Non-surgical treatment for kids

On January 18, 2010, in Uncategorized, by Andrea

Kids need help.  Badly.  Pediatric obesity is not on the rise — it’s reaching epidemic levels.  And given that many that are affected are low-income, there needs to be options for those families to afford treatment.  Treatment should not be relegated just to those who can afford it.

From MSNBC.com:

Obesity treatment for kids works, panel says

Advice could transform how doctors deal with overweight children

CHICAGO – An influential advisory panel says school-aged youngsters and teens should be screened for obesity and sent to intensive behavior treatment if they need to lose weight — a move that could transform how doctors deal with overweight children.

Treating obese kids can help them lose weight, the panel of doctors said in issuing new guidelines Monday. But that’s only if it involves rigorous diet, activity and behavior counseling.

Just five years ago, the same panel — the U.S. Preventive Services Task Force — found few benefits from pediatric obesity programs. Since then, the task force said, studies have shown success. But that has only come with treatment that is costly, hard to find and hard to follow.

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The good news is, “you don’t have to throw your arms up and say you can’t do anything,” said task force chairman Dr. Ned Calonge. “This is a recommendation that says there are things that work.”

Calonge said the panel recognizes that most pediatricians are not equipped to offer the necessary kind of treatment, and that it may be hard to find, or afford, places that do. The recommendations merely highlight scientific evidence showing what type of programs work — “not whether or not those services are currently available,” he said.

The new advice, published online in the journal Pediatrics, could serve as a template for creating obesity programs. It also might remove one important cost barrier: Calonge said insurers will no longer be able to argue that they won’t provide coverage because treatment programs don’t work.

Evidence the panel evaluated shows intensive treatment can help children lose several pounds — enough for obese kids to drop into the “overweight” category, making them less prone to diabetes and other health problems. The treatment requires appointments at least once or twice a week for six months or more.

The recommendations follow government reports last week that showed obesity rates in kids and adults have held steady for about five years. Almost one-third of kids are at least overweight; about 17 percent are obese.

The task force is the same group of government-appointed but independent experts whose new mammogram advice startled many women in November. That guidance — that most women don’t need routine mammograms until age 50 — is at odds with the American Cancer Society and several doctor groups.

Costly programs
In this case, the task force advice mirrors that of the American Academy of Pediatrics. Many pediatricians already measure their young patients’ height, weight and body mass index at yearly checkups.

Task force recommendations in 2005 said there wasn’t enough evidence to encourage routine obesity screening and treatment. The update is based on a review of 20 studies, most published since 2005, involving more than 1,000 children.

The review excluded studies on obesity surgery, which is only done in extreme cases.

The panel stopped short of recommending two diet drugs approved for use in older children, Xenical and Meridia, because of potential side effects including elevated heart rate, and no evidence that they result in lasting weight loss.

Calonge, chief medical officer for Colorado’s public health department, said evidence is lacking on effective treatment for very young children, so the recommendations apply to ages 6 to 18.

The most effective treatment often involves counseling parents along with kids, group therapy and other programs that some insurers won’t cover. But adequate reimbursement “would be critical” to implementing these programs, Dr. Sandra Hassink, a member of the American Academy of Pediatrics’ board of directors, said in a Pediatrics editorial.

Dr. Helen Binns, who runs a nutrition clinic at Chicago’s Children’s Memorial Hospital, says such programs are scarce partly because they’re so costly. Her own hospital — a large institution in one of Chicago’s wealthiest neighborhoods — doesn’t have one.

Many families with obese or overweight children can’t afford that type of treatment. And it’s not just cost. Many aren’t willing to make the necessary lifestyle changes, she said.

“It requires a big commitment factor on the part of the parent, because they need to want to change themselves, and change family behavior,” Binns said.

Motivation.

On January 15, 2010, in General Nutrition, by Andrea

Really.  This would do it for me I think.

From MSNBC.com:

Floor caves under Weight Watchers weigh-in

No one injured — but dieters might have extra motivation to shed pounds

msnbc.com
updated 4:01 p.m. ET, Fri., Jan. 15, 2010

As a Weight Watchers group gathered for a routine weigh-in, the dieters got an idea of how far they still had to go: The floor underneath them collapsed, a Swedish newspaper reports.

“We suddenly heard a huge thud; we almost thought it was an earthquake and everything flew up in the air,” one of about 20 group members said to the Smalandsposten newspaper. “The floor collapsed in one corner of the room and along the walls.”

After the initial collapse on Wednesday evening, the floor started to cave in other parts of the room, and the stench of sewage crept into the clinic, which is in Vaxjo, a city in south central Sweden. The group is looking for an alternate location for future meetings, Weight Watchers consultant Therese Levin told the Swedish paper.

