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    Fizzy Drink Peddlers at Their Worst

    August 30th, 2016

    soda-can-tabs
    For anyone interested in health, and especially in obesity prevention, there is truly no end of amazement and amusement in the preposterous nonsense spewed by the sugar-sweetened beverage industry.

    Last fall, Prof. Peter J. Rogers of the University of Bristol was interviewed by MedicalResearch.com about the astonishing assertion that diet soda has no connection with excess weight. His study was published by the International Journal of Obesity, and the Medical Research interviewer asked about its background. Apparently, low-calorie sweeteners had received a bum rap.

    The bad reputation came, allegedly, from “selective reporting of studies and outright speculation,” and this team of researchers set out to clean up diet soda’s besmirched name. “Our aim,” Prof. Rogers told the interviewer, “was to review the totality of evidence on this subject.”

    His other statements included the idea that “Indeed, in some contexts low-calorie sweeteners may be better than water perhaps…” and while a scientist may get away with using an honest qualifier when the results are not crystal clear, the use of two of them — “may” and “perhaps” — in the same sentence, reminded critics of what are commonly called “weasel words.”

    When asked what recommendations the findings might suggest, Prof. Rogers said that having a low-calorie sweetened drink might reduce a person’s desire for dessert.

    The original article can be seen here and the most interesting part is the Conflict of Interest section, in which several of the study authors declare grants from Sugar Nutrition, UK; from the Dutch Sugar Bureau, and from Canderel (manufacturer of aspartame artificial sweetener), as well as other connections that might be considered improper.

    After the year-end holiday clamor had passed, several interested media outlets commented on the study, some with a rather shrill tone. This excerpt is from a mild-mannered one:

    Scientific research claiming that diet drinks could be better than water at helping people lose weight was funded by an industry body which includes Coca-Cola and PepsiCo among its members…

    That “industry body” is ILSI Europe, which paid fees of around £750 ($1,000 USD) to some of the co-authors. Journalist Jonathan Owen went on to say:

    Although more than 5,500 papers were reviewed, the comparison of diet drinks with water was based on just three. Two did not find any significant statistical difference in weight loss, and only one paper, funded by the American Beverage Association, found that those drinking diet drinks were more likely to lose weight.

    Wow, talk about “selective reporting”! Perhaps the study authors should be congratulated for their persistence in plowing through 5,500 scientific reports to find one that supported the result they were looking for. But the Alliance for Natural Health noted that…

    […] women who drink diet sodas are much more likely develop heart disease and even die than other women. Women who consumed two or more diet drinks a day were 30% more likely to have a heart attack or other cardiovascular “event,” and were 50% more likely to die than women who rarely drink diet sodas.

    They also called the Rogers study “bizarre” and scolded, “Liar, liar, pants on fire,” before finishing up with:

    Shame on those involved in this for thinking that their manufactured, aspartame-filled beverages can improve upon water — the essence of life!

    Your responses and feedback are welcome!

    Source: “Low Calorie Sweeteners Not Linked To Weight Gain,” MedicalResearch.com, 11/12/15
    Source: “A recent study that said Diet Coke can help you lose weight was quietly funded by Coca-Cola,” independent.co.uk, 01/17/16
    Source: “‘Diet Coke Is Healthier than Water!’,” anh-usa.org, 02/02/16
    Photo credit: Allison Matherly via Visualhunt/CC BY

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    What Else Might a Microbiome Study Accomplish?

    August 29th, 2016

    abs-of-steel
    Childhood Obesity News looked at the possibility that working with the microbiome could make anorexia obsolete. There have been tantalizing glimpses of what might be in store for the fields of addiction and autism, and hope for the possibility of banishing even such an unromantic condition as Irritable Bowel Syndrome.

    There is some kind of link between the microbiome, food allergy, and addiction. In the realm of food, bread and cheese are two monstrously powerful addictors. By strange coincidence, gluten and casein are two of the most common food allergens. The allergic reaction triggered in the digestive tract is partly the work of the resident bacteria. The immune system goes nuts, and next thing you know, inflammation is widespread. Systemic inflammation has been seen to connect with obesity.

