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Obesity
BMI and risk factors
Obesity is a disease in which excess body fat has accumulated to such an extent that health may be negatively affected. It is commonly defined as a body mass index (weight divided by height squared) of 30 kg/m2 or higher. This distinguishes it from being overweight as defined by a BMI of between 25-29.9 kg/m2. Obesity may be treated with dietary advice, anti-obesity drugs and in severe cases with one of several forms of bariatric surgery. Many studies show an association between excessive body weight and various diseases, particularly cardiovascular diseases, diabetes mellitus type 2, sleep apnea, certain types of cancer, and osteoarthritis. As a result, obesity has been found to reduce life expectancy. With rates of adult and childhood obesity increasing, authorities view it as a serious public health problem. Attempts to address it include population-wide measures to improve dietary choices and increase physical exercise.
Nutrients of interest to fight obesity
ChromeMate, Green Tea Extract, Guggul Lipid, Chrysin, EPA, Forskolin extract
Obesity, weight change, and functional decline in peripheral arterial disease.
J Vasc Surg. 2006 Jun;43(6):1198-204.
McDermott MM, Criqui MH, Ferrucci L, Guralnik JM, Tian L, Liu K, Greenland P, Tan J, Schneider JR, Clark E, Pearce WH.
Department of Medicine, Northwestern University's Feinberg School of Medicine, Chicago, IL 60611, USA. mdm608@northwestern.edu
BACKGROUND: Our objectives were to determine whether obesity is associated with a greater functional decline compared with the ideal body mass index (BMI) among persons with peripheral arterial disease (PAD) and to determine the associations between weight gain and loss and functional declines in PAD. We hypothesized that baseline obesity and weight gain during follow-up would each be associated with functional declines in persons with PAD.
METHODS: The design was a prospective cohort study. The subjects were 389 men and women with PAD (mean ankle-brachial index, 0.65 +/- 0.14) who were followed up prospectively for a median of 48 months. The main outcome measures were functional assessments (6-minute walk, usual- and rapid-paced 4-m walking speed, and summary performance score). Weight and height were measured at baseline and annually. Results were adjusted for age, sex, race, comorbidities, ankle-brachial index, education, leg symptoms, exercise status, depressive symptoms, pack-years of cigarette smoking, prior-year functioning, and patterns of missing data.
RESULTS: Compared with those with a baseline BMI between 20 and 25 kg/m2, PAD participants with baseline BMI greater than 30 kg/m2 had a significantly greater average annual decline in 6-minute walk performance (-13.1 vs -26.5 m/y; P = .004), usual-paced 4-m walking velocity (-0.028 vs -0.055 m/s per year; P = .024), and fast-paced 4-m walking velocity (-0.053 vs -0.086 m/s per year; P = .012). Persons with weight gain between 5 and 10 pounds after baseline who walked for exercise regularly had significantly less decline in the 6-minute walk than persons without significant weight change who did not walk for exercise (P = .04).
CONCLUSIONS: Obesity is associated with functional decline in persons with PAD. Walking exercise may protect against functional decline in PAD persons with modest weight gain.
Is rimonabant efficacious and safe in the treatment of obesity?
Doggrell SA. Expert Opin Pharmacother. 2008 Oct;9(15):2727-31.
RMIT University, School of Medical Sciences, Discipline of Pharmaceutical Sciences, Bundoora, Victoria 3083, Australia. sheila.doggrell@rmit.edu.au
BACKGROUND: The incidence of obesity is increasing worldwide, and in the USA approximately 100 million adults are overweight or obese. Orlistat and sibutramine are the drugs used at present for weight loss, but they both have a relatively modest effect.
OBJECTIVES/METHODS: This evaluation is of the Rimonabant in Obesity (RIO) programme of clinical trials, and of the first trial to determine whether rimonabant has any effect on a clinical outcome. The Strategy to Reduce Atherosclerosis Development Involving Administration of Rimonabant - the Intravascular Ultrasound Study (STRADIVARIUS) determined whether treatment with rimonabant decreased atherosclerosis.
RESULTS: The individual trials of the RIO programme showed that rimonabant 20 mg caused body weight loss, and also caused small decreases in waist circumference, plasma triglycerides and fasting glucose levels, and the incidence of the metabolic syndrome, while increasing levels of HDL cholesterol. Gastrointestinal side effects were the most common reported in the individual trials. However, when the five trials were combined, a small but significant increase in the incidence of depression and anxiety became apparent with rimonabant 20 mg. STRADIVARIUS showed that rimonabant 20 mg had no effect on atherosclerosis that was not progressing in subjects who were mostly also taking antithrombotic agents, statins, beta-blockers and angiotensin inhibitors.
CONCLUSIONS: At present, it is doubtful whether the benefits of rimonabant outweigh the risks. Unless rimonabant is shown to have benefits in ongoing clinical outcome studies, there is little rationale to support its use in the treatment of obesity.
Studies:
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