More Evidence Ties Obesity to Disability in Older Women – WebMD

Evidence Ties Obesity to Disability in Older Women

By Dennis Thompson

HealthDay Reporter

MONDAY, Nov. 11 (HealthDay News) — Women who are obese as they near retirement age have a higher risk of early death and may find their remaining years blighted by disability, researchers say.

Obese women are three to six times more likely to suffer a disability late in life that will make it difficult for them to get around, with the risk rising with their level of obesity, according to a new study published online Nov. 11 in JAMA Internal Medicine.

A second study in the same journal issue found that being overweight or obese raises your risk of heart attack and heart disease even if you are otherwise healthy.

The number of women aged 85 years and older in the United States is increasing, according to study background information, with 11.6 million women expected to reach 85 by 2050.

Obesity rates also continue to increase, and nearly one-third of U.S. women 75 years and older are obese. This extra weight not only reduces life span, but also can severely harm an older woman’s quality of life.

“For dying and losing the ability to walk, the risks were alarmingly high — over threefold to upwards of over sixfold,” said study co-author Eileen Rillamas-Sun, a staff scientist at the Fred Hutchinson Cancer Research Center, in Seattle. “I believe that remaining mobile is very important to most older people, especially since it is useful for retaining one’s independence.”

The new findings aren’t that surprising, but they’re important, one expert noted.

Together, the two studies “verify something that we knew, but give us some more ammunition to craft more programs and pay more attention to women’s body weight and obesity overall,” said Dr. Georges Benjamin, executive director of the American Public Health Association (APHA).

“The obesity epidemic isn’t just our kids, and if you are thinking forward we are having this enormous growth as the baby boomers age through society,” he said. “We’re going to have to spend a lot of time encouraging women to achieve a sensible body weight.”

Rillamas-Sun’s study examined the health records of nearly 37,000 older women participating in the Women’s Health Initiative, a long-term study sponsored by the U.S. National Institutes of Health.

The researchers found that about 12 percent of healthy-weight women had become disabled by age 85, requiring a walker or some other assistance for getting around.

By comparison, between 25 percent and 34 percent of obese women were disabled, with incidence rising with the patient’s body mass index (BMI), a measurement of body fat that takes height and weight into account.

Overall, a waist circumference greater than 35 inches was associated with a higher risk of early death, along with new diseases developing during the study period and mobility disability, the researchers said.

Beyond Obesity: Reframing Food Justice with Body Love by TC Duong

Oakland has been at the forefront of what many would call the food justice movement – a movement to ensure that disenfranchised communities have power over they foods they produce, sell and eat.  Organizations like People’s Grocery have led the way in identifying the intersections between race, income and health.  Phat Beets Produce and City Slicker Farms have been innovators in community-led urban gardening.

Being in one of the centers of food justice work has been exciting but as someone who has also been involved in body acceptance movement, I find myself increasingly uncomfortable with the frame of obesity prevention as a justification some use to enter this great work.  Many groups doing this work have to apply for funding (such as Michelle Obama’s Let’s Move) that frames food access as obesity prevention.  Researcher Linda Bacon coined the term “Health at Every Size” to challenge ideas that weight loss is desirable for everyone and I wanted to think further about the impact of the framework of obesity prevention of food justice and communities of color.  That’s when I read Sonya Renee’s post  Weight Stigma in Diverse Populations.

Sonya-Renee-Taylor-2

By stating “Our society tells us fatness is not beautiful.  Blackness is historically, not beautiful.  So even while battling weight stigma and reclaiming size diversity as beautiful, the presence of Blackness complicates the narrative,” Sonya Renee names the very real intersection between marginalization of women of size and black women.  Performance Poet, Activist and transformational leader, Sonya Renee is a National and International poetry slam champion, published author, and change maker.  As the founder and CEO of the The Body is Not An Apology, she is working to promote an international movement focused on radical self love and body empowerment. I asked Sonya more about the impact of the obesity prevention frame on food justice work.  Her responses are eye opening.