    Alcohol increases the permeability of the intestinal lining, a circumstance that can’t help but impact the microbiota. When opiates hit the system, gut bugs demonstrate their objections in dramatic ways. Throw into that mix the fact that stress affects the bugs, and the bugs affect stress.

    The microbiome can affect the thought processes and emotions. The mind and emotions have a great deal to do with a person’s proneness to addiction. There are powerful indications that, when science finally puts it all together, an inexpensive, organic cure might be found for at least some addicts — which is much better than none.

    Some studies approach either obesity or addiction by way of cravings. A very recent ScienceDaily.com headline states that “Cravings for high-calorie foods may be switched off in the brain by new supplement.”

    This is the kind of news that people want to hear. The supplement is inulin-propionate ester. When it hits the intestines, it releases more propionate than inulin does. Propionate is a molecule that signals the brain to reduce appetite.

    Where does it come from? It is excreted by gut bacteria after they ingest inulin, which is a fiber. The researchers hypothesize that some people naturally produce more propionate than others, and have an easier time staying slim. This suggests that modifying the microbiome could make a difference.

    It was a small experiment, believed by co-author Dr. Douglas Morrison to shed new light on how the gut microbiome, the diet, and individual’s general health are all “inextricably linked.” The subjects drank shakes that contained either inulin or inulin-propionate ester. Then, they had MRI scans while being shown pictures of high-calorie or low-calorie foods.

    The author of the original article that was reprinted on ScienceDaily.com Kate Wighton says:

    The team found that when volunteers drank the milkshake containing inulin-propionate ester, they had less activity in areas of their brain linked to reward — but only when looking at the high calorie foods. These areas, called the caudate and the nucleus accumbens, found in the centre of the brain, have previously been linked to food cravings and the motivation to want a food.

    In other words, inulin-propionate ester reduces cravings for high-calorie foods, and appetite in general. Senior author Prof. Gary Frost says the supplement, available in powdered form, “can decrease activity in brain areas associated with food reward at the same time as reducing the amount of food they eat.”

    Inulin-propionate ester is also produced by gut bacteria, but in a laboratory. It might turn out to be the next “silver bullet” cure, or just another daydream.

    In a bravura display of diverse talents, the microbiota can also apparently cause malnutrition, because certain bacteria in malnourished children lack “both the ability to synthesize vitamins and the ability to digest complex carbohydrates.” Dr. Jeffrey Gordon says:

    […] bacteria might cause malnutrition even in someone whose diet would otherwise be sufficient to sustain him. It might thus be possible to treat quite a lot of malnutrition by rejigging a sufferer’s gut bacteria.

    Your responses and feedback are welcome!

    Source: “Cravings for high-calorie foods may be switched off in the brain by new supplement,” ScienceDaily.com, 07/01/16
    Source: “Me, myself, us,” Economist.com, 08/18/12
    Image by Eyesplash

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    What Might a Microbiome Study Accomplish?

    August 26th, 2016

    apple-a-day
    A lot of researchers have found evidence that, even though the path might not be direct, gut permeability can indirectly lead to obesity. When junk molecules sneak through the unauthorized holes and enter the bloodstream, the body defends by setting up the reaction we call inflammation, and multiple bad outcomes can ensue.

    This is why the old saying, “An apple a day keeps the doctor away,” may be literally true. Asher Preska Steinberg, co-author of a Caltech study, says, “It’s too early to draw any conclusions, but it may be that eating an apple a day will affect the shape of the lining in your gut.”

    The study had set out to discover what happens when the gel layer encounters different kinds of polymers. But what is the gel layer, and why should we care?

    The university’s website says:

    Our intestinal tracts are lined with a mucus gel that acts as a protective barrier between the insides of our bodies and the outside world. The gel lets in nutrients and largely blocks out bacteria, preventing infections. It also regulates how some drugs are delivered elsewhere in our bodies.

