35 Burst results for "Obesity"
AP News Radio
New Zealand airline is asking passengers to weigh in before their flights
"A New Zealand airline is weighing passengers before they board. As part of a monthlong survey, air New Zealand is planning to wait 10,000 passengers, so pilots can estimate weight and balance before takeoff. It is voluntary, but the airlines insisting that travelers shouldn't fear stepping on the scale. There is no visible display involved, and the way in data remains anonymous. The surveys designed to calculate average weight that goes on a plane. Numbers required by the domestic civil aviation authority, and the timing of it may be necessary, as recent health stats show New Zealanders are getting heavier in light of increasing adult and childhood obesity rates. I'm Mimi Montgomery.
AP News Radio
Powerful new obesity drug poised to upend weight loss care
"A drug still in testing for obesity treatment may be poised to upend weight loss care. With the brand name manjaro is a once weekly injection already approved to treat diabetes. Today, drug maker Eli Lilly reported that a late stage trial found it helped people with diabetes lose up to 16% of their body weight over a span of 17 months, earlier evidence showed participants without diabetes, lost up to 22% of their body weight, making the medication more effective than other new drugs like ozempic and wake ovy. The company is applying for fast track approval from U.S. regulators, although the drug has been used off label since last year, analysts predict to appetite could become a blockbuster with annual sales of $50 billion a year. Jennifer King, Washington
AP News Radio
Pandemic pounds push 10,000 U.S. Army soldiers into obesity
"There were jokes about people gaining weight during the COVID-19 lockdowns, but the U.S. Military isn't laughing about its surge in obesity. The army says nearly 10,000 active duty soldiers became obese between February of 2019 and the spring of 2021. That's when the pandemic meant restricted duty and limited exercise and body mass scores went up, increases were also noted in the navy and the marines, raising concerns about the fitness of America's fighting forces. Military personnel who are overweight are more likely to be injured and less likely to endure the physical demands of their profession and the price tag each year is over a $1 billion. Experts say the solution for the military is the same as for anyone else. Diet exercise and possibly medication. I'm Jackie Quinn
AP News Radio
Study hints healthier school lunch can reduce obesity
"New research suggests that healthier school lunches can help curb obesity. I'm Norman hall, a new study shows a 2010 federal law that boosted nutrition standards for school meals may have begun to help slow the rise of obesity among America's children. The national study found a small but significant decline in the average body mass index of more than 14,000 school kids ages 5 to 18. Their heights and weights were tracked before and after implementation of the healthy hunger free kids act of 2010. The study is new evidence that improving the quality of school meals through legislation might be one way to help shield the trajectory of childhood obesity. It's been rising for decades and now affects about one in 5 U.S. kids. I Norman hall
AP News Radio
New rules would limit sugar in school meals for first time
"U.S. agriculture officials have proposed new nutrition standards for kids in school that would limit sugar and salt. Their proposed changes would focus on sweetened foods like cereal, yogurt, and donuts. Reducing the amount of sugar allowed or the frequency that sweets are served incrementally from 2025 through 2027. Sodium levels would be reduced by 30%, and whole grains would be added. Health experts say the reductions could help decrease the risk of disease in kids, including obesity, diabetes, high blood pressure and other problems. But some critics say if approved, the new regulations would be a burden to fulfill a 60 day public comment period, begins this month. I'm Jackie Quinn
America First with Sebastian Gorka Podcast
Ami Horowitz Debunks Myths About White Leftists and Black Americans
"The first part of that video that we don't have time to show here, but everybody should follow you at army Horowitz and armie Horace dot com. You interview white people also from New York and what do they tell you are me? You know, that video started off a series of videos I do where I where I show white people talking about black people and then talking about I talk to black people, the white people said. And across the board, every time I do it, it is the exact same thing. You have white people pontificating about the inability of black people to do a number of things. In this case, I walk around with ID. Or nowhere, the DMV is, or in some cases, I did one most recently I loved about black obesity. And I asked white people, why is there higher obesity rate in the black community and they tell me racism? I can't make stuff. They actually told me that black people stress eat because the amount of racism out there. That's not a joke. I didn't wait to hang on hang on. They said black people are overweight. Because they're stressed out because of white racist. That wasn't one person who told me that. That is a narrative that I heard. And then of course, I go to black community, and I asked them, I said, why is there higher black obesity than whether we see them? Because we eat the wrong foods. We don't have personal responsibility. Exactly what you and I would think the answer would be is common sense is why her from the black community as opposed to the liberal community who the white community says, we know better, listen to us. We know better than black people. That's the overarching theme every time I talk to white leftists about black people, that's they talk about black people don't know, we know better.
The Dinesh D'Souza Podcast
How Did People Stay Effortlessly Thin in Past Decades?