There are a lot of well-meaning people trying to do right by their communities by working on “food justice.”  Does that have relevance to size acceptance and body love?  Where do you see the intersections?  

I think food justice absolutely has relevance to size acceptance and body love or what The Body is Not An Apology calls Radical Self Love.  Radical Self Love is about being an advocate for your own well-being, your body and then allowing that advocacy to demand those things that aid well-being.  Asking for healthy food and access to nutrition is without question an element of radical self-love.  Also, when we think about who has access to good grocery stores, nutritious choices in their communities; we must look at the ways body impacts that.  There is a racial aspect that must be named which is about what bodies are valued and cared for systemically and which we do not. Those observations lead us directly to the way we further disenfranchise bodies of color, fat bodies, poor bodies.  Food justice is about ensuring all bodies have access and autonomy over their bodies.

How do community activists combat the obesity frame in public health, especially related to black communities?  There’s some real dollars attached to doing food justice as “combating obesity.”

I think it is essential to talk about the intersections of discrimination.  Asking how is a framework that makes someone’s body “wrong” an act of public health? We must ask who benefits from a war against people’s bodies.  Does it benefit communities to be at war with their bodies?  Does it benefit large people to view their bodies as a thing they must fight?  If the benefit is not to the communities we serve then what makes the model a justice movement?  Given that there are actual health indicators that can be assessed without size and size actually is not valid indicator of health unto itself, it is completely possible to talk about health without pathologizing bodies.  I also challenge public health professionals to be honest about the mental health aspects of having society be at war with your body or teaching people to be at war with themselves which is the translation of “combating obesity.”  Anything that reinforces inequity, bigotry, prejudice or shame IS NOT a justice movement.  Food justice work that does not include dismantling weight stigma in my opinion is not a justice movement.

There’s a lot of momentum around promoting health in marginalized communities (i.e. Michelle Obama’s work) but with the frame of ending obesity.  What frame would you recommend using to address what are real problems of accessibility for food and recreation?

I often just sit with the idea that the “ending obesity” paradigm is actually saying “we want to end Fat People.”  There simply is no health promotion in that framework.  The Body is Not An Apology operates from the framework that says injustice starts in many ways from the inability to make peace with the body, our own and others.  From that premise, the issue of promoting health is not about the failure of the body but the failure of our society to protect and care for EVERY BODY equally and the ways in which we as individuals and communities have internalized that lack of care.  If we cared for each person in our society we would have those things that are required for basic human sustainability in all communities.  We would have grocery stores with affordable healthy options; we would have playgrounds and recreation in all communities.  If we did not have recreation due to community violence we would be addressing and healing community violence.  We would be ensuring our media replicated images of all members of society in nuanced, dynamic, psychological healthy ways.  If we were using an intersectional community care model we would be addressing the myriad ways we could better care for each other and for ourselves.

How do we incorporate the historical analysis of the commodification of black bodies into our work as food justice advocates?

Understanding the commodification of black bodies helps understand why there is little investment in our community’s well-being and health.  I think it would also help black people understand how their demand to be treated humanely via Food Justice is as vital as the Civil Rights movement, abolition movement etc.  The value of black bodies was directly tied to unpaid labor.  When that unpaid labor was no longer a resource, we saw a complete divestment in the lives of black people.  Now that the commodification of black bodies comes via the criminal justice system there is an absolute necessity to foster the disrepair of black communities. The commodification depends on us growing up in such a way that increases our likelihood of engaging in criminal activity.  That is shown time and again to be directly tied to poverty and not having one’s basic needs met.  Food justice is about ensuring that all communities have their basic needs met so that they might thrive. The treatment of people in such communities is an illustration of the difference between commodifying bodies and valuing bodies. Food Justice is about demanding our bodies be valued!

Finally, how do we make the shift from shame and blame to love?