    A whole list of co-existing factors is suspected of contributing to the leaky gut syndrome, and its mysteries are far from explained. Scientists were already aware that the bacterium H. pylori makes holes in the stomach lining to burrow in and protect itself from the acidic environment, and those same holes allow acid to escape into places where it doesn’t belong.

    Also, they had learned that the gel (the mucus lining of the gut) can change rapidly. It is described as being something like a sponge, with natural holes that are compressed by some substances, including polymers like dietary fiber. This appears to offer protective value. In mice that had been raised germ-free, the compressive effect was greater.

    The report quotes team member Dr. Rustem Ismagilov:

    This implies that species of bacteria in our gut that are known to break down polymers can weaken the compressing effect. We previously thought of the gel as a static structure, so it was unexpected to find an interplay between diet and gut microbiota that rapidly and dynamically changes the biological structures that protect a host.

    The condition known as the Irritable Bowel Syndrome (IBS) is also under scrutiny, and is not completely understood, but connections have been observed between its symptoms and the presence of bacterial overgrowth in the small intestine. People with more severe IBS are found to have more than is considered normal of some types of bacteria, and less of others.

    In particular, their aerobe to anaerobe ratio is increased, in comparison with the norm. What this may mean in terms of eventually alleviating this condition is unknown, but the signs look hopeful.

    Your responses and feedback are welcome!

    Source: “Dietary Fiber and Microbes Change the Gel That Lines Our Gut,” Caltech.edu, 06/13/16
    Source: “The Interplay of the Gut Microbiome, Bile Acids, and Volatile Organic Compounds,” NIH.gov, 03/03/15
    Photo credit: Valerie Everett via Visualhunt/CC BY-SA

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    Appetite, Its Lack, and the Microbiome

    August 25th, 2016

    kid-eating-pizza
    One way we can think of the microbiome is as an organ. According to The Economist,

    An organ does not have to have form and shape… The immune system, for example, consists of cells scattered all around the body but it has the salient feature of an organ, namely that it is an organized system of cells.

    Childhood Obesity News has been exploring the connections between the microbiome and various other things, and between those various other things and obesity. Many questions remain to be answered, but it appears that the microbiome is able to influence appetite and its delinquent sister, craving.

    Difficult as it might be to imagine in the midst of the obesity epidemic, the eating disorder called anorexia nervosa (AN) is still much dreaded. In search of a preventative, Japanese researchers…

    […] studied 25 women with AN and compared their microbiomes to 21 age-matched healthy females. They found that AN patients had a lower amount of total bacteria and specifically, lower amounts of C. coccoides group, C. leptum subgroup, B. fragilis, and Streptococcus.

    It has been shown that a lack of eating goes along with a decrease in gut flora diversity and a less-than-optimal microbiome.

    Nutritionist and trainer Sean Croxton works on the premise that when a person doesn’t take in enough calories, the leptin levels aren’t right, which results in a craving for carbohydrates. Some of the organisms in us are called fat-inducing microbiota, because they can cause the body to resist leptin.

    However, the causation/correlation ratio between various bugs and a multitude of reactions has yet to be determined. One study, published in Psychosomatic Medicine, showed that a patient’s Clostridia population can be rebuilt, if that turns out to be desirable.

    It does seem that working with the gut bacteria could put an end to anorexia. AN is particularly challenging and tantalizing to researchers because the majority of anorexia patients also suffer from depression. The Microbiome Institute says,

    In terms of the mental health aspect of anorexia and the microbiome, the researchers found a direct association between eating disorder psychopathology and microbiome diversity, with lower diversity corresponding to worse eating disorder psychopathology. The same was true for depression, as the degree of depression was inversely correlated with bacterial diversity.

    Your responses and feedback are welcome!

