Weight Loss in Low Income Patients in Primary Care Settings

Clinically significant weight loss is possible in underserved, low-income patients in primary care settings.

WeightControl.com Interview with:
Peter Katzmarzyk, Ph.D., FACSM, FAHA, FTOS
Professor and Marie Edana Corcoran Endowed Chair
Pediatric Obesity and Diabetes
Assoc Exec Dir for Population and Public Health Sciences
Pennington Biomedical Research Center
Baton Rouge, LA

WeightControl.com:  What is the background for this study?

Response: Obesity remains one of the greatest public health threats, and there is good evidence that intensive lifestyle interventions should be a primary approach to obesity management and treatment. However, there has been minimal uptake of obesity treatment approaches in primary care, which is the cornerstone of medicine in the US.

WeightControl.com: What are the main findings?

Response: We developed an intervention to reduce calorie intake and increase physical activity that was delivered by health coaches embedded in primary care clinics. The sample was diverse with a large percentage of low-income and African American patients. The results demonstrated that patients in the intensive lifestyle intervention lost approximately 5% of their initial body weight, compared to patients in usual care who lost about 0.5% of their body weight. These weight loss differences between the two groups were maintained out to 2 years, which demonstrates the durability of the intervention.    

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COVID-19 Linked to Difficulty with Weight Control

With the current concerns that the pandemic may lead to increases in obesity rates, it’s important to develop appropriate and large-scale support options for those aiming to manage their weight.

WeightControl.com Interview with:

Dr Sarah-Elizabeth Bennett
Senior Research Associate
Slimming World, UK

WeightControl.com:  What is the background for this study?

Response: This research is part of a larger Health and Wellbeing study, investigating the behaviour changes made by members of Slimming World, the UK’s largest group-based weight management organisation. New members were surveyed regularly over the course of one year and a representative sample of non-members were also surveyed at similar timepoints for comparison. The survey at the six-month point coincided with lockdown, so questions were added to learn more about how lockdown measures had impacted the nation’s health, wellbeing, and lifestyle behaviours. The following findings were based on the responses of 222 members who had completed all 3 surveys to-date and 637 non-members.

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Weight Control: Better to Eat a Big Breakfast than Big Dinner

The importance of the time of day and our internal clock for food intake and energy metabolism is a very exciting research field. Future studies should investigate why we spend so much more energy after breakfast than after dinner

WeightControl.com Interview with:
M. Sc. Juliane Richter
University of Lübeck
Center of Brain, Behavior and Metabolism
Section of Psychoneurobiology

WeightControl.com:  What is the background for this study?  What are the main findings?

Response: The background for this study is that there is still the misbelief that it does not matter when we eat and that the only thing that counts is the energy balance of the whole day. However, since our body has an internal clock and many processes in the body, for example glucose metabolism, are subject to diurnal variations, we investigated whether diet-induced thermogenesis also varies during the course of the day.

Diet-induced thermogenesis is the energy our body spends for the digestion, absorption and transport of nutrients. We found that diet-induced thermogenesis after breakfast is more than twice as high as after dinner. We also investigated whether this difference in time of day depends on the amount of calories consumed. In both cases, high- and low-calorie meals, the body spends more energy after breakfast than after dinner.

breakfast-timing of meals for weight control
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Obesity Prevented and Reversed in Mice By Blocking Cellular Receptor

We are beginning to understand how the blockage of the AHR prevents and reverses obesity, which may lead to a therapeutic treatment of obesity in humans.

WeightControl.com Interview with:
Craig R. Tomlinson, Ph.D.
Director of Genomics & Molecular Biology Shared Resource
Norris Cotton Cancer Center
Geisel School of Medicine at Dartmouth
Dartmouth Hitchcock Medical Center
Lebanon, NH 03756

WeightControl.com:  What is the background for this study?

Response: Obesity, a global epidemic, is a known contributor to numerous diseases, including diabetes, heart disease, and cancer. Preventing and reversing the obesity epidemic would be a critical aid in preventing and treating these diseases.

Our laboratory had discovered that a drug called NF, which was known to block the activity of a cellular receptor called the AHR, prevented obesity in mice fed a high-fat diet. We undertook studies to determine how the AHR, when inhibited by NF, exerted its effects on obesity.

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Is There a Link Between Obesity and Periodontal Disease?