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No one was injured, and the cause of the collapse is still under investigation.

Afterward, the participants moved the scales to a hallway to have a real weigh-in. That time, the floor held.

High-tech weight loss.

On January 6, 2010, in Uncategorized, by Andrea

Many people have seen the BodyBuggs on The Biggest Loser.  I hadn’t cause I don’t watch that crap, but many have.  I’m going off what people have said — that they were on the show.

In any case, I learned about the things on ObesityHelp.com in the form of a different device, the GoWearFit system — basically the same thing, but a slightly toned down version.  Like BodyBugg v3 or something.

I wanted it.  I got it.  I wore it.  I loved it.

Me.

(See?  It’s there on my arm..)

I loved my little sensor.  It was always with me.. it told me how crappily I slept.  Or how little I didn’t sleep (hey, I’m a busy mom of two, what do you really expect?), and it told me how much I moved.. how much I burned per minute without moving and how much I burned when I did move.  And it kept my ass moving more.  It was handy.

My stats..

And it was great.  I don’t know if it actually helped me to lose weight, but it did tell me things about my resting metabolic rate, and how close / wrong the machines at the gym were for measuring calories burned (FYI — they were off quite a bit for jogging, and fairly close for elliptical).  And it motivated me not to sit on my ass all day long.

But then I hit a period when I stopped going to the gym due to pain issues.  And it was a subtle reminder of how much of a failure I was — seeing my numbers never hit a target and never seeing my weight shift according to their.. recommendations.  Cause they tell you how you SHOULD be losing on a graph and I never met those “goals.”  And so off it came and it hasn’t gone back on since.

So here’s an article that reminds me that it’s there, waiting for me to turn it back on..  I like the article because it shows the potential, but I don’t like the innuendo that all fat people that are dieting lie about portion control or activity.  Perhaps there is true forgetfulness, and perhaps some DO lie, but to channel Gregory House and assume that EVERYONE lies is just wrong.

From MSNBC.com:

Fight against fat goes high-tech with sensors

Experimental wireless devices track how much you exercise, eat daily

updated 10:59 a.m. ET, Wed., Jan. 6, 2010

ALHAMBRA, Calif. – The fight against fat is going high-tech. To get an inside look at eating and exercise habits, scientists are developing wearable wireless sensors to monitor overweight and obese people as they go about their daily lives.

The experimental devices are designed to keep track of how many minutes they work out, how much food they consume and even whether they are at a fast-food joint when they should be in the park. The goal is to cut down on self-reported answers that often cover up what’s really happening.

In a lab in this Los Angeles suburb, two overweight teenagers help test the devices by taking turns sitting, standing, lying down, running on a treadmill and playing Wii. As music thumps in the background, wireless sensors on their chests record their heart rates, stress levels and amount of physical activity. The information is sent to a cell phone.

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“I can’t feel my legs,” 15-year-old Amorette Castillo groans after her second treadmill run.

Traditional weight-loss interventions rely mainly on people’s memory of what they ate for dinner and how many minutes they worked out. But researchers have long known that method can be unreliable since people often forget details or lie.

The new devices are being designed in labs or created with off-the-shelf parts. Some similar instruments are already on the market, including a model that tracks calories burned by measuring motion, sweat and heat with armbands.

But the devices in development aim to be more sophisticated by featuring more precise electronics and sometimes even video cameras. Many emerging systems also strive to provide instant feedback and personalized treatment for wearers.

At the University of Southern California lab, the teens alternated between being sedentary and active as researchers resolved the technical bugs. Later this year, some will wear the body sensors at home on weekends. If they get too lazy, they will get pinged with a text message.

“We’ll be able to know real-time if they’re inactive, if they’re active,” said Donna Spruijt-Metz, a USC child obesity expert in charge of the project.

The devices are made possible by advances in technology such as accelerometers that can measure the duration and intensity of a workout. They also use Bluetooth-enabled cell phones that can take pictures of meals and send information back.

Will all this wizardry lead to a slimmer society? Scientists say there’s reason to hope. Getting an accurate picture of what people eat and how often they move around will help researchers develop personalized weight-loss advice.

Obesity is epidemic in the United States with two-thirds of adults either overweight or obese. It’s a major health concern for children and adolescents, who are at higher risk for high blood pressure, high cholesterol and diabetes as they grow older.

A federally funded pilot project by the Pennington Biomedical Research Center in Louisiana is exploring whether people can lose more weight when tracked by technology.

Participants carry around Blackberry Curves to snap pictures of their meals and leftovers. They also wear a quarter-sized device on their shoe that counts the number of steps they take.

Counselors pore over the incoming data and give individually tailored health advice through e-mail or telephone. Every month, the participants get their weight checked, and their progress is compared against a separate group that receives only generic health tips.

