bedroom TVs associated with childhood obesity

Kids who have a TV in their bedroom are at a significantly higher risk of obesity and a larger waist circumference.

This finding came from a study in American Journal of Preventive Medicine which showed that a child’s waist size may greatly increase with prolonged TV viewing. The research is similar to a prior report which indicated that children’s muscular fitness decreases the more hours they spend watching TV, while their waistline gets bigger.

How to Be Better at Stress
Stress is unavoidable in modern life, but it doesn't have to get you down. Work, money and family all create daily stress, while bigger issues like politics and terrorism contribute to our underlying stress levels.
Effects of Advice to Drink 8 Cups of Water per Day in Adolescents with Overweight or Obesity
Source - JAMA
Importance Health care professionals commonly recommend increased water consumption, typically to 8 cups per day, as part of a weight-reducing diet. However, this recommendation is based on limited evidence and virtually no experimental data from the pediatric population.
Lifespan Weighed Down by Diet
Source - JAMA
Since the end of the Civil War until the late 20th century, lifespan increased rapidly in the United States, a tremendous public health triumph brought about by a more dependable food supply, improved sanitation, and advances in medical care. In 1850, life expectancy among whites was an estimated 38 years for men and 40 years for women.
Failure of Non-Metabolic Weight Loss Regimens
Contestants lost hundreds of pounds during Season 8 of the Biggest Loser, but gained the weight back. A study of their struggles helps explain why so many people fail to keep off the weight they lose.
Obesity and pain linked, study of one million Americans shows
Source - Science Daily

A clear association between obesity and pain — with higher rates of pain identified in the heaviest individuals — was found in a study of more than one million Americans published January 19 in the online edition of Obesity. In “Obesity and Pain Are Associated in the United States,” Stony Brook University researchers Arthur A. Stone, PhD., and Joan E. Broderick, Ph.D. report this finding based on their analysis of 1,010,762 respondents surveyed via telephone interview by the Gallop Organization between 2008 and 2010

.”We wanted to explore this relationship further by checking to see if it was due to painful diseases that cause reduced activity, which in turn causes increased weight,” says Joan E. Broderick, Ph.D., Associate Professor in the Department of Psychiatry and Behavioral Science and School of Public Health at Stony Brook University, and lead investigator of a National Institutes of Health-funded study on how arthritis patients manage their own pain.

Dieting and Medical Therapy vs. Bariatric Surgery

Seven dangerous myths about weight loss — or are they little white lies?
Source - Forbes
The cover copy of a thousand magazines was attacked this morning in the august pages of the New England Journal of Medicine by Krista Casazza, David B. Allison, both from the University of Alabama, Birmingham, and a long list of co-authors. Much of what you’ve been told about weight loss is wrong and, in the current style of journalists everywhere, they break these misconceptions down into a list of widely-held myths, which they then attack with dry academic savagry.
More Evidence Metabolic Surgery Superior to Drug Treatment in Patients With Obesity
Source - ASMBS
Metabolic or bariatric surgery was significantly more effective than medical management in treating type 2 diabetes in patients with milder forms of obesity, according to new research presented here at an American Society for Metabolic and Bariatric Surgery (ASMBS) national clinical symposium on obesity prevention, treatment and research.
Surgery for Diabetes May Be Better Than Standard Treatment

Two studies have found that weight-loss operations worked much better than the standard therapies for Type 2 diabetes in obese and overweight people whose blood sugar was out of control. Those who had surgery, which stapled the stomach and rerouted the small intestine, were much more likely to have a complete remission of diabetes, or to need less medicine, than people who were given the typical regimen of drugs, diet and exercise.

The surgery also helped many to lower their blood pressure and cholesterol.

Short Answers to Hard Questions About Weight Loss
Almost everyone who has ever dieted knows how hard it is to keep the weight off. And almost everyone, including many scientists, has wondered what works.