Discuss prevention strategies and treatments for overeating and obesity

Why?• Obesity rates in adults are very

high in many countries and it is difficult to reduce excessive weight once it has become established.

• Therefore many prevention strategies aim to prevent children from becoming obese (e.g. targeting schools and after-school services as natural settings for promoting physical activity and learning about healthy eating.

Discuss prevention strategies and treatments for overeating and obesity

Prevention for Obesity

• The promotion of healthy eating and regular physical activity is essential for both the prevention of future obesity (primary prevention) and for treating those who are already overweight and obese or just preventing them from gaining more weight (secondary prevention).

Discuss prevention strategies and treatments for overeating and obesity

Examples of prevention strategies

Discuss prevention strategies and treatments for overeating and obesity

Michelle Obama’s Let’s Move

• Let's Move! is a campaign to end childhood obesity in the United States. The campaign was started by First Lady Michelle Obama.

• The initiative has the initially stated goal of "solving the challenge of childhood obesity within a generation so that children born today will reach adulthood at a healthy weight."

Discuss prevention strategies and treatments for overeating and obesity

NFL PLAY 60

• will focus on the health and wellness of young fans by encouraging them to be active for at least 60 minutes a day to reverse the trends of childhood obesity.

Discuss prevention strategies and treatments for overeating and obesity

Fat and sugar tax

• Some countries (e.g. Denmark) have introduced taxes on unhealthy food such as fat and sugar in order to encourage a more healthy diet and reduce the costs of obesity.

• When the price of a food increases, the consumption of that food normally decreases. Discuss prevention strategies and treatments

for overeating and obesity

Fat and sugar tax• The fat and sugar tax is a way

for governments to control people’s diets and encourage them to eat more healthily (just like taxing cigarettes and alcohol to decrease consumption of these substances).

• This is called social engineering.

• But they stopped it after a year…why do you think?

Discuss prevention strategies and treatments for overeating and obesity

Treatment of Obesity

Discuss prevention strategies and treatments for overeating and obesity

Dieting

• Obesity treatments always involves dieting in one form or another.

• It seems to be somewhat ineffective.

Discuss prevention strategies and treatments for overeating and obesity

Meta-analysis of studies on effectiveness of dieting Wadden (1993)

• The study reviewed randomized control studies on the effectiveness of either moderate or severe calorie restriction on weight loss.

Discuss prevention strategies and treatments for overeating and obesity

Meta-analysis of studies on effectiveness of dieting Wadden (1993)

• The results showed that patients stayed in treatment for 20 weeks and that 50% lost around 9 (20 pounds) kg or more.

• Modern approaches to diet with counseling were more effective in the short term compared to previous methods, which mainly focused on dieting and weight loss.

• The majority of obese patients in research trials tended to regain their lost weight.Discuss prevention strategies and treatments

for overeating and obesity

Meta-analysis of studies on effectiveness of dieting Wadden (1993)

• Wadden’s findings are supported by data from a meta-analysis of 92 studies of interventions for the treatment and prevention of obesity.

• The conclusion of that study was that weight gain after treatment is the norm.

Discuss prevention strategies and treatments for overeating and obesity

Meta-analysis of studies on effectiveness of dieting Wadden (1993)

• Weight loss is not quick and this fact may result in many negative emotions and giving in to eat more than allowed.

• Many dieters are guided by all-or-nothing thinking.

• The belief that one little transgression (e.g. eating an ice cream) ruins the overall attempt to lose weight could make them stop the diet and indulge in food.

• This is described as the “what the hell effect” and it has been repeatedly demonstrated in chronic dieters.

Discuss prevention strategies and treatments for overeating and obesity

Surgical treatments for Obesity

• Surgical treatments are used with severe obesity. The two most common are:

1. Gastric bypass: a surgical procedure that cuts off part of the stomach to prevent overeating by limiting the ability to absorb food

2. Gastric banding: a surgical procedure where a band is tied around the upper part of the stomach to reduce food intake and help the patient to feel full earlier.

Discuss prevention strategies and treatments for overeating and obesity

Meta-analysis of effectiveness of surgical treatments of obesity Maggard et al. (2005)

• The study reviewed the results of 147 studies.

• The results showed that gastric surgery resulted in weight loss of 20 to 30 kg.

• The results were maintained for up to 10 years and patients reported an overall improvement in health.

• Gastric bypass was overall more effective than gastric banding.

Discuss prevention strategies and treatments for overeating and obesity

Drug treatments for Obesity

• The National Institute of Health in the USA considers obesity to be a chronic disease.

• Two sorts of drugs are used……

Discuss prevention strategies and treatments for overeating and obesity

Appetite-suppressant drugs• decrease appetite or increase

the feeling of being full because they act on neurotransmitters that affect mood and appetite (e.g. serotonin and adrenaline levels).

• There is some evidence for the effectiveness of these drugs although they have some side effects such as nausea, constipation, and dry mouth.

Discuss prevention strategies and treatments for overeating and obesity

Lipase inhibitors

• reduce fat absorption. • The drug has some

unpleasant side effects, especially after eating fat.

• This may have a preventive effect since eating fat becomes associated with unpleasant consequences such as diarrhea.

Discuss prevention strategies and treatments for overeating and obesity

Do drugs work?

• Few studies have evaluated the safety and long-term effectiveness of drugs and some are concerned that they may be over-prescribed.

• Sibutramine has now been taken off the market in many countries because of its serious health risks (e.g. heart failure and sudden death).

Discuss prevention strategies and treatments for overeating and obesity

• Sibutramine is a neurotransmitter reuptake inhibitor that reduces the reuptake of serotonin (by 53%), norepinephrine (by 54%), anddopamine (by 16%), thereby increasing the levels of these substances in synaptic clefts and helping enhance satiety; the serotonergic action, in particular, is thought to influence appetite.

• Older anorectic agents such as amphetamine and fenfluramine force the release of these neurotransmitters rather than affecting their reuptake.[13]