The study involves just seven people, but researchers eventually hope to have 40.

“It’s highly personalized. You get feedback very quickly,” said Corby Martin, who heads Pennington’s Ingestive Behavior Laboratory.

Ethical questions
By using technology to capture eating and exercise details, researchers hope to bypass self-reporting that can sometimes give an incomplete picture.

But some medical experts are concerned about ethical questions. Even if people agree to be tracked, researchers worry about intruding into the rest of their lives and the lives of those around them.

“As a researcher, I’m a professional voyeur, and I like to find out whatever I can about human subjects,” said William McCarthy, a professor of public health and psychology at the University of California, Los Angeles. “But if I were a subject, I’d be concerned about the level of detail that’s being captured about my behavior from moment to moment.”

University of Pittsburgh engineer Mingui Sun has developed a necklace equipped with a video camera that records where a person goes and what he or she eats. Before a researcher sees the data, it’s filtered by a computer that blurs out other people’s faces.

The device is not smart enough to know whether the wearer ate a Big Mac or tofu. So a researcher inputs the food, and the computer calculates the portion size, calories and nutrients.

Sun’s lab workers are wearing the prototype, and he hopes to test it on real people by the middle of the year.

Another concern is whether people, particularly youngsters, will stick with it.

Fellow Pittsburgh researcher Dana Rofey recently completed a study of 20 overweight female preteens and teens who wore armbands tracking the number of steps taken and calories burned daily.

Researchers found the armbands were worn 75 percent of the time. Though the study did not include a comparison group, researchers were pleased with the high compliance rate.

On a recent weekday, Castillo and another study volunteer, 13-year-old Eric Carles, headed straight from school to the USC lab, where they strapped the sensors on and went through a sort of circuit training. The project manager timed them as a postdoctoral student recorded the session through a one-way mirror.

Through periods of sitting, standing and exercising, they chatted about scary movies and upcoming exams. Wearing the devices felt “weird” to Castillo initially, but she has since grown used to it.

Castillo admits she doesn’t exercise as she often as she would like and has a sweet tooth for chocolate. Carles, who plays after-school sports, confesses he eats a lot. The teens were willing to try anything to help them lose weight.

After enduring more than two hours of required physical activity, the two were allowed to do whatever they want. Researchers called it “free living,” and it offered a glimpse into the activities teens would choose when they test the sensors at home.

The two chose to play a music video game. With Castillo on drums and Carles on the guitar, they rocked out to Duran Duran and Bon Jovi as researchers looked on.

Watch out Jared..

On December 27, 2009, in Uncategorized, by Andrea

TacoBell has decided to join the revolution.

Which revolution?  The one that spouts that by eating their food, YOU TOO!!! could lose weight!

In a great, wonderful, umm.. I’m out of sarcastic words for my thoughts on this marketing ploy.  So let’s just roll with it.  TacoBell now has a website and marketing campaign dedicated to their “Drive Thru Diet” menu — basically their Fresco menu — all touting low calories and low fat.

And they even have a skinny spokeswoman for it:

Um. TacoBell makes you look like that...?

Christine’s Story:

As you know, the Drive-Thru Diet® menu is not a weight-loss program. It’s about making different choices. For me, I didn’t want to cut out my fast food so I started choosing Fresco items from the Drive-Thru Diet® menu and making other sensible choices. I reduced my daily calorie and fat intake by 500 calories to 1250 calories a day, and, after two years, I ended up losing 54 pounds! These results aren’t typical, but for me they were fantastic!

For a healthier lifestyle, pay attention to total calorie and fat intake and regular exercise. Fresco can help with calorie reductions of 20 to 100 per item compared to corresponding products on our regular menu. Not a low calorie food.

What gets me is that some might actually buy it.

So let’s see.  There’s no mention of added chemicals or sodium to this “healthy” menu.. both of which are in abundance in fast food — especially at TacoBell.  And I can tell you that if I ate at TacoBell — even off this lower fat menu every day, my too low BP would go up, my cholesterol would go up all because I don’t have DS guts to help me get rid of the junk that I’m sure is in this crap.

Actually, I take it back.  If I had to eat this every day, I might look like Christine — TacoBell and I don’t get along so it might just be beneficial.  Maybe I should give it a whirl for my last 15-20 lbs?

If you want to read up on this, um.. healthy diet plan — feel free!  More info can be found at http://www.drivethrudiet.com.

And if you decide to try it?  Lemme know how it works for you, k?

EndoBarrier approved in Europe

On December 27, 2009, in Uncategorized, by Andrea

Wow!  Exciting news — this is a non-surgical method to help treat Type 2 Diabetes and obesity.  Basically a sleeve that is inserted via endoscope and helps malabsorb nutrients in the first portion of the small intestine without incisions or actual slicing and dicing of the guts.