The question I ask that gets me to the answer of that question is always about who does blame and shame serve?  How does blame and shame make a world that creates positivity and possibility?  I reject the notion that there is some way that my body can be wrong.  And if there is nothing wrong with my body then there is no place for blame or shame.  From this space I can focus on how I can better LOVE my body and how I can better advocate that the world support me, my family, and my community in growing that love.

Written and Posted with permission from TC Duong

Thanks to TC for allowing us to share this wonderful article!  —First Read and Found on Oakland Local —

New Drug May Someday Battle Obesity and Diabetes – WebMD

New Drug May Someday Battle Obesity and Diabetes

Researchers find slim evidence to support many

By Dennis Thompson

HealthDay Reporter

WEDNESDAY, Oct. 30 (HealthDay News) — A new diabetes drug may one day perform double duty for patients, controlling both their blood sugar levels and helping them lose weight, researchers report.

In mouse trials, doctors found the drug prompted weight loss, in addition to managing blood sugar levels.

“That [weight loss] is not what this drug was designed to do, but it’s a very attractive additional benefit,” said study co-author Richard DiMarchi, a research chemist at Indiana University in whose lab the drug was created.

The injectable medication is based on a single molecule that combines the properties of two hormones that send chemical signals to the pancreas, said DiMarchi.

“They signal to the pancreas that you are taking a meal,” DiMarchi said. “The pancreas then responds by secreting insulin and to synthesize additional amounts of insulin for subsequent use.”

People with type 2 diabetes have lower levels of these pancreas-signaling hormones, which are known as incretins, explained Dr. John Anderson, president of medicine and science at the American Diabetes Association.

“The incretin defect in type 2 diabetes is well known, and it’s only within the last few years we have had agents to treat it,” Anderson said.

Human and primate trials revealed that the new drug controls blood sugar with fewer side effects than other diabetes medications. Those side effects can include nausea, vomiting and stomach pain.

“In this study, the degree of gastrointestinal discomfort is much more modest than is experienced in conventional drugs,” DiMarchi said. “We get beneficial glycemic control with this combination drug, and it seems to be with less adverse drug effect.”

The medication combines the action of the hormones GLP-1 and GIP. Current diabetes medications of this sort target GLP-1 receptors in the body; studies involving GIP have produced mixed results.

GLP is known to suppress appetite, and DiMarchi said the weight loss observed in mice might be occurring because the second hormone, GIP, is somehow “turbo-charging” that appetite suppression.

In the mouse trials, a drug based on GLP-1 alone decreased body weight by an average 15 percent. But the new drug combining GLP-1 and GIP decreased body weight by nearly 21 percent, as well as controlling blood glucose and decreasing appetite.

A six-week human trial involving 53 patients with type 2 diabetes found that the medication effectively controlled their blood sugar levels. However, the researchers did not note any change in weight during the relatively short study period.

The higher potency of the combined molecule suggests it could be administered at lower doses than other incretin-based medications, reducing side effects and making the drug easier to take.

“Currently approved drugs are quite effective,” DiMarchi said, “but they are insufficient in normalizing glucose, and they certainly don’t cause much loss of body weight.”

Child obesity: Families 'in denial' over dangers of overweight …

Families in denial over dangers of child obesity
Families ‘need to recognise that obese children are in trouble’ (Picture: PA)

Obese children are having their chances of fighting the flab scuppered by relatives in denial, a report reveals.

Overweight youngsters face serious health problems in later life and need family members to recognise they are in trouble, the study states.

And with about 30 per cent of two to 15-year-olds in England classified as overweight or obese, the National Institute for Health and Care Excellence is calling for urgent action. ‘Efforts to manage a child or young person’s weight are not always supported, and are sometimes undermined, by members of the wider family,’ the Nice report says.

‘A lack of recognition or denial that the child is overweight can hinder uptake and adherence to a lifestyle weight management programme.’ Children with at least one obese parent are more likely to follow suit themselves, the Nice report added.

Meanwhile, 79 per cent of overweight early teens are likely to be so as adults, raising the risk of cancer, heart disease and type 2 diabetes.