"I don't spend a lot of time on health websites, well, to be honest, I don't spend any time on health websites, my health guru is Deborah, Deborah, as soon as they're right here. But in any event, I saw this really interesting item, which includes a picture of people on the beach. Now this is Gold Coast Australia 1972. But the meme that accomplished companies it is, how were people effortlessly thin in the 1950s and 1960s. And even the 1970s. And the word that caught my attention was effortlessly. Now the writer goes on to say that people in the past, and this is the recent past. I mean, obviously within our lifetime, he says they didn't do crazy diets. They didn't have any calorie counting apps. They didn't have to fast. They didn't even have a gym membership. And they even ate dessert. So the question is, here we are in our society now. Struggling to manage weight and figure out how to get thinner. And he goes, this wasn't really a fight. This wasn't a struggle. People didn't have to like go to heroic lengths. It seemed to happen naturally. Now, he goes on to point out that people, in those days, again, we're talking about the recent past, 8 food cooked from scratch. I think that's an important factor. They ate food that they made. They ate full fat. They ate out only as a treat. So this is actually a cultural shift that people would go out to eat, you know, a couple times a month, but this idea of eating out every three days or multiple times a week, this is new. They didn't eat foods with long ingredient lists. So this is also a phenomenon of our time. You look at the box and it's got all this stuff in the food. So there's an interesting graph here showing the obesity of the United States. And the United States was, as a society, not obese, the turning point was a 1980, and then starting in 1980 you see rising obesity. It's leveled off slightly in the last few years. But by and large Americans have added on a lot of pounds in the decades from 1980 to the present. And so the writer says, what happened? Well, U.S. dietary guidelines got introduced, the food industry created a multitude of low fat products, huge increase in refined grains, added sugar, increase of additives and pesticides, and societal norms changed to eating out. So people eat out a lot more. And he goes on to make the point that writer does that people now eat out, well, some people eat out for pleasure. We do W and I eat out a lot. But people also eat because they're sad or from boredom. And he goes on the point that they're never full because the protein and the nutrients have sometimes been removed from the from the food supply.
AP News Radio
New guidance: Use drugs, surgery early for obesity in kids
"New medical guidelines say children struggling with obesity should be treated early and aggressively, and that includes possible weight loss surgery. The new guidelines say waiting to see if children outgrow their obesity can only worsen the problem, and lead to lifelong health problems, such as high blood pressure, diabetes, and depression, for the first time the American academy of pediatrics is setting ages at which young people should be offered medical treatment, such as drugs and surgery, in addition to intensive diet exercise and other approaches, the guidance says doctors should offer obese young people 12 and older appropriate drugs and teens 13 and older with severe obesity should be referred for weight loss surgery on a case by case basis. I'm Donna water
The Trish Regan Show
"Where's Jackie?"
"To thank all of you here for including bipartisan elected officials like representative governor senator Braun, senator Booker, representative Jackie, are you here? Where's Jackie? I didn't think she was going to be here. To help make this no, you see Jackie couldn't be there because you see, mister president Jackie passed away. In a car accident, back in August, something that everybody kind of knew, and by the way, given that you were there at this bipartisan event to end food insecurity and to take on the issue of obesity in America, given that this was so important to her, don't you think it might have known? She was dead, that she passed away. Tragically, in a car accident,
The Officer Tatum Show
McDonald’s to Face $10B Race Discrimination Suit From Byron Allen
"It says McDonald's will face a $10 billion lawsuit against them for not advertising enough on black owned media. Now, let me just explain who this helps in who this hurts. The fact that the plaintiff are the fact that and I believe it was a black man that did the suing. The fact that we're suing people because you're not advertising junk food enough on black networks. It's asinine to me. Now the people who are making money from advertisement who wants to sell out the black community because they don't care nothing about your health, you know, one of the leading cause of deaths for black people in America is heart disease and diabetes, hypertension, I mean, literally obesity is rampant amongst the black community. However, you get people who want to sue McDonald's because they don't spend enough advertising to black people. That's like saying, why don't you sell us more stuff to kill us? How dare you, not sell things that's going to destroy our community on our network. Why won't you sell destructive things in our community on our network? Why you just sell it on a white people network where black people ain't listening to? But no, it's about money. Says the federal courts this week ruled that McDonald's will have to face a $10 billion lawsuit allegation that is discrimination or discriminates against black owned media channels by refusing to advertise on them. It says media tycoon, Bryant Byron Allen, a company Alan media group, we're bringing the suit against the fast food retailer with the U.S. district judge for Nando, outgoing, all going, I think it's how you say his name. Clearing the way for Allen to attempt to prove his claim in court. So they're
AP News Radio
Article on 'fat' Arab women sparks uproar over body-shaming
"An article that discussed female obesity in the Middle East has been slammed by critics on social media as misogynistic and an attempt to that shame Arab women The article in London based magazine The Economist was entitled why women are fatter than men in the Arab world The article ran through possible explanations of the obesity gap of ten percentage points between men and women in the Middle East Fats a word now considered taboo in much of western media was repeated 6 times The author used the example of the curves of Iraqi actress in as Talib as the Middle East and ideal of beauty Thailand is now suing the magazine for defamation many critics on social media were appalled by what they described as the meaning stereotypes about Arab women I'm Karen Chammas
The Dan Bongino Show
Ami Horowitz: The Left's Party Line Is Black People Are Purely Victims
"Part of I spend a lot of time on issues around race It animates me it's important to me And in particular how the left views black people right So like you said in the segment leading to this they're always ready to jump on the races and where we're all racist Of course when we're all racist no one's races but of course they don't understand the nuance of that But when you ask them white leftist the people who have the white savior complex about what they think about black people across the board actually voter ID but I just did a video a couple weeks ago about black obesity The condescension the patronizing that exists The implicit racism of the left is institutional dogma for them that black people have no agency Their victim of circumstance and nothing more That's their party line Literally And that's what's important to
The Charlie Kirk Show
Why Omicron Can't Cancel Christmas
"A crime was basically announced right after Thanksgiving. It was the new variant. Made the stock market plummet. New York in anticipation of a Macron decided to re-engage and lockdowns, mask mandates vaccine mandates on a cron is something that we must be very afraid of is what we're told. Oh Macron, if you just watched Fauci, the NIH and the CDC, it sounds like this is COVID two. It is mutating in a more vicious, deadly and aggressive manner. What's really going on here? How many people have actually died? Of all Macron. Is the virus getting stronger or is the virus getting weaker? Well, according to Neil Ferguson, who was the original lockdown artist, he was the person that originally, the imperial college study, way back at the beginning of the pandemic in March of 2020, he has even come out and he said that Amy Kron is 45% less likely to cause hospitalization than delta, by the way, that's without factoring an Ivermectin hydroxychloroquine azithromycin vitamin D levels vitamin C, obesity age, underlying health conditions, intravenous intervention, aspirin melatonin or Qin. And if you're not able to rattle off all those treatments, I encourage you to listen to our podcasts and equip yourself. Your government wants you to be scared and unprepared. Your government wants you to be fearful and confused. There are legitimate interventions and treatments that could potentially help you. Get to know them. Do not leave yourself or your loved ones helpless, trusting the federal government or the bullet bureau going into Christmas. 45% less likely to cause hospitalization than delta, according to a major British study by Neal Ferguson. Among the previously infected, the risk of hospitalization from a drop by as much as 69% for both the vaccinated on the unvaccinated. So what does that tell us? That means that if you've had COVID before, even if you get COVID again, it's likely not to be as intense.