Clinicians should educate patients about the importance of weight control affecting oral/periodontal health.

WeightControl.com Interview with:

Andres Pinto DMD, MPH, MSCE, MBA, FDS RCSEd, FICD 
Professor and Chair
Oral and Maxillofacial Medicine and Diagnostic Sciences
Director, Oral Medicine Internship and MSD Program

University Hospitals Cleveland Medical Center
Assistant Dean for Graduate Studies
Case Western Reserve University and
Cleveland Clinic
Health Education Campus
School of Dental Medicine
Cleveland, OH

WeightControl.com:  What is the background for this study?  What are the main findings?

Response: There is  strong association between oral health and systemic health.  Periodontal disease affects almost half of Americans and is characterized by increased inflammation. The focus of our review was to evaluate the association between obesity and periodontal disease, which has been reported earlier, with attention to the effects on the non-surgical management of periodontal disease. Our results indicate both disorders share similar inflammatory characteristics and may be associated.

However, multiple factors mediate this relationship, of course including oral hygiene. We were unable to find conclusive evidence on the impact of obesity on treatment planning for periodontal therapy, although the presumptive common pathophysiology provides an opportunity for active patient education.

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Using Diet Pills For Weight Control Linked to Increased Risk of Eating Disorder in Young Women

Over-the-counter diet pill and laxative use are not a healthy way to manage weight and young women, or consumers of any age or gender, should not use them for weight control

WeightControl.com Interview with:

Jordan A. Levinson BA
Division of Adolescent and Young Adult Medicine
Boston Children’s Hospital
Boston, MA

WeightControl.com:  What is the background for this study?

Response: Many unhealthy weight control behaviors, including the use of diet pills and laxatives for weight control, can put individuals at risk for developing eating disorders. Though the use of these products is common, it is incredibly dangerous and not recommended by health care providers for weight control. 

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Red Raspberries May Help Control Blood Sugar in Prediabetes

WeightControl.com Interview with:
Britt BurtonFreeman, Ph.D
Director of the Center for Nutrition Research at IFSH
Associate Professor, Food Science and Nutrition
Illinois Institute of Technology

"Raspberries" by theslowlane is licensed under CC BY 2.0. To view a copy of this license, visit: https://creativecommons.org/licenses/by/2.0
“Raspberries” by theslowlane

WeightControl.com: What is the background for this study? What are the main findings?

Response: Red raspberries contain appreciable amounts of dietary fiber and a variety of other nutrients, such as vitamin C, vitamin K, magnesium and potassium. They also contain phytochemicals, such as polyphenols with documented biological activity suggesting metabolic benefits. However, there is limited data assessing the potential effects of red raspberries in humans, particularly in those people who might benefit the most, ie., people at risk for diabetes mellitus.

We investigated the health benefits of consuming 1-2 cups of red raspberries in a group of people who were overweight/obesity and had prediabetes and insulin resistance.

The results showed that when a breakfast meal was consumed with raspberries, less insulin was needed to manage blood sugar compared with a meal with no raspberries. Moreover, when two cups of red raspberries were included in the breakfast meal, blood sugar concentrations were significantly lower compared to consuming breakfast without raspberries.

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Same Health Benefits with Fast or Slow Weight Loss

WeightControl.com Interview with:

Jennifer L. Kuk, PhD
Associate Professor
York University
School of Kinesiology and Health Science
Sherman Health Science Research Centre, Rm 2002
Toronto, Ontario 

WeightControl.com:  What is the background for this study?  What are the main findings?

Response: Traditionally, weight loss is prescribed at the rate of 1 to 2 pounds per week.  However, this is largely based on the observation that weight losses faster than 2 pounds per week put patients at an increased risk for gallstones.  It is unclear whether this is the optimal rate of weight loss for CVD or diabetes outcomes. Furthermore, fast weight loss has historically thought to be associated with poorer long term weight loss.  However, this was largely based on research using liquid diets.  Recent evidence suggests that faster weight loss may be similar to slower weight loss when more sensible lifestyle interventions are used.  Thus, if there are additional benefits of faster weight loss for CVD or diabetes outcomes, then there may a rationale for prescribing faster weight loss as the overall rate of gallstones is fairly low.

We observed that those who lose weight faster than 2lb/wk tend to lose more weight overall, but for the same overall weight loss, there is no difference in terms of health benefits with fast or slow weight loss.

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