Although critical of families who refuse to admit their children have a problem, Nice said local authorities should step in to help battle the bulge. Prof Mike Kelly said: ‘Parents should not have to face the challenge of obesity on their own.

We are recommending family-based lifestyle programmes are provided which give tailored advice.’

However, Tam Fry, of the National Obesity Forum, said councils have been handed a ‘poisoned chalice’ of dealing with it without proper funding.

Dog Diabetes: What to Watch For



Dog via Shutterstockby petMD | petMD.com

Diabetes-Related Emergencies

Diabetes in dogs is treated with insulin, much the same way as it is in humans. But if too much or too little insulin is administered, it can be very dangerous for the animal.

What To Watch For Diabetes causes high blood sugar levels and is signaled primarily by excessive urination, excessive drinking, increased appetite and weight loss. In cases where the diabetes is not treated promptly and allowed to progress to the point of a crisis, symptoms may include a loss of appetite, weakness, seizures, twitching, and intestinal problems (diarrhea or constipation).

Primary Cause

Diabetic emergencies can be caused by either injecting too much or too little insulin, or not treating the diabetes in the first place. Both cases are equally dangerous for the dog and can cause coma or death. In cases where the diabetes is not treated, it can progress to diabetic ketoacidosis, a very serious condition that can cause death of your pet. Diabetic ketoacidosis can also be seen in dogs where the diabetes had been regulated and yet in which another condition has developed affecting the body’s ability to regulate the diabetes.

Immediate Care

If signs of an insulin dosage problem are noticed, it should be treated as an extreme emergency. The following steps may provide aid to your dog until you are able to bring her to a veterinarian (which should be as quickly as possible):

Syringe liquid glucose into the dog’s mouth. This can be in the form of corn syrup, maple syrup, honey, etc. If the dog is having a seizure, lift its lips and rub glucose syrup on the gums. Be careful not to get bit.

Veterinary Care

Depending on the cause of the crisis, dogs suffering from diabetic emergencies may need to be given glucose or insulin intravenously. In cases of diabetic ketoacidosis, hospitalization is required to provide insulin and electrolyte therapy. Glucose levels will be checked every one to three hours to monitor response of the treatment.

Treatment

Once the emergency has passed, normal insulin treatment will resume.

Living and Management

Always make sure you have a supply of glucose, honey, or corn syrup available for emergencies. Follow your vet’s instructions for the proper schedule and dosage of insulin treatments. Keep the insulin in a fridge and before administering, make sure it has not expired. The insulin should also be rolled — never shaken — prior to administration.

Prevention

Obesity has been linked to diabetes; consult with your veterinarian if weight loss can be of assistance in your dog’s case. Also, be cautious when administering steroids (i.e., prednisone), as chronic use of the drug may cause the onset of diabetes in dogs.

If you are unable to consult with your veterinarian, you can check your dog’s symptoms on petMD.com with the Symptom Checker tool.

More From petMD.com:

petMD’s Symptom Checker

Comatose Dog Care

Dog Seizures and Convulsions

How to Give a Pet Liquid Medication (VIDEO)

Chinese Jerky Treats Causing Pet Deaths Prompts FDA Probe

Grape and Raisin Poisoning in Dogs




Suffering from Obesity | Dances With Fat

Belly Bump with one of my heroes - Marilyn Wann

Belly Bump with one of my heroes – Marilyn Wann

I decided to repost this blog based on a few conversations I had and saw in the last few days.  I see people talk a lot about how we need to “do something,” and how abusive and exploitative things like The Biggest Loser are justified  because so many people are “suffering from obesity”.  I won’t presume to speak for everyone but I will say that while I sometimes do suffer because I’m obese, I’ve never suffered from obesity.

I’m suffering from living in a society where I’m shamed, stigmatized and humiliated because of the way I look. Where I’m oppressed by people who choose to believe that I could be thin if I tried (even though there’s no evidence for that), and that I am, in fact, obligated to try to be thin because that’s what they want me to do – as if personal responsibility means that I’m personally responsible for doing what they think I should do and looking like they think I should look (though this does not seem to be a two way street as none of these people has ever invited by commentary and suggestions on their life and choices.)