AP News Radio
Study: Childhood Obesity in U.S. Accelerated During Pandemic
"Hi Mike Rossi are reporting a study finds childhood obesity accelerated in the U. S. during the pandemic a new study from the centers for disease control and prevention links the cove in nineteen pandemic to an increase in obesity in U. S. children and teenagers the CDC study found an estimated twenty two percent of children and teens in the U. S. world peace in August twenty twenty one up from nineteen percent a year earlier the rate of obesity increased most in kids ages six to eleven the study was based on a review of medical records of more than four hundred thirty two thousand kids and teens ages two to nine who were weighed and measured at least twice before the pandemic and at least once early in the pandemic hi Mike Rossi up
Ben Greenfield Fitness
Study Reveals the Secret to Longevity in Japanese Centenarians
"To ancient things. A new study is pop. The is a japanese study and his japanese study was looking at a group of japanese centenarians. Who seem to have these seemingly magical powers. They have an average age of one hundred seven amongst the healthiest longest living humans on earth protected from chronic diseases that that inevitably haunt a lot of the rest of us as we age like obesity and diabetes hypertension and cancer. But what they found these people that really stood out was the trillions of microbes that lived in their gut It wasn't the amount of the microbes but it was. It was the composition of those gut bugs. The composition of those gut bugs basically. They had a bacterial signature. Those similar to the strains of bacteria in in each and every single one of the centenarians but a lot of them had a very similar microbiome in one strain in particular stood out and it was type of bile acid. Okay or is it a bacteria that synthesizes bile acid now bile acids what you might know. Is this kind of boring bodily fluid that's commonly known for digesting fats. But it's now being called as a class of entering hormones hormones that go beyond their classic role in fat digestion and absorption. So what they found. Is that these bile. Acids helped to protect sensitive gets infection and other environmental stressors. So it's really interesting because we know that that the gut bile acid content to decrease a little bit as one ages in the secondary by lasts a really powerful so they've done studies in mice before they looked at the these these microbiomes humans and they found that the gut bile acids to regulate immune cells and prevent some dangerous microbes from taking over the gut. And what a what they looked at in the seniors a particular group of gut bugs called or owed oral back to rasaie adora backdoor and that turned out this little bile acid called eyeso- aloe lithocholic acid or eyeso- aloe
Decoding Obesity
"obesity" Discussed on Decoding Obesity
"Always wondered if those weight loss supplements in the supermarket actually work. Well stick till the end of this episode. I haven't amazing guest and we discussed this at great lengths today. I want to begin by thanking you. All for continuing to listen to my podcast. At the same time. I wanted to request you all again to. Please leave me review on apple. Podcast if you haven't done so already go ahead and do that and if you've done that i'm so thankful to all while this may seem like a small thing to you but friends. This is actually very very important in the world. The podcasts all you have to do is just head on over to apple podcast. If you have an iphone or apple podcasts on your computer if you have an android device and just click on right of you. And that's it and you're done. I wanna welcome dr sandra lerner to my podcast today. She's a board certified physician in family medicine and obesity medicine and she does practice obesity medicine. Full time you know. She's lost four sixty five pounds. She had gained some weird because offer stressful practice. And it's just for life should gain about forty pounds and she changed her lifestyle. She changed the way she lived. And she lost about sixty five pounds and so she does use that experience and her knowledge and skills to also offer private weight loss coaching to her patients on her clients. So welcome sandra to my show. Hi nice to be here. Thank you much for having me. Thank you for coming on so this is such an interesting topic right. People who've actually had issues with wait. I'm sure they've seen those is in the supermarkets where they basically sell supplements and multiple weight loss supplements. And so i thought you know. Let's just do an episode on this and this is kind of demystified this part of it or this part of it. So let us begin by talking about history of weight loss supplements. Where did they really begin. So it is a release seductive topic when you are walking down the aisles. You are just your company that just by everything you can. That would possibly help you lose weight. And what i wanna know right off the bat. Is that there really. Isn't any magic bullet except your own effort in grit in doing this and so it's really interesting because we have been interested in supplements since ancient history but it really gained popularity through the eighteen hundreds with traveling salesman in the us and then through the turn of the century and in the nineteen twenties. One of the things that happened is through the roaring twenties in the flapper girls and the dancers there was a shift in what was considered to be the ideal body type which was one of the pivotal things that happened. That really fueled the industry because this shift to sort of leaner more athletic body type both in men and women is really what had people turning defined what can i do to really get to that ideal body image. That's interesting. Yeah so how of these supplements changed over time. So initially they've never been in a regulated industry so they were a lot more unregulated than they are now so so there's been one of the things that as these supplements have gained in popularity. There's been a little bit more regulation as time has gone on. But really it's very unregulated is still the wild west right. Yeah while they found all kinds of crazy things in these supplements over the counter. And i think there was one study that showed about ten percent of them have things that aren't even listed on the label. Light thyroid hormone finito. In which is a seizure. Medication as our is up. Desiccated thyroid desiccated testosterone. And all kinds of things have been found in these substances and there's a huge list of them on the fda website under med watch supplements that have had bad reactions in people or right. Yeah but the problem is a lot of times. You walk down those aisles and and you see these supplements and they talk about. They'll have these things dritan. Big bold letters scientifically proven. This study was done are that study was done. So what's the deal with that. So they can put whatever they want on the label. They can't claim to cure or treat anything so they can say supports healthy weight loss but they can't say causes weight loss and the reason is because in order to actually make that claim it has to be fda approved and has to go through the pharmaceutical process as opposed to like the nutrient supplement process. And so as long as it's part of a nutrient supplement they can say scientifically proven to support or scientifically proven to promote. But it can't really cross the line into a real plane and the studies that they do itself regulated industry and so what that means is they can study five people and say look. I gave five people. H c g hormone. Which did happen. And h c g and they followed this. Very low calorie diet increased their activity in they lost weight and it's not a surprise. They lost weight because they were eating. A six hundred calorie diet right and so and a lot of the claims that are made are along those lines that they support healthy weight loss with nutritionally sound diet and increased activity. You know well you won't find that written in ball right you'll find. Yeah and i think it's important to understand that medications are obviously regulated by fda but this unfortunately is not regulated by the fda because this is not a drug and that's they're labeled supplements which are not a regulated market at all and. That's the one thing that these companies kind of get away with is by mocking them as supplements and such an unregulated market rate right. So what if he is actually doing about this. Or how are they actually regulated. It's not regulated. There happened some moves to regulate the industry over time. There was regulation in nineteen seventy. That helped move it forward but for the most part it's not really come a long way and there is a place for supplements. I mean certainly as physicians. We will recommend sometimes omega three to support an improvement and cholesterol or vitamin d or vitamin c. And these are important and they're important dietary supplements for daily use but in terms of weight loss. There haven't really been any that have shown any significant evidence that they're effective. But i recommend is relate just making sure that you take all your supplements to your doctor and review them and the other thing is there are ways that you can look at the label and determine whether this is something that is even safe to buy at all and a couple of things you can look at is. Make sure that it's made in the united states and that it's regulated by one itself regulated that it's certified by u. s. p. or an f. s. lavely those lanes show that the supplement contains the dietary amount that is labeled on the product. And so at least you know what you're buying at that point. I mean there's still so much of stuff that they mix into these things. I think it becomes so difficult and a lot of times. what happens. is they'll mention a lot of products into the supplements which it's sort of to make sense out of what planned the used. What quantity they use it in. And that really makes it very very difficult to understand the quantities. Right it's a two point one billion dollar industry and there's two point one billion reasons why this industry is not going to be more regulated..