    Source: “Me, myself, us,” Economist.com, 08/18/12
    Source: “Microbiome therapies may be an option for treating anorexia nervosa,” MicrobiomeInstitute.org, 01/07/16
    Source: “The anorexia nervosa gut microbiome differs from healthy controls and is related to mental health,” MicrobiomeInstitute.org, 10/13/15
    Source: “The Dark Side of Fat Loss with Sean Croxton,” BulletproofExec.com, undated
    Photo credit: mind on fire (John Nakamura Remy) via Visualhunt/CC BY-SA

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    Stomach Pump Backlash

    August 24th, 2016

    pierced-belly
    Anyone who has followed along with “Newfangled Gizmo — the Reverse Feeding Tube” and “More on the Personal Stomach Pump” will recall that the device/system is designed to extract stomach contents that have barely begun the digestive process. As a result, a person can savor all the captivating sensations of aroma, mouth feel, texture, taste, chewing, and swallowing, without paying the weight-gain consequences. Of course this invention has been compared to high-tech bulimia.

    It is also reminiscent of the legendary vomitorium, a special room where Roman dinner guests could empty their stomachs and return, refreshed, to feast more. Actually, the vomitorium in that sense of the word didn’t exist. The myth was started by one writer about 50 years ago. Despite the reputation for decadence enjoyed by the ancient Romans, they never sank quite that low. It took contemporary American ingenuity to perfect the science of wasting food.

    How old is old enough?

    As we learned, AspireAssist is meant to be prescribed only to people age 22 and above. Maybe that will change; maybe it won’t. Either way, 22 could still include college students, and let’s hope they don’t decide to experiment with the device as a means to avoid a hangover after drinking too much alcohol. Inspired by TV depictions of emergency tracheotomies, will some kid think he can reverse a friend’s drug overdose by stabbing him in the stomach with a ball-point pen and applying the suction gear?

    In a more mundane scenario, it is easy to envision someone frantically scrambling to unplug the drain tube with a knitting needle, unbent wire hanger, or other unsanitary object, because of not having the time or money for a doctor appointment.

    Erika Nicole Kendall, an NASM-certified trainer who “lost 170 lbs on my own through diet and exercise,” has major doubts about AspireAssist and no hesitancy about expressing them:

    How do we explain this to all of the bulimics, in recovery, who used the binge and purge system as a means of weight management… How do we explain to bulimics that the logic behind why they did what they did was wrong, but so long as they gave some money to big pharma, they could have medically assisted bulimia? This device is enabling emotional eaters. This device enables people to eat their feelings…

    Kendall also wonders if having the device might “compel them to become just as addicted to their precious stomach pump as they already are to the food they keep consuming.” She worries about infection, what with the skin port being basically an eternally open wound.

    Can people who have this go swimming? And what about intimate situations? A grownup who slims down might want to get into some serious dating. With a supernumerary plastic belly-button, how does that work out?

    Kendall, who calls this “the greatest big pharma scam ever in the history of big pharma scams,” raises another excellent question. If the candidates for AspireAssist were amenable to changes in their eating habits, such as they are expected to make once the device is installed, why didn’t they just make those changes, and forget about the stomach-hole solution?

    She points out a huge liability. Because all that mandatory chewing is an exhausting hassle, the person is tempted to stick with “smooth, soft, dissolving food that will probably obliterate your blood sugar and cause any number of components of metabolic syndrome.” Kendall goes on to say:

    Check this out. You can’t eat the things that promote weight loss, you can only eat the things that promote weight gain… which is why you need — need — to keep wearing the device long term.

    Normally, when a person undergoes abdominal surgery, one of the most horrifying prospects is the necessity for an ileostomy or colostomy. Who wants to walk around with a hole in the front of their torso that they have to empty waste from? But apparently, some people don’t mind so much.

    Imagine this future for today’s overweight and obese kids. Will so many grow up to be so intractably heavy that the apparatus of the personal stomach pump will become the norm? And even fashionable? Will we wake up one day to find that the skin port is the new navel ring?

    Your responses and feedback are welcome!