I’m suffering from doctors who have bought into a weight=health paradigm so deeply that they are incapable of giving me appropriate evidence-based healthcare.  I’m not just talking about diagnosing me as fat and giving me a treatment plan of weight loss (which is using a completely unreliable diagnostic and then prescribing a treatment that has the opposite result 95% of the time).  I’m also talking about the two doctors who tried to prescribe me blood pressure medication without taking my blood pressure or looking at my chart to see that it is always 117/70 (which means that taking blood pressure medication would have been dangerous).  I’m talking about a doctor trying to get me to lose weight to treat me for Type 2 Diabetes when I actually had anemia.  I’m talking about a doctor telling me that my strep throat was due to my weight. I’m talking about people who are supposed to be scientists abandoning science and research in a way that strongly resembles the time when the Catholic church told Galileo to sit down and shut up.

I’m suffering from a societal witch hunt where instead of putting me in a river they put me on a scale.  People look at my body and feel comfortable blaming me for everything from global warming to healthcare costs despite a lack of evidence for either. People send me ridiculous hate mail, say nasty things to me at the gym (although making fun of a fat person at the gym is something I will never understand).  People who are drenched in thin privilege try to use that position of privilege to make me feel bad about myself.

I’m suffering from the misinformation campaign that is led by the diet industry, weight loss pharmaceutical industry and surgeons who profit from mutilating people who look like me, none of whom are willing to be honest about the risks or horrible success rates of their interventions long term, and some of whom just don’t seem to care.

I am suffering from living in a society that tells me that the cure for social stigma, shame, humiliation and incompetent healthcare is for me to lose weight, when the truth is that the cure for social stigma is ending social stigma.

What has lessened my suffering is that I now realize that this isn’t my fault – although it becomes my problem. One of the reasons that I choose to pursue a life of social justice work is that nothing makes me feel better than knowing that I am doing what I can to fight this and making some kind of difference – whether it’s in the lives of individuals or in society, or just in my own life.  I deserve better and so does everyone else and I and lots of others are fighting for it and we’re going to win.  But to be clear, we shouldn’t have to.  Nobody should have to fight to be treated with basic human respect.   And that’s what I find so sad – all of this suffering of fat people could end right this second and nobody needs to lose a pound – society just needs to stop trying to shame, stigmatize, humiliate and hate people healthy.  We can work on access to healthy foods, we can work on access to safe movement options that people enjoy, we can work on making sure that people have access to appropriate, evidence-based healthcare.  If we give up being a horribly failed example for making people thin, we could be a successful example for giving people options for health.

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If my selling things on the blog makes you uncomfortable, you might want to check out this post.  Thanks for reading! ~Ragen

Obese Patients With Pancreatic Cancer Have Shorter Survival …

Obese Patients With Pancreatic Cancer Have Shorter Survival, Study Finds

People with non-alcoholic fatty liver disease

By Steven Reinberg

HealthDay Reporter

TUESDAY, Oct. 22 (HealthDay News) — A diagnosis of pancreatic cancer usually carries with it a poor prognosis, and the news may be even worse for those who are obese: It could mean dying two to three months sooner than pancreatic cancer patients of normal weight, new research shows.

Prior studies have tied obesity to a higher chance of getting pancreatic cancer, but the new study asked whether the disease affects the tumor’s aggressiveness and the patient’s overall survival.

“[The new research] adds to the growing body of evidence that obesity is linked to cancer,” said Dr. Smitha Krishnamurthi, an associate professor of medicine at the Case Western Reserve University School of Medicine.

The study was published Oct. 21 in the Journal of Clinical Oncology. Krishnamurthi was not involved in the new study, but did write a related journal commentary.

Because it is so often asymptomatic and is detected late, pancreatic cancer remains one of the most deadly tumor types. According to the American Cancer Society, more than 45,000 people will be diagnosed with the disease this year, and it will claim over 38,000 lives.