BBC World Service
Diabetes Has Surged Among US Youth, Decades-Long Study Finds
"On the rise among the nation's youth. A new study shows that Type one and type two diabetes have surged in those under 20. NPR's Ping Hong reports Over the past two decades, more and more young people have been diagnosed with diabetes. It's a chronic condition where the amount of sugar in the bloodstream is too high and can lead to serious health problems like heart and kidney disease. In the Under 20 age group, Type one diabetes has increased by 45% since 2000 and one Take two diabetes, which is linked to obesity has nearly doubled in that time, with the greatest increases seen in black and Hispanic youth. The reasons for the rise and diabetes are not totally clear, but could be related to rising rates of childhood obesity and exposure to environmental chemicals. The results published in JAMA, come from a long term research study funded by the CDC and the National Institutes of
The Nutrition Diva's Quick and Dirty Tips for Eating Well and Feeling Fabulous
Midlife Weight Gain: Don't Blame Your Metabolism
"Most of us reach our final adult height at around age. Eighteen or twenty. Unfortunately that doesn't mean that we stop growing on. Average americans continue to gain a pound or two a year every year from the time they reach adulthood until age sixty or so when this trend starts to reverse of course by then a lot of damage has been done although gaining a single pound or two over. The course of a year isn't going to make a big difference in your health gaining thirty or forty pounds over the course of your adult lifespan can have a significant negative impact. On your risk of diabetes heart disease cancer and other conditions related to obesity such as knee pain and sleep apnea so what drives this weight gain in middle age. There's long been an assumption that this seemingly universal trend is due at least in part to a slowing of the metabolism in midlife. We've all been told that our bodies engines simply reva little faster when we're younger and that there's not that much that can be done. If we want to avoid gaining weight through midlife we're going to have to spend more time exercising or adjust our food intake to compensate for this inevitable slowing of the metabolism. Now if you refuse to go gently into this good night you can find all kinds of special diets workouts and supplements promising to goose up your middle aged metabolism to the extent that any of these actually succeed in boosting your resting metabolic rate. The effect is likely to be quite small as i've said before trying to lose weight by boosting. Your metabolism is like trying to row a boat with a butter knife. You're going to be rowing for an awfully long time. Without moving very far but a new study is during all of these assumptions about midlife metabolism into the blender researchers used a sophisticated technique called the doubly labeled water method to measure energy expenditure in a diverse population of over six thousand people and these subjects ranged in age from newborn to ninety five years old and they also came from a wide variety of ethnic backgrounds and cultures and the results were almost exactly the opposite of what our observations might have led us to believe not surprisingly are metabolic rate is highest when we're babies it peaks at about twelve months of age and then declined steadily until we reach early adulthood but then our metabolic rate is remarkably stable from age twenty to age sixty. There is virtually no slowing in
Decoding Obesity
"obesity" Discussed on Decoding Obesity
"It was like it happened overnight. I was oblivious to the council that i was packing on and so prior to this weight loss i hit two fifty bucks was wrong and i'm five six and so and i have a muscular build. Which is okay because you can carry more weight. However i look back now my pictures and i'm like wow. I was in complete. Denial of how heavy. I really was right. So what do you think caused this. You were talking about being off some of the drugs. Do you mind sharing that with us. Yeah definitely you know. I think if i go back to the very beginning i had a tumultuous childhood lots of adversity alcoholics side of the family for dad lots of verbal and mental in abuse and domestic violence situations. And so i think that i then created relationship with food to soothe me definitely emotional eater right and then when i went down the addiction path you know unfortunately i discovered methamphetamine which is a terrible drug very fortunate to be one of the ones that got out of that world and what it does suppresses your appetite for dana so your body goes into starvation mode and then when you finally feed it you crave horrible foods and junk and sugar because that's what your brain has needed and it said into the yoyo cycle that i was already in any way and then when you get sober from something you look at it like well. I've quit smoking. Cigarettes quit smoking pot of quit drinking of quick everything i'm going to eat. It's like you give yourself permission our reward for all the other good things you've done and eat instead which is an addiction to right. Absolutely one question for you. Is that a lot of times. We see that people who suffer from some kind of an addiction. Kind of replace the foods for that addiction at times and that might become a problem for them leading to the obesity. Now that may not be the case for you because you were on a stimulant drug the methamphetamine. Which does revel the metabolism and when you were eating. Whatever you were eating you were not gaining as much weight because of the way you are but you think you had any sort of addiction that kind of replaced here methamphetamine addiction. Oh work in food absolutely work and food right and in our society. Today we absolutely welcome hustlers. We welcome working seven days a week. Twenty hour days and all that did was replaced another addiction. So and again i'm an emotional eater so in getting so you go through a lot of emotional things and mindset and you really working on clearing out the cobwebs and so if i felt something didn't matter if it was happiness i'll let celebrate. Oem sad better eat. That'll make me feel better. And then i really began to learn more about how food does affect your mood and it began to make sense. Why oh it's evening my serotonin stepping so of course. I'm going to crave chips. Chips are going to give me that. Carbohydrate boosted send going to release serotonin and make me feel good so it's not like it was even in my head. It was really what was creating with the food. I was eating right and so what changed. What was your son of the light bulb moment. That made you kind of decide that you wanted to change needed to do something about it. That's a great question. So i've three kids. The oldest is a girl and she had a weight issue as well. And you know we had tried different things fad diets kito omni drops you name it and she heard about ideal protein which is another system..
The Bio Report
A Procedural Therapy Seeks to Address Type 2 Diabetes
"Thanks for joining us. Thank you so much happy to be. Here we're gonna talk about diabetes your company facto and its efforts to develop a therapeutic procedure to treat the condition. Let's start with type two diabetes. How big a medical problem does it represent today. Type two diabetes. A massive problem for the healthcare system and the scale of that problem looms large because it's growing very very rapidly along with the obesity epidemic. There are about thirty million people with type two diabetes in the united states this year. Twenty twenty one there are going to be approximately fifty million people. The disease in the next fifteen years in the us alone. How well controlled this condition with existing therapies. There are nearly sixty drugs that have been approved to lower blood. Sugar for people with type two diabetes across a range of different classes but more than half of the people with the condition still are not getting good control of their disease and that's measured by a blood sugar measurement called hemoglobin onc- so more than fifty percent of people with type two diabetes have hemoglobin. Anc that is above the normal or acceptable range. Despite all of these drug therapies are available.
