Category Archives: Overweight & Obesity

Brown Fat and the Cat in the Hat

My son Paul made this

My son Paul made this (I’ll see you in heaven, Romeo)

The Joslin diabetes blog has an interesting article on brown fat and its effect on metabolic rate and insulin sensitivity. Brown fat is just a type of body type different from the more plentiful white fat (which is actually more pale yellow). If there are other colors of body fat, I don’t know.

If you can “activate” your brown fat, it helps you burn more calories, which could be helpful if you’re trying to lose weight. It also improves insulin sensitivity: beneficial if you have type 2 diabetes or are prone to it.

From Joslin:

“When brown fat is fully activated, it can burn between 200 and 300 extra calories per day. It is most successfully activated through cold exposure. A recent study of people with type 2 diabetes had volunteers sit in a 50 degree room for a couple of hours a day for 10 days in shorts and short-sleeved shirts.

“When I say cold, it’s not icy cold, it’s not like the winter in Boston,” she says. “It’s more or less like the temperature we have here in autumn. After this mild cold exposure, all ten volunteers with type 2 diabetes, as shown in that study, displayed increased brown fat activity and improved insulin sensitivity. This is very exciting.”

Dr. Tseng is working on understanding exactly what is happening on a cellular level to activate brown fat in the cold to see if she can create a drug that will mimic the effects. “Although cold works, it’s just not pleasant,” she says. “If you had to sit in a cold room for a few hours every day, perhaps not everybody could accept that.”

Source: How Your Body Temperature Can Affect Your Metabolism | Speaking of Diabetes | The Joslin Blog

Another way to activate brown fat is exercise (at least if you’re a man or a mouse).

Steve Parker, M.D.

We Don’t Know How to Get Overweight Kids to Exercise

From a recent meta-analysis:

“In conclusion, there is no evidence that currently available interventions are able to increase physical activity among overweight or obese children. This questions the contribution of physical activity to the treatment of overweight and obesity in children in the studied interventions and calls for other treatment strategies.”

Source: Effectiveness of interventions on physical activity in overweight or obese children: a systematic review and meta-analysis including studies with o… – PubMed – NCBI

For weight loss in overweight and obese children, you have to focus on diet modification. Same as adults.

Skinny Women Are More Likely to Get That Service Sector Job

“Your worst fears have been confirmed, working ladies.

A study by researchers in the UK and Canada, published in the journal PLOS One, found that women who are on the heavier end of the “healthy” Body Mass Index, or BMI, range were subject to more weight-based prejudice than men who were solidly overweight.”

Source: Employers are more likely to hire skinny women | New York Post

I’m not too surprised about finding. And I’m not saying it’s right.

Easily calculate your BMI here.

Steve Parker MD, Advanced Mediterranean Diet

Two diet books in one

New Anti-Obesity Drugs Allegedly Underused

The article linked below promotes anti-obesity drug prescribing. Like many physicians, I’m not a big fan of these drugs. The article mentions some reasons why.

Phentermine has been around for years, but is FDA-approved for only short-term treatment, like three months.

Some of the newer drugs are approved for longer term: lorcaserin (Belviq) and  the combination drugs topiramate+phentermine (Qsymia) and naltrexone+bupropion (Contrave).

Whether you like these drugs or not, you may find the article interesting:

“About two-thirds of adults in the United States are overweight, and 46% fit the indications for antiobesity pharmacotherapy (body mass index ≥30 kg/m2 or ≥27 kg/m2 with hypertension, type 2 diabetes, or dyslipidemia) as an adjunct to diet and exercise, but only 2% of those receive treatment. This is in sharp contrast to the 8.4% of adults in the U.S. diagnosed with diabetes, of whom 86% receive antidiabetes pharmacotherapy, the investigators noted.”

Source: New Antiobesity Drugs Underused | Medpage Today

Why Aren’t the French Fat?

Julianne Taylor has a fascinating blog post based on her recent trip to France and Great Britain. Julianne is a dietitian and lives in New Zealand.  Please read the entire article.

Her conclusions:

“What can we learn from the French way of eating?

Don’t snack. At all. Eat 3 balanced meals, and snack only if needed.

Planned snacks are fine, children always have an after school snack, or small meal in France. Treat the snack with the same respect as you would a meal.

Don’t eat anywhere other than at a table. Don’t eat walking around, at your desk, in front of the TV, or snack out of the fridge. Prepare, then eat a meal at a table, preferably with company and actually experience the process of savoring your food. Eat slowly.

Choose food freshly prepared from whole ingredients like protein, fruit and vegetables.

Model eating like this to your children, and don’t push them into our bad habits. Enjoy family meals together at the table without any screens or phones.

Treat food is fine, savor a small portion as part of a meal if you wish.

Water should be the main drink, wine in moderation can be enjoyed with meals if desired,”

Source: Eating habits in France, what we should copy | Julianne’s Paleo & Zone Nutrition

And the Winner Is: Louisiana 

The contest? Which U.S. state is the fattest.

“Louisiana had the most number of obese adults in the United States in 2015, according to a report released by Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF).Based on The State of Obesity: Better Policies for a Healthier America, 36.2 percent of adults in Louisiana are obese, while Colorado was at the other end of the spectrum with 20.2 percent of its adult population obese.”

Source: Louisiana Has Highest Obesity Rate In Adults Across US : HEALTH : Tech Times

Honorable mention to West Virginia, Mississippi, and Alabama.

Preventing Obesity and Eating Disorders in Adolescents

From the American Academy of Pediatrics journal:

“Family involvement in the treatment of both adolescent obesity and EDs  [eating disorders] has been determined to be more effective than an adolescent-only focus. An integrated approach to the prevention of obesity and EDs focuses less on weight and more on healthy family-based lifestyle modification that can be sustained. Pediatricians can encourage parents to be healthy role models and supportively manage the food environment by creating easy accessibility to healthy foods (eg, fruits, vegetables, whole grains, beans and other legumes, and water) and by limiting the availability of sweetened beverages, including those containing artificial sweeteners, and other foods containing refined carbohydrates. Discussions between pediatricians and parents about increasing physical activity and limiting the amount of total entertainment screen time to less than 2 hours/day are important and may lead to changes in family behavior. Another area of prevention is avoiding the presence of a television in the teenager’s bedroom, because having a television in the room predicts significantly less physical activity as well as poorer dietary intakes compared with not having a television in the room. Other evidence-based approaches encourage parents to include more family meals, home-prepared meals, and meals with less distractions as well as fewer discussions about weight and about dieting. Understanding that poor body image can lead to an ED, parents should avoid comments about body weight and discourage dieting efforts that may inadvertently result in EDs and body dissatisfaction.

Source: Preventing Obesity and Eating Disorders in Adolescents | From the American Academy of Pediatrics | Pediatrics