In the new study, a team led by Dr. Brian Wolpin, an assistant professor of medicine at the Dana-Farber Cancer Institute and Harvard Medical School, collected data on more than 900 patients with pancreatic cancer who took part in either the Nurses’ Health Study or the Health Professionals Follow-Up Study. These patients were diagnosed during a 24-year period, the researchers said.

After diagnosis, the patients lived for an average of only five months. Normal-weight patients, however, lived two to three months longer than obese patients, the researchers found.

This association remained strong even after the researchers took into account factors such as age, sex, race, ethnicity, smoking and the stage of the cancer at diagnosis. The study did not, however, prove a cause-and-effect relationship between weight and length of survival.

In addition, obese patients were more likely to have more advanced cancer at the time they were diagnosed compared with normal-weight patients. Overall, the cancer had already showed signs of spreading in 72 percent of obese patients at the time of diagnosis, compared with 59 percent of normal-weight patients.

It also seemed to matter how long the patient had been obese — the association between weight and survival was strongest for the 202 patients who were obese 18 to 20 years before being diagnosed with pancreatic cancer.

Krishnamurthi said the reasons for the link aren’t clear. She said the study can’t tell us whether shorter survival in obese patients “was due to biologic changes that can occur in obesity, such as increased inflammation in the body, or whether the obesity caused other conditions that interfered with the treatment of pancreatic cancer.”

Extreme Obesity, And What You Can Do About It

Too much weight can take a toll on your body, especially your heart. The good news is that there are steps you can take to get healthier — and even losing a little body weight can start you on the right path.

Why lose weight?
If you’re extremely obese, losing weight can mean “less heart disease, less diabetes and less cancer,” said Robert Eckel, M.D., past president of the American Heart Association. “Metabolic improvements start to occur when people with extreme obesity lose about 10 percent of their body weight.”

Losing weight can reduce your risk of heart disease and stroke; risk factors like high blood pressure, plasma glucose and sleep apnea. It can also help lower your total cholesterol, triglycerides and raise “good” cholesterol — HDL.

Understanding Extreme Obesity
A healthy BMI ranges from 17.5 – 25 kg/m2. If your body mass index is 40 or higher, you are considered extremely obese (or morbidly obese.) Check out the American Heart Association’s BMI calculator for adults to determine if your weight is in a healthy range. (Note: BMI in children is determined using a different BMI calendar from the CDC.)

A woman is extremely obese if she’s 5 feet, 4 inches tall and weighs 235 pounds, making her BMI 40.3 kg/m2. To reach a healthy BMI of 24.8, she would have to lose 90 pounds to reach a weight of 145 pounds.

A man is extremely obese if he’s 6 feet, 2 inches tall and weighs 315 pounds, making his BMI 40.4 kg/m2. To reach a healthy BMI of 25.0, he would need to lose 120 pounds to reach a weight of 195 pounds.

Doctors use BMI to define severe obesity rather than a certain number of pounds or a set weight limit, because BMI factors weight in relation to height.

How to Get Healthier
If you’re extremely obese, taking action to lose weight and improve your health may seem overwhelming. You may have had trouble losing weight or maintaining your weight loss, been diagnosed with medical problems and endured the social stigma of obesity.

“The key to getting started is to find a compassionate doctor with expertise in treating extreme obesity,” said Dr. Eckel, who is also professor of medicine and Charles A. Boettcher II Chair in Atherosclerosis at the University of Colorado Anschutz Medical Campus in Aurora, Colo. “Bonding with your physician is the best way to get past first base and on the path to better health.”

If you’re extremely obese, Dr. Eckel recommends that you become more active, but not to start a vigorous workout program without getting physician advice and not until you’ve lost about 10 percent of your body weight.
“You can continue the level of physical activity that you’re already doing, but check with your physician before increasing it,” Dr. Eckel said. “Some people with extreme obesity may have health issues like arthritis or heart disease that could limit or even be worsened by exercise.”

