LuckCong's Health Blog

Doctors are guilty of wrongly believing that obese people are simply lazy, research suggests.
Researchers at Yale University said the findings highlight the difficulty in tackling the stigma around obesity.
Many obese people complain that others believe they are overweight simply because they eat too much or fail to exercise.
This is despite the fact that obesity can be caused by a variety of other factors, such as genes and environment.
Dr Marlene Schwartz and colleagues carried out psychological tests on 389 professionals who treat and study obese people.
They found that younger professionals, in particular, were most likely to have unfavourable stereotypes of obese people.
Workers who did not deal directly with obese patients were also inclined to see them in an unfavourable light.
"On both implicit and explicit measures, health professionals associated the stereotypes lazy, stupid and worthless with obese people," said Dr Schwartz.
"The stigma of obesity is so strong that even those most knowledgeable about the condition infer that obese people have blameworthy behavioural characteristics that contribute to their problem, i.e. being lazy," she said.
"Furthermore, these biases extend to core characteristics of intelligence and personal worth."
Dr Ian Campbell of the UK's National Obesity Forum said he was not surprised by the findings and said they would probably be replicated if the test was carried out on British doctors.
"It is disappointing but it is not surprising to see that health professionals have the same ingrained prejudice against obese people as the general public," he said.
"It is becoming increasingly clear that as much as 80% of people who are obese are predisposed genetically.
"Although it is very rare to find a case where obesity is purely genetic, there are many cases where it is not in the patient's control."
He said it was unhelpful for doctors to be biased against obese patients.
"It is important for doctors and other health professionals to show understanding and enthusiasm for change.
"If a doctor is biased against the patient's efforts, then it is unlikely to have a good outcome."

A study published Monday found that people who sleep less tend to be fat, and experts said it's time find if more sleep will fight obesity.
"We've put so much emphasis on diet and exercise that we've failed to recognize the value of good sleep," said Fred Turek, a physician at Northwestern University.
Monday's study from Eastern Virginia Medical School in Norfolk covered 1,000 people and found that total sleep time decreased as body mass index -- a measure of weight based on height -- increased.
Men slept an average of 27 minutes less than women and overweight and obese patients slept less than patients with normal weights, it said. In general the fatter subjects slept about 1.8 hours a week less than those with normal weights.
"Americans experience insufficient sleep and corpulent bodies. Clinicians are aware of the burden of obesity on patients," the study said.
"Our findings suggest that major extensions of sleep time may not be necessary, as an extra 20 minutes of sleep per night seems to be associated with a lower body mass index," it added.
"We caution that this study does not establish a cause-and-effect relationship between restricted sleep and obesity (but) investigations demonstrating success in weight loss via extensions of sleep would help greatly to establish such a relationship."
The study was published in the Archives of Internal Medicine along with an editorial by Turek and Northwestern colleague Joseph Bass commenting on it and related research.
In an interview with Reuters, Turek said some studies have shown sleep deprivation causes declines in an appetite suppressing protein hormone called leptin, and increases in another hormone that causes a craving for food. In addition neuropeptides in the brain governing sleep and obesity appear to overlap, he said.
Obesity has been rising dramatically in developed countries and reached epidemic levels in the United States, it added, leading to a variety of health problems.

Around half a million children in Europe are suffering classic health problems of the middle-aged because they are too fat, according to new estimates.
The levels of obesity among Europe's children have been on the rise over the last 15 years, but experts are now starting to see the health consequences emerge on a large scale.
In Britain, one in five children is overweight or obese. In Spain the figure rises to 30% of children, and in Italy it reaches 36%. According to US government estimates, 30% of American children are overweight or obese.
In a new analysis presented at the start of this year's European Congress on Obesity in Athens, experts reported that high blood pressure, raised cholesterol, damaged blood sugar regulation and other dangerous conditions -- often referred to collectively as the metabolic syndrome -- were increasingly being identified alongside the rising levels of childhood obesity in Europe.
"The figures suggest that children in the EU could soon be measuring up to their counterparts in the US, where the numbers affected by the metabolic syndrome doubled from 910,000 to two million in less than 10 years," said the analysis by the International Obesity Task Force, a network of eminent obesity scientists and policy experts.
The group estimated that between 2,000 and 10,000 European children already had the type of diabetes usually diagnosed in middle age.
As the estimates were unveiled, a statement was delivered to the conference on behalf of EU Commissioner for Health and Consumer Protection Markos Kyprianou.
He outlined plans for a Europewide code of conduct to rein in the marketing of unhealthy food to children and broader policy initiatives across agriculture, education and transport that address the obesity problem.
The European Union would publish a new strategy on diet and exercise before the end of the year and submit the document to public consultation with the food industry, anti-obesity activists and others to shape a final plan by the end of 2006, Mr Kyprianou said.
The move echoes unprecedented steps taken last year by the World Health Organisation, which launched a global strategy on diet and physical activity after health ministers from around the world approved the plan.

Citing an epidemic of obesity, Surgeon General Dr. David Satcher today called on communities and schools to help children and adults lose weight and stay healthy.
Satcher identified schools as central to efforts to prevent and decrease excess weight problems, and recommended they improve physical education programs and provide healthy food alternatives. Communities also must offer safe places to exercise, he urged.
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"Many people believe that dealing with overweight and obesity is a personal responsibility," Satcher states. "To some degree they are right, but it is also a community responsibility."
An estimated 300,000 deaths may be attributed to obesity in the United States each year, and more than 60 percent of adults in 1999 could be classified as overweight or obese, according to the new report from the surgeon general.
But the problem is not just a concern for adults. The prevalence of obesity for adolescents has nearly tripled in the past two decades, making early intervention all the more critical.
According to the report, in 1999, 13 percent of children between the ages of 6 and 11 and 14 percent of those aged 12 to 19 were overweight.
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And the younger a person begins to carry excess weight, the greater the potential impact on their future quality of life. Weight gain and obesity are major contributors to poor health, increasing the risk of a number of medical conditions including heart disease, diabetes, arthritis, asthma, and even certain cancers.