Decoding Obesity
"obesity" Discussed on Decoding Obesity
"Dive into this very interesting topic. I just wanted to quest you to. Please leave me review on apple podcasts. Also i want to see you in the decoding. Obesity facebook community. It's a free community joining and interact with people who are on a similar journey as yours. A lot of us still hold us misconception that obesity is all about willpower and self control. I know i have mentioned this. In the past as well and i just want to reiterate that obesity has been recognized as a chronic disease. A two thousand twelve online poll of eleven hundred forty three adults conducted by reuters and the market research from its source actually found that sixty one percent of the. Us adults believed that personal choices about eating and exercise what a sponsor for the obesity epidemic but interestingly the biologic cause of obesity was proposed as early as nineteen or seven as with other chronic diseases. That is a genetic competent obesity as well but before you started blaming it all on the jeans i do want to point out that this is certainly not the complete picture. Let's talk about the genetics. There have been various studies done on this to explore the genetic base of obesity. Quite a few landmarks were actually done before. We have the technology for genetic analysis. How were these studies done then. You might wonder well. These were done in twins ever wondered why identical twins look similar that's because genetically very similar fraternal twins on the other hand are not genetically similar. And that's why they also look different. So in nineteen seventy six. There was a scandinavian study conducted by 'em borgeson him to answer this question. How much of a role do genes play in obesity in children. The study design was simple and elegant. He enrolled forty identical twins and sixty one fraternal twins in his study. The twins that were selected for the study had at least one of the twins at one hundred fifteen percent of their ideal body weight. What makes this study. Really amusing is the fact that these two impairs had the same environment right from the womb. To the time they were studied what he found was that the head of the ability of obesity was anywhere between forty to sixty percent in one thousand nine hundred. Eighty six albertson card at the university of pennsylvania conducted another study proving this point further. He and his colleagues looked at danish adoption. Registry of five forty dollars the adoption records included the heights and the weights of the adoptees biologic and adoptive parents and when they analyze data and the looked at the bmi for both sets of the parents what they found was that despite having shared an environment within adoptive parents the adoptees bmi approximity those of their biologic parents rather than their adoptive parents. This study of course pointed to was the impact of jeans on obesity but did not provide any information on the extent of this impact so the same scientists performed another study. They looked at identical twins that were reared in different elements to distinguish between the importance of shared jeans and shared environment. This study was a little more complex. But what the scientists basically concluded was that the head of the ability of obesity was about seventy percent. As of this morning enough a group of scientists wanted to see if genetically similar individuals would respond similarly to overfeeding so the enrolled twelve pairs of identical twins and offered them about a thousand calories a day six days a week for a total of eighty. Four days in one hundred. Apd in this study. Even though the individual change in the body composition and weight gain varied considerably. these changes were significantly. Similar within each of the twin pairs now headed abilities understandable but is it one gene autumn multitude of genes. That caused this. But the answer to this question is yes you see. There are certain forms of obesity which are very very rare. That i'm wanna. Jenny went in his a single gene mutation that leads to obesity defects in at least fifteen genes that caused this kind of obesity have been identified but these again a very very rare the susceptibility to calm obesity. That we see is paula. Jenny that is because of an interplay of various different genes not only that these genes vetting the extent of expression making an even more complex genes are the basis for the signals of energy balance in the body. I under sponsors. That guide food intake. Small changes in these genes can affect their levels of activity. V often hear about nature versus nature in a lot of diseases and this is exactly the situation with obesity has while genetics does play a heavy role enough physical makeup. It is the environment that leads to the full expression of these genes and approve this. Actually people have done studies. There was a study done in norway. Called the hunt study which concluded that genetically predisposed people are at greater risk for higher. Bmi and that genetic predisposition interacts with the ub genetic environment that they're living in resulting in a higher bmi more importantly however the bmi has increased over the past few decades for both genetically predisposed and the non predispose people so this basically implies that the environment actually trump's this situation and it means a main contributes towards obesity and there was another study called the logic study which looked at the role of genetics in obesity treatment success to lifestyle changes in children with obesity. And this study concluded that teens actually play a very minor role in reproduction by lifestyle changes. And that you know. The environmental social and behavioral factors are much more important to consider in obesity treatment strategies. In the end. I would say that it is definitely an interaction between the genes and the environment but as these studies have proven. It's you know the environment that really plays a very very big role in the development of obesity and ill and in the weight loss strategies that we apply however you know the relative impacts of these genes the development and the environment are not constant for an individual and it's these varying levels of interaction that causes increased complexity in the development and management of obesity. Well that's all. We have time for today. I hope you all enjoyed this episode. You've been listening to the decoding obesity. Podcast please remember the information in this. Podcast should not be used in any legal capacity whatsoever. The thoughts and opinions expressed on this podcast are solely the host and his guests and do not constitute medical advice views and opinions on this show do not necessarily represent the views and opinions of any organization and that brings us to the end of the show. Thank you so much for listening in. Don't forget to visit our website. Www dot decoding obesity dot com for show notes in more info. And if you've enjoyed this episode please feel free to rate review and subscribe on your preferred podcast listening platform. We really appreciate that effort until next time..