Treatment Options
Talk to your doctor about the health benefits and the risks of treatment options for extreme obesity:

  1. Change your diet. You may be referred to a dietician who can help you with a plan to lose one to two pounds per week. To lose weight, you have to reduce the number of calories you consume. Start by tracking everything you eat.

    “You have to become a good record-keeper,” Dr. Eckel said. “Reduce calories by 500 calories per day to lose about a one pound a week, or cut 1,000 calories a day to lose about two pounds a week.”
     

  2. Consider adding physical activity after reaching a minimum of 10 percent weight-loss goal.
     
  3. Medication. Some people can benefit from medication to help with weight loss for extreme obesity. Keep in mind that medication can be expensive and have side effects.
     
  4. Surgery. If changing your diet, getting more physical activity and taking medication haven’t helped you lose enough weight, bariatric or “metabolic” surgery may be an option. The American Heart Association recommends surgery for those who are healthy enough for the procedure and have been unsuccessful with lifestyle changes and medication. Risks can include infections and potentially dangerous blood clots soon after the operation, and concerns about getting the right amount of vitamins and minerals long-term.

Get The Social Or Medical Support You Need
Although some people can modify their lifestyle and lose weight on their own, many need extra help. A social support system can help encourage your progress and keep you on track. Decide what support best fits your needs — either a weight-loss support group or one-on-one therapy.

Some people with extreme obesity suffer from depression. Talk to your doctor about the best treatment, as some anti-depressant medications can cause weight gain.

Learn more:

  • BMI Calculator
  • BMI in Children
  • 5 Goals to Losing Weight
  • Losing Weight With Life’s Simple 7 Infographic
  • Preventing Childhood Obesity: Tips for Parents and Caretakers
     

UNC-Chapel Hill will test new device aimed at diabetes and obesity

— UNC-Chapel Hill researchers are testing a promising device that fights two of the most common health problems that Americans face – obesity and diabetes.

The EndoBarrier is a thin sleeve made of a plastic-like material that lines part of the upper digestive tract so that food simply passes through that section rather than undergoing full digestion.

A team led by Dr. Laura Young of the UNC Diabetes Care Center is part of a nationwide, 500-patient, 20-site study of the device. It has begun seeking local volunteers to participate.

The EndoBarrier has been approved for use in Europe and various countries elsewhere, including Australia, Chile and Israel. It must undergo a large-scale test here, though, before the U.S. Food and Drug Administration will allow it to be marketed in this country.

Diabetes, which is characterized by problems controlling high glucose levels in the blood and often closely tied to obesity, is a big cause of heart disease, stroke and complications that include loss of eyesight and kidney failure.

In patients elsewhere, the EndoBarrier has substantially reduced patients’ weight and lessened and even reversed the symptoms of Type 2 diabetes, by far the most common type.

The device’s effects are similar to those triggered by gastric bypass surgery. One advantage, though, is that it doesn’t require surgery. Instead, it is put in place via the mouth and throat by a relatively simple procedure involving a flexible instrument .

The procedure usually takes about 15 minutes, Young said. And unlike surgery, it’s easily reversible if it causes problems.

If it is effective, she said, the device could also reduce a patient’s need to use various medications for diabetes.

More than 650,000 people in North Carolina have been diagnosed with diabetes, according to the U.S. Centers for Disease Control and Prevention. Nationwide, the number of new cases has been climbing since 1992 and has nearly tripled since then.

The study is focused on the device’s effect on Type 2 diabetes, Young said, with weight loss a secondary interest.

Once the EndoBarrier is installed, improvements in patients’ diabetes symptoms often come within days, before the gradual weight loss that the device causes even kicks in, according to earlier studies and results with patients in other countries.

The effects on diabetes appear to come by not just blocking the body from digested food but also altering hormonal signals that part of the digestive tract sends to other parts of the body, Young said.

“We think it’s a way to help the body respond to the food that comes through it in a different way,” she said.

