XIX World Congress on Obesity Surgery, Montreal

XIX World Congress on Obesity Surgery, Montreal


XIX World Congress on Obesity Surgery, Montreal

Posted: 27 Aug 2014 05:00 AM PDT

ifso14 logoFor the rest of this week I will be reporting from the XIX World Congress of the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) here in Montreal, Canada.

Although I am not a surgeon, staying up to date on all aspects of bariatric surgery is essential for anyone working in the field of bariatric care – and advances there are.

But I am not just here to listen. This morning, together with my colleague Sean Wharton, I will be presenting a 4 hour masters course on obesity management for allied health professionals and later today, I will be presenting a talk on the use of the Edmonton Obesity Staging System as a better way to determine the risk and prognosis of bariatric patients.

I certainly look forward to an intense week of learning and networking in this wonderful city.

@DrSharma
Montreal, QC

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Does Facebook Use Promote Eating Disorders?

Does Facebook Use Promote Eating Disorders?


Does Facebook Use Promote Eating Disorders?

Posted: 26 Aug 2014 05:00 AM PDT

facebook_button_eu3gSocial media are not just a means of sharing your life with the world – they also open your life to praise (likes and positive comments) or criticism.

Thus, it is easy to see how avid use of such platforms (especially those with ample picture posts) can potentially promote body image and weight obsessions in those who may not be quite confident and happy about their appearance.

That this may not just be an interesting theory is suggested by two studies by Annalise Mabe and colleagues from Florida State University, published in the International Journal of Eating Disorders.

In the first study 960 female college students completed an Eating Attitudes Test that included Dieting and Bulimia/Food Preoccupation subscales with items such as "I eat diet foods" and "I give too much time and thought to food."

Duration of Facebook use was assessed with the question "How much time do you spend on Facebook per week?" with options ranging from 0 to >7 hours (average used tended to be just over 2 hours per week).

This study found a small but statistically significant positive relationship between the duration of Facebook use and disordered eating.

In the second study, 84 women, who had participated in the first study and endorsed Facebook use on a weekly basis were randomization to either spending 20 mins on their facebook account or finding information about the ocelot on Wikipedia and YouTube.

Participants with greater disordered eating scores endorsed greater importance of receiving comments on their status, and greater importance of receiving "likes" on their status. Those with greater eating pathology reported untagging photos of themselves more often and endorsed comparing their photos to their female friends’ photos more often.

Participants in the control group demonstrated a greater decline in weight/shape preoccupation than did participants who spent 20 min on Facebook. Furthermore post hoc comparisons supported a significant decrease in weight/shape preoccupation in controls.

Facebook use resulted in a preoccupation with weight and shape compared to an internet control condition despite several multivariate adjustments.

As the authors discuss, their finding,

“indicates that typical Facebook use may contribute to maintenance of weight/shape concerns and state anxiety, both of which are established eating disorder risk factors.”

In terms of practical implications of these findings, the authors suggest that,

“Facebook could be targeted as a maintenance factor in prevention programs. For example, interventions could address the implications of appearance-focused comments such as "you look so thin" or "I wish I had your abs," in perpetuating the thin ideal on Facebook, much as "fat talk" perpetuates this ideal in everyday conversations. An adaption of the "Fat Talk Free" campaign as well as adaptations of media literacy programs could encourage girls and women in the responsible use of social media sites.”

Clearly, this appears to me as a rather fertile area for further research.

I’d certainly be interested in hearing about your experience with facebook and any effects it may have had on your body image or eating behaviours.

@DrSharma
Edmonton, AB

ResearchBlogging.orgMabe AG, Forney KJ, & Keel PK (2014). Do you “like” my photo? Facebook use maintains eating disorder risk. The International journal of eating disorders, 47 (5), 516-23 PMID: 25035882

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How Does Bariatric Surgery Work?

How Does Bariatric Surgery Work?


How Does Bariatric Surgery Work?

Posted: 25 Aug 2014 05:00 AM PDT

sharma-obesity-gastric_bypass_roux-en-y3Regular readers will be well aware of the fact that bariatric (unfortunately, often referred to as “weight-loss surgery”) is currently the most effective treatment for severe obesity.

However, exactly why and how surgery works remains unclear. Earlier concepts of surgery working either because it creates a mechanical restriction to food intake and/or reduces caloric load due to malabsorption are not borne out by newer studies.

Rather, it seems that complex neurohormonal changes together with often profound changes in ingestive behaviour act together to account for the resulting weight loss (and more importantly) for the long-term weight-loss maintenance.

Just how many factors interact in specific and unspecific ways to lower body weight is now discussed in a review paper by Timothy Sweeney and John Morton, from Stanford University, in a paper published in Clinical Gastroenterology.

As the authors discuss, there is a complex interaction between a wide range of factors including several hormones (leptin, ghrelin, adiponectin, glucagon-like peptide 1 (GLP-1), peptide YY, and glucagon), bile acid changes in the gut and the serum, and changes to the gut microbiome.

The most profound changes in these systems are seen with the roux-en-Y gastric bypass, which induces large and distinctive changes in most measured fat and gut hormones, including early and sustained increase in GLP-1, possible through intestinal bile acid signaling. This may well explain why this operation appears to be the most effective and durable procedure.

Clearly, hope remains that by better understanding the exact mechanisms through which surgery (which will only ever be available to a vanishingly small minority of people with excess weight) works, we will identify mechanisms and targets for desperately needed pharmacological treatments.

@DrSharma
Edmonton, AB

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Obesity Weekend Roundup, August 22, 2014

Obesity Weekend Roundup, August 22, 2014


Obesity Weekend Roundup, August 22, 2014

Posted: 24 Aug 2014 05:00 AM PDT

As not everyone may have a chance during the week to read every post, here’s a roundup of last week’s posts:

Have a great Sunday! (or what is left of it)

@DrSharma
Edmonton, AB

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Do Bite Counters Count Bites?

Do Bite Counters Count Bites?


Do Bite Counters Count Bites?

Posted: 22 Aug 2014 05:00 AM PDT

bite counterWith the current electronic self-montioring craze, it was only a matter of time before someone would try to come up with a device that counts the number of bites it takes you to finish a meal.

The device (Bite Counter), is worn no the wrist of the dominant hand and contains a tri-axial accelerometer that detects an upward, arcing motion from the table to the mouth.

Now a study by Jenna Desendorf and colleagues from the University of Tennessee, tested the accuracy and validity of this device in 15 adults (23–58 years old) while eating a meal consisting of foods/beverages, each consumed with different utensils: meat (knife and fork), side items (fork), soup (spoon), pizza (hands), can of soda (hands), and a smoothie (straw), while being observed them through a one-way mirror and counted the number of bites taken.

As the paper, published in Eating Behaviors reports, the overall accuracy of the device was around 80%. However, this varied substantially between foods: meat (127%), side items (82.6%), soup (60.2%), pizza (87.3%), soda (81.7%), and smoothie (57.7%).

So, while this device may well underestimate the number of bites taken during a mixed meal, the real question is what people will start monitoring next – number of chews? (I joke about this on my show) Saliva flow? Numbers of swallows per bite? Oesophageal transit time?

I can perhaps see some research applications but as a way to help improve your eating?

The company claims that limiting your number of daily bites to 100 will help you lose weight.

I am yet to be convinced.

@DrSharma
Edmonton, AB

ResearchBlogging.orgDesendorf J, Bassett DR Jr, Raynor HA, & Coe DP (2014). Validity of the Bite Counter device in a controlled laboratory setting. Eating behaviors, 15 (3), 502-4 PMID: 25064306

 

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