    Source: “Vomitoriums: Fact or Fiction?,” History.com, 11/20/12
    Source: “Friday 5: Five Things VERY Wrong With A Personal Stomach Pump,” BlackGirlsGuideToWeightLoss.com, 03/24/14
    Photo credit: jammmick via Visualhunt/CC BY

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    More on the Personal Stomach Pump

    August 23rd, 2016

    spigot-on-the-wall
    To get up to speed, see yesterday’s post on the reverse feeding tube, and we will consider the lifestyle changes involved in having one of these installed. What is it like to live with AspireAssist?

    Sara G. Miller interviewed Dr. Shelby Sullivan of the Washington University School of Medicine, where clinical trials took place. Like many other professionals, Dr. Sullivan recommends a slow and mindful rate of eating on general principles, because the body then has time to send and recognize its signals of fulness. With the AspireAssist system, very thorough chewing is not suggested as an option, but mandated as an absolute necessity.

    No matter how diligently chewed, the food has to be broken down even more by the stomach. So the person must wait half an hour before retiring to the bathroom with the handy gadget in its carrying case. The steps for use are described in yesterday’s post, and illustrated in a 1:40 video that shows a greatly condensed version.

    But sometimes, the emptying mechanism refuses to work, which can easily happen, especially in the early days to an inexperienced user. The inside diameter of the tube is just under a third of an inch. Food particles need to be no more than .02 inches.

    In other words, to eventually fit through that tube, a piece of food an inch long must be divided in at least five parts. Miller reports:

    Patients need to chew their food up really well, until it basically disintegrates in their mouth, Sullivan said. Otherwise, the food particles will get stuck in the tube, and nothing will come out… A clogged tube won’t cause any pain, and patients can normally clean it out on their own, though as a last resort doctors can clean the tube using a brush…

    In the best-case scenario, the clear evacuation tube provides entertainment. According to Dr. Sullivan, by this time, the fat will have separated out, so globs of it can be seen among the general stream.

    Or, in the case of a healthful meal, the stomach contents may still resemble dinner as it looked on the way in. While the sludge spurts from the device, observing it is said to provide “positive reinforcement for healthier foods and negative reinforcement for unhealthier foods.” In other words, depending on how squeamish the person is, watching the recently-eaten meal exit through the tube can be an extreme form of aversion therapy.

    So. Eat very, very slowly and chew everything until it liquifies. Say, half an hour for that. Then wait an additional half hour, go to the bathroom and do your thing, which is (optimistically) another 15 minutes. Seems like, once the routine is done, it would be time to start the next round. One and a quarter hours per meal, minimum. With two meals, 2.5 hours; with three meals, almost four hours per day, devoted to eating and purging.

    Who has that kind of time? Could anyone handle this, who has children or elders to take care of? And what about an outside job? Imagine trying to cope with this process in the restroom of an office suite, or the port-a-potty on a construction site.

    Then, imagine going through the expensive procedure and daily time-consuming ritual, only to suspect that it was all an exercise in futility. Would there be grounds to believe this? Yes. Critics suggest that any benefits attributed to AspireAssist should actually be credited to the slow eating and thorough chewing alone.

    Next: More stomach pump backlash.

    Your responses and feedback are welcome!

    Source: “Stomach Sucker: How Does New Weight-Loss Device Work?,” LiveScience.com, 06/22/16
    Photo credit: John Loo via Visualhunt/CC BY

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    Newfangled Gizmo — the Reverse Feeding Tube

    August 22nd, 2016

    orange-cooler
    A device called AspireAssist is said to help people lose 31 pounds, or an average 12% of body weight, in the first year. Here’s the spoiler: That first year will cost between $8,000 and $13,000. And the aftercare goes on forever. But we will get back to that.

    While the patient is under twilight anesthesia for about a quarter of an hour, the doctor (not necessarily a surgeon; could be a gastroenterologist) puts a tube in the person’s mouth and maneuvers it until the end reaches its exit point, a hole in the abdomen. The other end winds up in the patient’s stomach. This is the standard procedure to place a feeding tube. However, rather than inputting a nutritional liquid, this tube will serve to evacuate partially digested food.