The only question I have is this:  The website touts that when “the desired effect has been achieved, the device can be easily removed” — and even a patient testimonial states that “When it was time for it to come out, I wanted it to stay.”  So how long does / can the device stay in, and after it is removed, won’t the weight come back?

And how about another question?  Could this be used as a revision surgery for current WLS’es?

From GI Dynamics:

EndoBarrier

The EndoBarrierTM Gastrointestinal Liner may be the ideal treatment for patients with both type 2 diabetes and obesity. It works by creating a physical barrier between food that has been ingested and the intestinal wall. The EndoBarrier Gastrointestinal Liner is placed endoscopically (via the mouth) in a simple, brief procedure and is easily removed.

Hundreds of patients have been treated with the EndoBarrier System in clinical trials in South America, Europe, and the US.

From Medical News Today:

New Type 2 Diabetes And Obesity Treatment Approved – EndoBarrier Receives European CE Mark

Article Date: 26 Dec 2009 – 0:00 PST

GI Dynamics, a leader in non-surgical, endoscopic treatments for type 2 diabetes and obesity, today announced that it has received European CE mark approval for the EndoBarrier™, a non-surgical therapy to treat type 2 diabetes and obesity. The CE marking (an acronym for the French “Conformite Europeenne”) certifies that a product has met EU requirements for marketing in Europe. Clinical trials involving more than 270 patients have demonstrated the significant weight loss and diabetes improvement achieved with the EndoBarrier Gastrointestinal Liner.

“Based on the clinical results to date, we believe the EndoBarrier, as part of a multidisciplinary approach, has the potential to change the treatment paradigm for type 2 diabetes and weight problems,” stated Jan Willem Greve, M.D., Ph.D., Gastrointestinal and Bariatric Surgery, Atrium Medical Center Parkstad Heerlen, Netherlands. “Due to its unique profile as a non-surgical and non-pharmaceutical treatment option, the EndoBarrier appears to provide the benefits of gastric bypass surgery without the complications and risks associated with surgery. Unlike traditional pharmaceutical approaches, this implantable device removes the burden of dose regimen compliance from the patient. We look forward to having access to the EndoBarrier as a new treatment option in our fight against these epidemics.”

Type 2 diabetes affects an estimated 21 million Americans and 200 million people worldwide. According to the World Health Organization, type 2 diabetes comprises 90% of people with diabetes around the world, and is largely the result of excess body weight. Type 2 diabetes can lead to significant health problems including cardiovascular disease, retinopathy, neuropathy and nephropathy.

“This European approval for six months of EndoBarrier therapy to treat type 2 diabetes and obesity is another key milestone for GI Dynamics as we continue to prepare to launch the product in Europe,” said Stuart A. Randle, chief executive officer of GI Dynamics. “The growing body of clinical data demonstrates the EndoBarrier is well positioned to offer a meaningful, non-surgical approach to controlling diabetic factors and facilitating weight loss in patients suffering from the twin epidemics of type 2 diabetes and obesity. With European marketing approval in hand, we look forward to initiating our commercialization plans in Europe in the first half of 2010.”

GI Dynamics is defining a new class of metabolic treatment options that fit between pharmaceutical regimens and surgery, called non-surgical therapeutics. Non-surgical therapeutics are designed to eliminate or reduce the risks and side effects associated with pharmaceutical regimens as well as surgical options. This new class of treatment can be performed easily and quickly without any incisions, thus reducing patient anxiety and recuperative time. Unlike traditional pharmaceutical approaches, non-surgical therapeutics remove the burden of dose regimen compliance from the patient. Additionally, non-surgical therapeutics hold the potential to improve the patient’s overall health, by providing the control necessary to institute lifestyle and nutritional improvements to maintain therapeutic effect, while being easily removed once the desired effect has been attained and lifestyle changes implemented.

About the EndoBarrier™ Gastrointestinal Liner

The patented EndoBarrier Gastrointestinal Liner is an advanced investigational, non-surgical medical device based on the EndoBarrier Technology platform for treating type 2 diabetes and obesity. The EndoBarrier Gastrointestinal Liner is placed in the GI tract endoscopically (via the mouth) to create a barrier between food and the wall of the intestine. Physicians believe that preventing food from coming into contact with the intestinal wall may alter the activation of hormonal signals that originate in the intestine, thus mimicking the effects of a Roux-en-Y gastric bypass procedure without surgery. A growing body of pre-clinical and clinical evidence supports the potential for EndoBarrier Gastrointestinal Liner to change the treatment landscape for people living with type 2 diabetes, obese people at risk for type 2 diabetes, and people with severe weight problems.

Source
GI Dynamics

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