Decoding Obesity
"obesity" Discussed on Decoding Obesity
"A lot of us still hold us misconception that obesity is all about willpower and self control. I know i have mentioned this. In the past as well and i just want to reiterate that obesity has been recognized as a chronic disease. A two thousand twelve online poll of eleven hundred forty three adults conducted by reuters and the market research from its source actually found that sixty one percent of the. Us adults believed that personal choices about eating and exercise what a sponsor for the obesity epidemic but interestingly the biologic cause of obesity was proposed as early as nineteen or seven as with other chronic diseases. That is a genetic competent obesity as well but before you started blaming it all on the jeans i do want to point out that this is certainly not the complete picture. Let's talk about the genetics. There have been various studies done on this to explore the genetic base of obesity. Quite a few landmarks were actually done before. We have the technology for genetic analysis. How were these studies done then. You might wonder well. These were done in twins ever wondered why identical twins look similar that's because genetically very similar fraternal twins on the other hand are not genetically similar. And that's why they also look different. So in nineteen seventy six. There was a scandinavian study conducted by 'em borgeson him to answer this question. How much of a role do genes play in obesity in children. The study design was simple and elegant. He enrolled forty identical twins and sixty one fraternal twins in his study. The twins that were selected for the study had at least one of the twins at one hundred fifteen percent of their ideal body weight. What makes this study. Really amusing is the fact that these two impairs had the same environment right from the womb. To the time they were studied what he found was that the head of the ability of obesity was anywhere between forty to sixty percent in one thousand nine hundred. Eighty six albertson card at the university of pennsylvania conducted another study proving this point further. He and his colleagues looked at danish adoption. Registry of five forty dollars the adoption records included the heights and the weights of the adoptees biologic and adoptive parents and when they analyze data and the looked at the bmi for both sets of the parents what they found was that despite having shared an environment within adoptive parents the adoptees bmi approximity those of their biologic parents rather than their adoptive parents. This study of course pointed to was the impact of jeans on obesity but did not provide any information on the extent of this
Decoding Obesity
"obesity" Discussed on Decoding Obesity
"Interestingly dope. These levels remain low with high protein diet. I also came across to other studies which looked at the changes of pilot function during ramadan while these studies didn't notice increase in the toddler stimulating hormone levels but the authors concluded that it may not be necessary to change the doors of tyrod medications based on these small changes that the soul. But of course you know this needs to be individualized. There was another study from two thousand sixteen that looked at the effects of eight weeks of time restricted. Feeding that is sixteen hours of fasting and eight ours of eating window on basal metabolism maximum strength body composition inflammation and cardiovascular risk factors in resistance trained men the also had similar results while the t three levels decreased with time restricted feeding as we see with other forms of fasting as well. There was no significant change in the tyler stimulating hormone levels so in the end. I would say that you know while there is definitely. Some change are cutting in the body with fasting and the type of diet. You're taking with respect to the tyrod hormone levels. But i'm not sure how significant this is clinically as with everything in medicine. It isn't one-size-fits-all so definitely if you have noticed any changes in your tolerant hormone levels with fasting or you're experiencing some symptoms. That point was nor functioning of your thyroid gland. Do consult your physician. I know this has been a very science based and a database to episode. But i really wanted to lay down all the facts about tyrod home on as it relates to be city. I hope you enjoy today's episode. If you haven't left me review yet adequacy to do so on apple podcasts. While we're out of time and that's all we have time for today. I'll see you all next time you've been listening to the decoding obesity podcast. Please remember the information in this. Podcast should not be used in any legal capacity whatsoever. the thoughts and opinions expressed on. This podcast are silly of the host and his guests and do not constitute medical advice views and opinions on this show do not necessarily represent the views and opinions of any organization and that brings us to the end of the show. Thank you so much for listening in. Don't forget to visit our website. Www dot decoding obesity dot com for show notes and more info. And if you've enjoyed this episode please feel free to rate review subscribe on your preferred podcast listening platform. We really appreciate that effort until next time..
Decoding Obesity
"obesity" Discussed on Decoding Obesity