In The Origin Diet, dietitian Elizabeth Somer asserts that certain cravings were central to human survival and evolution. "Fat and sugar were scarce hundreds of thousands of years ago," she writes."Fat was a precious source of calories (supplying more than twice the calories per gram of either protein or starch), and our ancestors had no need to develop an appetite shutoff valve for fat. Instead, when they found fatty food, they ate all they could get and developed an unlimited capacity to store extra calories."

The quest for fat and sugar, Somer believes, is now hardwired into our brains, governed by dozens of chemicals including endorphins. Serotonin, for example, is the "feel good" chemical. When levels are low, we seem to crave sweets and carbs, which raise serotonin and improve mood. This may help explain why many women crave chocolate near their periods.

What about the cravings that many pregnant women experience? Growing research suggests that odd food yearnings - and food aversions - may protect the fetus. Some pregnant women lose the desire to drink coffee or wine and turn green at the sight of fish, meat, eggs or vegetables. Instead, they crave sweets, fruits (especially citrus) and dairy products.

One explanation: These foods are least likely to carry harmful organisms or natural toxins. "It may be your body is telling you to keep your fetus away from anything that might be toxic," says Frances Largeman, managing editor of FoodFit.com, a website promoting healthy eating habits.

Largeman acknowledges that the theory doesn't account for why some pregnant women hunger for pickles and others for apple strudel. Cravings are difficult to explain scientifically, she says, "because people don't eat nutrients; they eat food." And everybody's preferences differ.

One explanation: These foods are least likely to carry harmful organisms or natural toxins. "It may be your body is telling you to keep your fetus away from anything that might be toxic," says Frances Largeman, managing editor of FoodFit.com, a website promoting healthy eating habits.

Largeman acknowledges that the theory doesn't account for why some pregnant women hunger for pickles and others for apple strudel. Cravings are difficult to explain scientifically, she says, "because people don't eat nutrients; they eat food."And everybody's preferences differ.
Some experts think cravings are as much a reflection of our social and psychological makeup as they are of our physiological impulses. "Food adds solace to our lives," says Jeff Hampl, a spokesman for the American Dietetic Association. "Often, cravings are tied to a childhood experience and good feelings associated with it. There's a subconscious desire to replace those emotions."

This would explain my predilection for rapini, since my mother serves it every Thanksgiving. Yet regardless of the reason, Largeman - who craves salmon sometimes - thinks you should satisfy a craving when it strikes. "A craving usually just gets worse," She says,"and it could lead to binging."

But most of us long for foods that aren't as nutritious as salmon. What should we do?

First, make sure you're experiencing a true craving - not just plain old hunger or thirst. "Sometimes people don't realize they're physically hungry," says O'Neil."If it's actually hunger, eating something reasonable such as a piece of fruit rather than a chocolate bar might do the trick."
Another option, he says, is to"leave the scene of the craving. Change your setting and engage in other things that don't involve food."

Finally, if your craving just won't be rebuffed, indulge it - judiciously."If you have a salty craving," says Largeman, "it's better to buy a single-serving bag of salt-and-vinegar chips than to buy a large bag and keep it around the house." Or try a less potent alternative - say, low-fat chocolate milk or a frozen fudge pop rather than a slab of fudge.

For years, Catherine Monk would ignore her sweet tooth, then splurge on half a pint of ice cream. Now wiser, she settles for a few table-spoons every night."That does it for me," she says.

The discovery of the obesity gene in humans half a decade ago offered evidence that chronic weight gain is the consequence of a mismatch between nature and nurture. Simplistic explanations, such as blaming obesity on a drop in fat consumption, ignore scientific reality. In countries like India and China, obesity was virtually unknown until the introduction of a high-fat, Western-style diet.

One well-known reason for this is that dietary fat converts to body fat more effciently than does protein or carbohydrate, but recently scientists have uncovered what appears to be an equally important factor. Some researchers in universities are investigating the possibility that high levels of fat and fructose are mucking up our brain chemistry, and thereby muting the signals that would normally tell us to put down the fork. These signals are produced by peptides, which are regulated by a number of hormones. Under normal conditions these hormones help maintain a stable body weight by adjusting levels of the peptides that control eating. But a diet loaded with fat and fructose hampers the regulation of these hormones. Complicating matters still further is that the brain loses its ability to respond to these hormones as body fat increases -- so the obese are doubly penalized.
Other researchers are finding evidence that constant exposure to fat and sugar can cause some humans to crave them as they do an addictive drug. A Princeton University psychologist recently showed that rats fed a high sugar diet were, when the sugar was removed, thrown into a state of anxiety similar to that seen in withdrawal from morphine or nicotine. Sarah Leibowitz, a neurobiologist, believes that frequent exposure to fatty foods may configure the brain to crave still more fat. She has shown in animal studies that galanin, a brain peptide that simulates eating behavior and decreases energy expenditure, increases when the animal eats a high-fat diet.

There are many factors contributing to the explosion of obesity in the United States, and the world, but the radical changes in the composition of our diet are first among them. While scientific work in this arena is in its infancy, it's already clear that varying the amount of fat and other nutrients in the diet affects brain chemistry by activating certain genes, and this in turn directs our dietary preferences. By submitting ourselves to a steady dose of highly processed, sweet, high-fat foods, we have unwittingly entered into a dangerous experiment, the long term consequences of which are only now beginning to surface.