In earlier, smaller studies, it was effective helping patients controlling blood glucose levels and effective in reducing weight by often double-digit percentages.

It also caused various problems for some patients, including abdominal pain, bleeding and obstructions by the device.

The EndoBarrier was developed by GI Dynamics, Inc., a 10-year-old company based in Lexington, Mass.

Dr. David Maggs, the chief medical officer for the company, said that both the device and the technique of putting it in place have been improved since the early studies. Those changes have significantly reduced the complications, he said.

Another issue with the device is whether its effects last. The EndoBarrier will remain in study participants only for 12 months, the standard period for use in patients elsewhere in the world.

Researchers will continue to follow patients’ conditions for several weeks after the device is removed, Young said, in hopes of learning more about what happens after it is out.

At this point, more than 1,000 patients have had the device implanted, Maggs said. After it is taken out, there seems to be a “legacy effect” that keeps blood glucose at improved levels and weight down, but there is only limited data so far on that.

If the trial proves that the device works and is safe, it is expected to be widely available by 2017.

Price: 919-829-4526

Obesity rate falls in 19 states for low-income preschoolers | MSNBC

How heavy can one country get? Until recently, the sky seemed the limit. If recent trends continued, government researchers warned in 2008, some 86% of U.S. adults would be overweight or obese by 2030, and a third of our kids would be fully obese by the time they turned 20.

But the fever may finally be breaking. A wisp of good news came from the Centers from Disease Control and Prevention (CDC), which announced Tuesday that obesity rates have recently declined among low-income children in 19 states and territories.  “While the changes are small,” CDC Director Tom Frieden said in announcing the new findings, “for the first time in a generation they are going in the right direction.”

The new study isn’t definitive, but it suggests that conditions are improving even for the nation’s poorest and most vulnerable children.

The CDC researchers reviewed height-and-weight records for 12 million preschoolers who participated in WIC and other nutrition-assistance programs. Their analysis covered 43 states and territories, and it yielded good news for nearly all of them. Obesity rates either fell or held steady in 40 of the 43 jurisdictions after rising steadily in recent decades. Only three states—Colorado, Pennsylvania and Tennessee—saw upward trends from 2008 to 2011, and those increases were all minor.

Nationally, about 13% of preschoolers are overweight or obese, but the risk is still significantly higher among kids who are poor enough to qualify for nutrition assistance. In California, for example, 16.8% of the enrollees were obese in 2011, despite a significant three-year decline (the 2008 figure was 17.3%). New Jersey and Massachusetts still hover at similar levels (16.6% and 16.4% respectively), despite similar reductions in recent years.

Puerto Rico’s low-income kids had the highest obesity rate of any state or territory (17.9% in 2011), but the nearby U.S. Virgin Islands saw the steepest three-year decline (from 13.6% to 11%).

Child obesity progress (CDC 08-13 map)

What accounts for all these encouraging trends? The study didn’t identify causes, but health authorities believe that public policy and public awareness have both helped. “Many of the states in which we’re seeing declines have taken action to incorporate healthy eating and active living into children’s lives,” says Janet L. Collins, director of the CDC’s obesity division.

Specifically, the CDC points to growing community efforts to make nutritious food affordable and accessible and ensure that all kids have safe places to play. First Lady Michelle Obama’s Let’s Move! Child Care initiative has probably helped too, with 10,000 child care programs now embracing its prevention strategies.

“I think the main reason [rates are falling] is that people are rallying together as stakeholders in this battle,” Dr. Lindy Christine Fenlason of Vanderbilt University told NBC News Tuesday morning. “We’re talking about teachers and parents and caregivers, those in the media, those in government, and those in the medical profession. Everyone has come around to support people in making changes to have a healthy weight.”

That’s not to say the epidemic is anywhere near over. Obesity still affects 12.5 million children and teens in this country, and the potential consequences are devastating, ranging from arthritis and sleep apnea to heart disease, diabetes, stroke and several cancers. But the latest findings show that progress really is possible.