    But the system is not up and running quite yet. Swollen tissue needs a couple of weeks to shrink. Then a valve, or skin port, is joined to the protruding tube end. Now, the person can attach “a smartphone-sized device” (which has to be carried around at all times) to the valve. It sucks matter from the stomach into a toilet (or flowerpot or kiddie pool — the possibilities are many.)

    It’s not over yet. Next, a little bag is used to force water into the stomach; then the draining process happens again. The number of repetitions is not specified, but the developers estimate that each use of the system takes as long as 15 minutes, and removes about a third of whatever food started out in there.

    Another Step

    This is not an episode that just blends seamlessly into normal life. Medscape.com says:

    As you lose weight and your belly size decreases, the doctor has to shorten the tube so the valve remains against your skin. Also, the device stops working after about 5 or 6 weeks, so you have to return to your doctor to get a replacement part.

    As if that weren’t deterrent enough, the side effects include “occasional indigestion, nausea, vomiting, constipation, and diarrhea.” Also, if too large of a meal was consumed, the tube might refuse to drain, because of the necessity to leave “space in the stomach for food to flow out through the device.” There will be repeated contact with medical professionals.

    The company’s press release says:

    Patients need to be regularly monitored by their health-care provider and should follow a lifestyle program to help them develop healthier eating habits and reduce their calorie intake.

    This means monthly counseling sessions, apparently forever. Maybe W8Loss2Go could help them, at this stage, to get their lives on track.

    A big AspireAssist selling point is that, unlike many types of bariatric surgery, theirs is reversible. But, confusingly, the Food and Drug Administration says it is “not intended to be used for short durations in those who are moderately overweight.”

    Presumably, the goal is to retrain the person’s lifestyle so the apparatus will some day no longer be needed, and the skin port can be removed. But the person is eligible only if morbidly obese, and only if their commitment to the system promises to be a lengthy one. Here is another puzzling caveat from the FDA:

    The AspireAssist device should not be used on patients with eating disorders…

    But overeating to the point of dangerous obesity is an eating disorder.

    Presently, AspireAssist is only recommended for people over the age of 22, but in the bariatric surgery field, those recommendations tend to shift downward pretty quickly. It has been called a brand of high-tech bulimia, whose sole advantage is that it doesn’t dissolve the patient’s teeth enamel like vomiting does. It has been called strange, gross, enabling, and, by a health worker we will discuss tomorrow, “the greatest big pharma scam ever in the history of big pharma scams.”

    Your responses and feedback are welcome!

    Source: “FAQ: New ‘Stomach Pump’ Weight Loss Device,” Medscape.com, 06/20/16
    Source: “Stomach Sucker: How Does New Weight-Loss Device Work?,” LiveScience.com, 06/22/16
    Source: “FDA Approves Stomach Pump Device For Weight Loss,” NaturalSociety.com, 06/17/16
    Photo credit: Barry Pousman via Visualhunt/CC BY

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    A Bouquet of Morbid Obesity Posts

    August 19th, 2016

    bouquet-of-morbid-obesity
    What ExactlyIs Morbid Obesity?” is the question asked by a Childhood Obesity News post, and the answer is, “Nothing you’d want to have.” Unfortunately, millions of children are afflicted with morbid obesity before they even get a chance to have any say in the matter, and it leads to nothing good.

    For an adult, it makes sense to say that anyone 100 pounds or more over their ideal weight is morbidly obese, but kids are smaller, so “severe obesity” is an interchangeable term. Every professional in the field is aware of the importance of early intervention. It is empirically demonstrable that the longer a child remains overweight, the more difficult weight loss becomes.

    According to one theory, after a certain amount of time in the obese zone, the body’s “set point,” the weight it believes it must maintain in order to survive, is recalibrated with such finality that it can never be adjusted downward.

    Dr. Pretlow has learned that kids are honest enough to admit a basic fact: Overeating stretches their stomachs and opens up the potential for those poor abused organs to be stuffed with even more food. A huge European-based research project has shown that the dopamine system of a morbidly obese individual goes all out of whack — like that of an alcoholic or drug addict.

