Tuesday, July 31, 2012

Predicting Who Is Likely to Succeed at Weight Loss

Obesity is a serious disease. And researchers throughout the world are trying to find ways to fight obesity. Obesity increases the incidence of comorbid illnesses and puts strains on a country’s budget. About a third of the U.S. population is obese. Therefore, establishing workable approaches to weight loss and weight control are important objectives. Moreover, predicting which overweight persons are likely to succeed at weight loss can lead to better selection criteria and more targeted weight loss methods.

A recent study found that ‘some individuals begin obesity treatment weighing more than they did at pretreatment assessment. Weight fluctuations between baseline screening and the first treatment session were examined among individuals enrolling in a group behavioral obesity treatment outcome study.’

This means, as the researchers indicated, that the characteristics of those persons who gain weight between assessment and the commencement of weight loss treatment should be examined, and compared to the characteristics of those persons who don’t gain weight during this period. This will allow markers to be discovered that can help predict the patients who are likely to adhere to the required lifestyle changes.

Another recent study shows that ‘Behavioural weight management interventions” can “produce 8-10% reductions in body weight, yet most participants regain weight after treatment ends.” The researchers conclude that “extended care is a viable and efficacious solution to addressing long-term maintenance of lost weight.’

If the use of markers that predict lifestyle change adherents are combined with extended care, weight loss treatment might be improved. And if the public is exposed to more calorie-related information and an environment that promotes physical activity, a dent in the obesity epidemic will likely be made. As we’ve stated in the past, weight loss centers should put special emphasis on better counseling and information delivery programs. These programs can help the obese individual achieve initial weight loss and adapt to a lifetime weight maintenance program.

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Tuesday, July 17, 2012

Using Appropriate Criteria, Bariatric Surgery May be Warranted for Some Adolescents

Bariatric surgery is being used more and more today to fight obesity. And the surgery is effective. In general, to be considered for bariatric or weight-loss surgery, a person’s BMI must be greater than 40. However, an obese person with a BMI greater than 35 can also be considered for the surgery if that person has comorbidities such as diabetes or high blood pressure. And usually, the obese person must be at least eighteen years old to be considered for the surgery.  However, that guideline might change.

With the increase in obesity in persons less than eighteen, bariatric surgery is gaining more consideration as an adolescent obesity treatment.  A past Washington Post article indicated that “As obesity among young people continues to rise, a growing number of clinicians and researchers say that weight-loss surgery may be their best chance to take off significant weight and either correct or avoid such conditions as diabetes and heart disease, which often go hand-in-hand with obesity.”

Indeed, the surgery may be appropriate for some adolescents, but many adolescents who might gain from the surgery decide against the surgery.  A recent study abstracted at Pubmed describes a randomized controlled study and other investigations showing that bariatric surgery may be appropriate for some adolescents. Some “studies demonstrate relative safety along with significant weight loss [among obese adolescents]. In addition, the vast majority of obesity-related comorbidities are resolved following these procedures."

However, even when bariatric surgical providers establish a selection process, and offer the surgery to adolescents wanting the surgery, in the end, most of the qualifying obese adolescents refuse the surgery. According to one study, ‘Most [adolescent] patients initially wanting bariatric surgery changed their minds. The treatment failure criterion presented a paradox, because most patients who met the criterion exhibited difficulty in making the lifestyle changes.’

The high refusal rate illuminates the importance of effective counseling. When bariatric surgery has been determined to be the best approach to an obese adolescent’s weight problem, counseling the patient so that he or she is prepared for the required lifestyle modification is imperative. Having good counseling programs in place can enable a center to boost any patient's chances of meeting weight loss goals.

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