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Weight-Loss Surgery May Help Severely Obese Teens, Study Finds

by on February 9, 2010

By Jason Gale Feb. 10 (Bloomberg) — Weight-loss surgery was more effective at slimming severely obese teens and improving their health than two years of diet and exercise, a study found. Adolescents fitted with Allergan Inc. ’s Lap-Band device lost about 11 times more weight compared with a group following so-called lifestyle approaches, researchers in Melbourne said. The results reported today in the Journal of the American Medical Association suggest bariatric surgery is an effective treatment for younger obese patients, the authors said. Weight-loss surgery has soared in popularity among U.S. adults in response to rising rates of obesity. The procedure has been controversial because the quality of evidence to support it is poor, said Edward H. Livingston , professor of surgery at the University of Texas Southwestern Medical Center in Dallas and a contributing editor to the journal. The study’s findings “go a long way toward providing the evidence necessary to evaluate the benefits and risks of bariatric surgery,” Livingston wrote in an accompanying editorial. “Many insurance companies in the United States will not pay for bariatric surgeries, and their decision to not cover this treatment is based on the lack of compelling, universally accepted evidence in its favor.” Obesity Rate Doubled At least one U.S. adolescent in six — more than 5 million people — was obese in 2004, according to the study. The number of obese Americans has more than doubled over 30 years to 72 million, according to the U.S. Centers for Disease Control and Prevention. People who are overweight or obese have a greater risk of diabetes, heart attacks and strokes, the Atlanta-based agency said last month. Allergan had 2009 revenue of $238 million for products designed to treat obesity and most of it was from sales of the Lap-Band, said company spokeswoman Cathy Taylor in an e-mail today. The Irvine, California, company is testing the device in severely obese adolescents ages 14 to 17 and submitted an application to the U.S. Food and Drug Administration last year for approval in that age group, she said. For the study, researchers at Melbourne’s Monash University followed 50 adolescents ages 14 to 18 over two years. All participants were deemed severely obese, having a body mass index , or BMI, greater than 35. Half were randomly selected for gastric banding and the remainder was asked to follow an individualized diet and exercise plan. Reversible Procedure Gastric banding is done when a surgeon places a band around the upper portion of the stomach to create a pouch to hold food, which limits the amount a person can eat. The reversible procedure is one of the two most common for weight loss, with the other being gastric bypass . In today’s study, two years after the start the gastric banding group had lost an average of 34 kilograms (76 pounds), representing an overall average loss of 28 percent of total body weight and 79 percent of excess weight, the researchers said. In comparison, the lifestyle group lost an average of 3 kilograms (6.6 pounds), or an average of 3.1 percent total weight loss and 13 percent excess weight loss. “Despite a comprehensive, behaviorally focused intervention, those in the lifestyle group were not able to achieve substantial weight loss,” wrote the study’s authors led by Paul E. O’Brien , director of Monash’s Centre for Obesity Research and Education. “Indeed, keeping adolescents and their parents involved in the trial for its two-year duration proved challenging.” Allergan supplied the Lap-Band Adjustable Gastric Banding system used in the research, the study said. Lower Risk Although the study wasn’t designed to measure improvements in specific health problems, it did demonstrate a reduction in a group of conditions associated with increased risk for cardiovascular disease and diabetes, the authors said. At enrollment, 9 study participants in the gastric banding arm and 10 in the lifestyle group suffered from so-called metabolic syndrome , as the group is known. After 24 months, none of the gastric banding group had the problem, compared with 4 of the 18 teens in the lifestyle group who completed the study. “Gastric banding proved to be an effective intervention leading to a substantial and durable reduction in obesity and to better health,” the authors said. The gastric banding group experienced no adverse events in the period shortly after surgery, the authors said. Eight operations to adjust the band or repair tubing connected to the band were required in seven patients in the surgery group. “The gastric banding approach to weight loss is not a quick fix,” the researchers wrote. Lifestyle treatments may achieve weight loss and improved health for some individuals and should remain the first option for obese adolescents, they said. The study was funded by the National Health and Medical Research Council. One of the study’s authors, John Dixon of Monash University, reported consulting agreements with Allergan and other companies. To contact the reporter on this story: Jason Gale at j.gale@bloomberg.net

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Weight-Loss Surgery May Help Severely Obese Teens, Study Finds