    Psychotherapy is expensive and not widely available, especially for children, but it can help a morbidly obese person with an eating addiction to figure out what’s going on underneath the cupcake fetish.

    All the mental/emotional angles are tricky and vitally important. What circumstances conspire to make a patient “treatment resistant“? Is this person reaping some kind of special attention that builds self-esteem more than being obese tears it down? Is he or she unconsciously trying to prevent the reoccurrence of inappropriate attention, or even assault? What does the fortress of denial protect?

    Statisticians find that extreme obesity in children has been increasing at a more voracious rate that plain old everyday childhood obesity. As a result, millions of kids are going to lose 10 or even 20 years from what would have been their expected lifespans, if they weren’t morbidly obese. This is partly due to the frequent presence of comorbidities, or concurrent disease processes that tend to gang up and cause early death.

    Even worse, every possible co-morbidity that goes along with obesity now manifests in children of younger and younger ages. The problem is not just that their lives will be shorter, but that the years of life they do have will be impeded by health problems that devastate its quality. This topic is explored further in “Childhood Obesity Comorbidities” and its companion piece that also brings in surgery.

    Also recommended are “The Unhealthy Weight Epidemic,” “Morbid Obesity and Motivation,” and “Where Did the World’s Biggest Boy Go?”

    Your responses and feedback are welcome!

    Photo via Visualhunt (modified)

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    Diet, Set Point, and Mindfulness

    August 18th, 2016

    brain-car-illustration
    Everyone in the world is quite literally on a diet, which consists of whatever they eat. A cow may eat grass or grain, but in either case the substance is its diet, and vice versa. In the laboratory sense, “diet” is value-neutral, with no judgment implied.

    Then, there are special cases, like a diabetic diet or a celiac diet, intentional programs or regimes designed to eliminate any substance that will worsen the patient’s medical condition. But for everyday purposes, “diet” colloquially means “reducing diet.” For simplicity, most people say “diet” as shorthand for the concept of pursuing weight loss by consciously limiting caloric intake, which involves eating certain foods and, mainly, not eating other foods.

    The premise behind the work of neuroscientist Sandra Aamodt is, “If diets worked, we’d all be thin by now,” so we know she means diet in the “Get a Bikini Body!” sense. Dr. Aamodt published the book Why Diets Make Us Fat, which explains the research behind the TEDGlobal talk she presented in June of 2013. It answers such questions as, “Why might one person lose 10 times as much weight as another person on the exact same diet?” (A sample is available of her reading of the audio version of the book.)

    What got Aamodt fired up in the first place was the work of Dr. Jules Hirsch, whose 1995 study of caloric intake and energy expenditure reinforced, although it did not invent, the “set-point theory.” The Rockefeller University bio page holds this summary:

    Both obese people and those who had never been obese reduced their energy expenditure when their weight was lower than normal, and burned calories faster when their weight was higher than normal.

    The basic concept is, the set point mechanism can’t distinguish between a reducing diet and a legit survival-threatening famine situation, so it zealously defends its fat stores. The more strenuously a person tries to reach a weight that is below her or his predetermined “set point,” the harder the body will fight back. Thanks to the inexorable power of metabolic suppression, even a person who easily and successfully loses weight will eventually “plateau out.”

    In fact, according to the studies on which Dr. Aamodt bases her theory, getting stuck at a certain weight is the best-case scenario. Because, says an article she wrote for The New York Times:

    After about five years, 41 percent of dieters gain back more weight than they lost. Long-term studies show dieters are more likely than non-dieters to become obese over the next one to 15 years. That’s true in men and women, across ethnic groups, from childhood through middle age.

    For one thing, concern about calorie restriction produces stress hormones, which increases abdominal fat, the dangerous kind. Surprisingly, there is evidence that exercise can reduce abdominal fat and produce health improvements, even when no measurable weight loss is attained. In other words, the scale is not the only measure of health — a finding that has greatly encouraged the Fat Acceptance movement.