"Please help me reach more people. I truly want to be able to help. As many as i can through this podcast all right. Let's talk about tyrod as it relates to be city sometime ago. One of the listeners actually reached out to me and asked me if intimate and fasting had any impact on the thyroid function. Now i had never heard or read about the impact of fasting on tyrod function so i decided to dive into it. I thought why not do an episode on pirate function and the titled hormone levels as the relate to busy in addition to the impact of intermittent fasting on the functioning of headline itself. If any i know this is the thing that a lot of people have on their minds. Let's begin by talking about the function of tyler at home hydrate home and plays an important role in the regulation of thomas genesis or body heat production and energy expenditure. In addition to its role in regulating food intake and glucose and lipid metabolism. People with hypothyroidism would be able to relate to this. They often have intolerance to call weather and mayfield lacking an energy because of this role of the tyler at home on it has been invested heavily. Obesity here's a quick and brief primer on the tyler hormones we take or tyrod stimulating hormone as a first step in patients to assess the functioning of the tyler gland. This is the hormone. That actually stimulates tyler. Atlanta produce tyler at home so a higher than normal level of. Tsa would mean that. The tyler is being stimulated more than it should be. One of the conditions in which this happens is when the tyler gland isn't producing enough thyroid hormone which causes the body to produce more of the st s. h. two stimulated more in order to meet the body's needs for appropriate level of thyroid hormone condition with higher levels of this. Tsa h. with normal levels of thyroid hormones is called supplemental hypothyroidism now. Interestingly this was very frequently reported in patients with obesity seven studies have found that there's a positive correlation between the slows or the toddler stimulating hormone levels and the bmi the hypothesis. That came along with this. Is that possibly. There's a mild tyler. Failure which is involved in the pathogenesis of the obesity itself. It sure seems very plausible since tyler at home one is an important regulator of metabolism. But as always with science there is more to the story. Interestingly there was an article published in one thousand nine hundred seventy nine title dietary induced alterations tyrod hormone metabolism during over nutrition the researchers noted that increased concentrations of dc levels. Which is a type of the tyler at home. One was present in volunteers. What gained we'd overfeeding. Recessions also shown a decrease in the levels of thc with fasting and with patients who have either xia a more recent study from denmark evaluated tyrod levels in relation to bmi in a normal population. They've found that patients who gained more weight or the previous six months had hired ph levels. We now know that the tyrod hormone level changes with weight in both directions. There was a study done. In patients undergoing gastric bypass the researchers found something very very interesting twenty. Five percent of the patients had sub clinical hypothyroidism. But all of these patients reverse this condition and one year after surgery not only that patients who had started with the normal s. level also lord there level significantly after one year of surgery similarly there have been studies that have shown that patients with anorexia. We've gained the weight. Have olsen ordered an increase in the tsa or the toddler stimulating hormone levels while patients with obesity. Who have lost their way. Experience a decrease in dirty essays levels this has led to a paradigm shift in thinking of hypothyroidism as it relates to the city. It is debatable whether a patient with obesity should be diagnosed as having sub clinical hypothyroidism based only on the elevator. Dss levels which is very commonly seen again in patients with obesity. Another important thing to talk about is the risk of tyrod cancer. Obesity as is the case with the link between obesity and other cancers debt is preliminary data linking obesity with modest increase in the risk of thyroid cancer as well we have discussed the risk that obesity poses for various malignancies at length in episode nine. Okay let's switch gears and talk a bit about the impact of passing on tyler at home one. Which was the original question posed to me. A google search will take you to a lot of blog posts on the impact of fasting on the tolerate. Function with some mentioning. You know it may be harmful in patients with hypothyroidism while others debating this well. Let's see what sign says about this. It is true that there is a decrease in the two three hormone levels with fasting. But is this clinically significant. Is this significant for patients who have hypothyroidism or low functioning tyrod. Does this mean that. Fasting has a negative impact on the tyler functioning. There was a study done on people with supplemental hypothyroidism which again is a condition wherein people have high levels of the thyroid stimulating hormone but normal levels of the home hormone itself and they looked at whether there was any difference in the weight loss. Efficacy in them if calorie restricted diet or alternate day fasting so after six months while the weight loss was similar in both groups. The insulin resistance decreased more in people who followed the alternate day fasting and more importantly talking about topic that we're actually talking about tyrod hormone levels if the changed are not the tyler hormone levels actually were not affected by alternate day fasting. Another study looked at the impact of starvation on the home and this is important to understand when we talk about intimate fasting. It is very different from starvation. In this study people faucet for four days though he said just did find a drop in t. three levels but these returned to normal after eating a mixed.