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Obesity Epidemic May Have Hit Plateau in U.S., Researchers Find

by on January 13, 2010

By Nicole Ostrow Jan. 13 (Bloomberg) — The number of U.S. adults and children who are considered obese may have leveled off over the past decade particularly among women, even if millions of Americans are still overweight, researchers found. About 36 percent of women were obese in 2008, little changed from 1999, according to a study published today by the Journal of the American Medical Association . About 32 percent of men were classified as obese in 2008, compared with 28 percent in 1999, with most of the increase occurring in the early part of the decade. The number of people who are obese has more than doubled in the past 30 years to 72 million, according to the U.S. Centers for Disease Control and Prevention. People who are overweight or obese have a greater risk of diabetes, heart attacks and strokes, said the Atlanta-based CDC . “We may have halted the progress of the obesity epidemic,” said William Dietz , director of the CDC’s Division of Nutrition, Physical Activity and Obesity, in a telephone interview yesterday. “We haven’t reversed it.” “The challenge here is what do we need to implement to drive these numbers the other way,” said Dietz, who was not involved in the study. Obesity for adults is defined as having a body mass index greater than 30, which is equivalent to about 186 pounds for a person who is 5 feet, 6 inches tall. The index represents weight in kilograms divided by height in meters squared. Health Impact The surge in obesity has undermined progress made in other public health areas such as heart disease, according to a study presented in November by University of Texas researchers in November. The advances include cholesterol-lowering drugs called statins, introduced in the late 1980s, and programs that the CDC said have cut smoking rates to 21 percent in 2008 from 37 percent in 1970. Companies such as Orexigen Therapeutics Inc. of La Jolla, California, Vivus Inc. of Mountain View, California, and San Diego-based Arena Pharmaceuticals Inc. are developing weight loss drugs. Orexigen has said it plans to seek U.S. approval of its Contrave medicine in the first half of 2010. In December, Arena Pharmaceuticals submitted an application for its obesity drug lorcaserin and Vivus submitted an application for its obesity treatment Qnexa. Japanese-based Shionogi & Co. is also developing a weight loss drug. Adults and Children The researchers analyzed data from the National Health and Nutrition Examination Survey from 2007 and 2008 for two studies published today, one on adults and another on children. In the adult study, height and weight measurements were looked at from 5,555 men and women ages 20 and older. In the children’s study, heights and weights were analyzed on 3,281 children ages two through 19 and 719 infants and toddlers from birth through two years old. While obesity was considered to be a body mass index of more than 30, overweight for adults was defined as having a BMI of 25 to 30. The researchers in the adult study found that overall, 33.8 percent of Americans were obese in 2007-2008, while 68 percent were considered either overweight or obese. Somewhat more men, about 72 percent, were classified as either overweight or obese compared with about 64 percent of women, the study showed. “It appears that the rapid increases we saw in the 1980s and the 1990s are at the very least slowing down,” said Cynthia Ogden, an author on both studies and an epidemiologist at the CDC, in a Jan. 12 telephone interview. “The prevalence still remains very high and obesity still continues to be a significant health concern in the U.S. We still have work to do.” Children and Teens In the study on children, the researchers found that about 32 percent of children ages 2 to 19 were at risk for being overweight or obese, similar to the findings reported in 2008 by the CDC. About 17 percent of the children were considered obese and almost 12 percent were considered the heaviest kids. The heaviest boys ages six to 19 continued to gain weight over the decade, the only children’s group that didn’t level off during the study period, said Ogden, who was lead author on the children’s study. J. Michael Gaziano , a preventive cardiologist at the Veterans Administration Boston Health Care System and Brigham and Women’s Hospital in Boston, said today’s findings are “silver linings to the cloud, but the cloud is still large.” There isn’t a consensus on how to manage and lose weight, and the government needs to invest more heavily in developing strategies that help people lose weight over the long term, said Gaziano, who wrote an editorial accompanying the studies in the journal. Dietz, the CDC official, said the agency has targeted six behaviors to help reduce obesity: physical activity, breast feeding, fruit and vegetable intake, reduction in TV time, reduction in high-calorie foods and reduction in sweetened beverage intake. The agency is also working with states to combat the obesity epidemic, according to its Web site. The studies were sponsored by CDC. For Related News and Information: To contact the reporter on this story: Nicole Ostrow in New York at nostrow1@bloomberg.net .

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Obesity Epidemic May Have Hit Plateau in U.S., Researchers Find

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