Friday, December 17, 2010

The CDC Underestimated the Overweight Problem

In 2005, CBSNews reported on a study by the Centers for Disease Control (CDC) that showed "that people who are modestly overweight actually have a lower risk of death than those of normal weight." The CDC's conclusions created a lot of confusion, because they implied that being overweight was not the serious problem Americans had been led to believe. Well, a new study published in the New England Journal of Medicine concludes that both obesity and overweight are "associated with increased all-cause mortality."
The study is further summarized on WebMD. Although the study pooled data from research where the subject population consisted of white adults, we believe that the results apply to most population groups. So, contrary to the CDC's 2005 conclusions, being just a little overweight increases your risk of death compared to someone of normal weight.
Indeed, the WebMD summary shows that if your BMI is between 25.0 and 29.9, your risk of death increases by 30%; if your BMI is between 30 and 34.9, your risk of death increases by 44%; if your BMI is between 35.0 and 39.9, your risk of death increases by 88%; and if your BMI is between 40 and 49.9, your risk of death increases by 251%.
Although the significance of being overweight is becoming more and more apparent, weapons to combat the problem are not being created fast enough. In fact, the number of weapons is decreasing. Sibutramine (Meridia) was recently taken off the market for health reasons, and two promising new weight loss drugs, qnexa and lorcaserin, were rejected by the FDA this year. Still, there are two recent bright spots in the fight against overweight and obesity.
The FDA is considering a reduction in BMI guidelines normally used for lap band surgery. Currently, it is recommended that a person have a BMI greater than 40, or a BMI between 35 and 40, with weight related comorbidities, in order to to be considered for bariatric surgery.

However, the FDA is considering lowering these guidelines by five points. Under the new guidelines, an obese person with a BMI of 35 would be a candidate for the surgery, and someone with a BMI between 30 and 35 would be a candidate, if the person has certain weight related comorbidities.

Another bright spot in overweight and obesity weaponry is the possible addition of a new FDA approved weight loss drug. The drug, contrave, has received the recommendation of an FDA panel.

However, even in light of these bright spots, there is a dearth of tools available to fight the overweight and obesity problems. So we must learn to use the tools we now have more effectively. This reality puts pressure on bariatric surgeons and physicians specializing in nonsurgical medical weight loss. This reality also offers opportunities for these two groups of physicians to work together.

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