    Also, dieting teaches us to respond to external cues like clocks, calendars, scales, and calorie charts. But a brain that is trained to obey external signals is much more likely to respond to TV ads and billboards — which are, of course, full of messages that urge people to eat. What we need to do is focus on internal cues instead. Dr. Aamodt says:

    I recommend mindful eating — paying attention to signals of hunger and fullness, without judgment, to relearn how to eat only as much as the brain’s weight-regulation system commands.

    Your responses and feedback are welcome!

    Source: “Obesity and Metabolism: Why Weight Loss Is Difficult to Sustain,” rucares.org, undated
    Source: “Why You Can’t Lose Weight on a Diet,” NYTimes.com, 05/06/16
    Photo credit: Dave Parker via Visualhunt.com/CC BY

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    Mindfulness and Obesity

    August 17th, 2016

    snack-aisle-piggly-wiggly
    Often, overeaters admit to not even realizing that they are snacking. There are two pragmatic solutions. One is to keep snackable items in a location that can only be accessed with difficulty, like in the basement or up on the highest shelf. Another is to not even bring these tempting pseudo-foods into one’s living quarters in the first place.

    At its most basic level, mindfulness is asking the question, “What am I doing right now?” and being aware of the true answer. It would seem that developing a rudimentary degree of awareness should be possible — enough of it, anyway, for enlightenment to dawn and allow the person to acknowledge that she or he is currently eating. There are probably people who can follow that up by asking themselves, “When I catch myself eating between meals, what is the best thing to do?,” and who can then stop.

    Dr. Pretlow points out a quandary: When emotional eaters realize what they are doing, they still are not able to stop. In the moment, the consequences of emotional eating are overwhelmed by the emotional urgency to either pursue pleasure or, more likely, to escape from pain.

    Yet, mindfulness is widely recommended, so it might be useful to learn more. Two months ago Dr. Pretlow said:

    Our current 4th study has provided a unique glimpse into the minds of obese young people and why they struggle to resist overeating and the forces/feelings that they say drive them to overeat, including the following:

    1) continual thoughts of food that they can’t shake (like a thought form)
    2) a coping mechanism for stress relief or comfort
    3) pleasure and missing out if they don’t eat the food
    4) playing tug of war with the mind — constant decision-making, over giving in or not
    5) boredom, feeling alone, having nothing to do, a void (eating to relieve this)

    Many more in our 4th study have been able to rise above these forces and lose substantial weight. We still haven’t figured out why some are able to rise above these forces while others are not.

    The alert reader will have noticed that everything on that list originates in the mind, and here is an interesting idea that Childhood Obesity News neither endorses nor condemns. In discussing motivation, we mentioned kinesiologist and functional diagnostic nutritionist Sean Croxton.

    One of his current projects is a podcast, “The Sessions.” As a guest on someone else’s podcast, he talked about graduating from college with all the knowledge of health and fitness that he would ever need — or so it seemed.

    But reality intervened, and Croxton saw that he was charging people for advice that didn’t work for them. As a results-oriented trainer, he could not accept this, and began to educate himself from primary sources.

    One thing he found among his clients was a widespread underlying issue called self-sabotage. It wasn’t going to matter much what people ate, or what else they did with their time, if they also insisted on shooting themselves in the foot. This series of excerpts describes the problem as he perceived it, and his solution:

    I feel like some people need to do some work on the inside before we can really focus on their physical nature…

    Mindset is huge. If your mind is not right, then you should probably get it right or go get yourself a new goal.

    The subconscious mind is not in line with the conscious mind, then you’re always going to have that self-sabotage issue no matter what you do.

    I took my butt over to hypnotherapy… and wrote a book.

    I do recommend that some people go get hypnotherapy if they really have a hard time with self sabotage.

    Your responses and feedback are welcome!

    Source: “The Dark Side of Fat Loss with Sean Croxton,” BulletproofExec.com, undated
    Photo credit: ilovememphis via Visualhunt/CC BY-ND

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Childhood Obesity News | OVERWEIGHT: What Kids Say | Dr. Robert A. Pretlow
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