Decoding Obesity
"obesity" Discussed on Decoding Obesity
"Yeah and you know. I'll be very honest before. I actually read about obesity medicine or actually learned about obesity as a disease. I used to think that the owners would be on me or on the person who suffering from obesity to actually lose away to basically just buying into the fact that you need to eat less exercise more and the owners was entirely on the person. But you know. I realize that just by changing terminology from calling somebody obese versus calling somebody suffering from obesity makes a big difference right. I mean here. You are kind of taking the blame away from the person and kind of associating a disease kind of a situation with the person absolutely. This is something called people. First language and i think it's a good tool for a lot of physicians to use when they are discussing people with obesity. So we wanna make sure that. We put the person first and not their diagnosis. If you had someone who had cancer you would say she has cancer. You wouldn't say she is cancerous. If you have someone who has obesity you would say. She has obesity. not she is obese. Ultimately you're no longer labeling the individual by their medical condition. Yeah just for people to know because a lot of times people may have the best intentions but may not necessarily use the best words for lack of knowledge. So what are some of the statements that may reflect weight bias. There are a lot of different ways weight. Bias can be reflected you can have overt weight bias. Which could be very blaming. Shameful statements directed at the person. You can make jokes on their behalf and a lot of things that you see on the media and social media are very overt but there can be subtle forms of weight bias as well and this could be not having gowns in in the doctor's office that fit properly or not having a blood pressure cuff. That will actually measure blood pressure on your patient. Sometimes you can see subtle body language if you see someone on an airplane that is being sometimes. It could be something as subtle as an iro on the airplane and wait by really control and a lot of different ways. Yeah and it's very important to understand. And i'm glad that you mentioned about the gowns and you know sometimes even the chairs that we have in our offices and also sometimes even the wing skills that we have because they may not necessarily you know measure the may not go all the way up till the person's weight and that kind of can be an embarrassing situation for the patient or herself right and you're really right when you say that it's also about the body language that people trae because a body language does convey a lot of our communication right. So that's such an important thing to understand. It does not necessarily mean the words but also means the non verbal communication that we have with each other as humans. And that's so important to understand that coming from a perspective of empathy for the person. Because you know really. It's kind of like judging somebody prematurely and not knowing what really they're going through in my opinion the right way to do things yes and when we think back about the doctor's office i know i talked a little bit about the gowns and you mentioned the skills but there are a lot of other ways than the doctor's office that it's important to think about weight bias. So having scale that accommodates our patients and a blood pressure. Cuff that accommodates our patients having appropriate gowns. Where people can feel really comfortable even something as simple as in the waiting room having chairs.
Decoding Obesity
"obesity" Discussed on Decoding Obesity
"Hi friend we often see people with obesity coming up in jokes and being made fun of and this obviously is not appropriate and in my opinion this is kind of akin to making fun of someone with a heart attack or diabetes or high blood pressure to discuss this very important topic. I have dr. Sarah smith back on my podcast but before we go further. I just wanted to remind you all that. I have set a goal for at least a thousand reviews on apple podcasts. In two thousand twenty one. I know this sounds very very bold on my part. But if you're liking this podcast please. Helping get my. Please go to apple podcasts. And leave me review now. Dr smith is a board certified obesity medicine physician and is also a life coach. She does one on one coaching to help people with obesity. And i'm so happy that she's back up podcast or discussed this very very important topic. Welcome back sarah. Thank you so much for having me offish car. I'm really excited to talk about this topic. Yeah this is something that is very close to my heart. And i'm very passionate about people with obesity come of softening enjoy so often the ridiculous and it's not just jokes. That people are cracking. It's even you know the stage comedians. They often will make fun of people with obesity. And it's so important to understand that you know. This is kind of undermining the fact that it is a disease and you know we should just have talk on this and discuss this and bring it out in the open so that people can know more about this. So it's so great to have you back on this podcast while we discuss this what we call eight buyers so let's help our listeners understand. What exactly weight bias absolutely weight bias is the negative attitudes beliefs preconceived judgements and discrimination based on someone's body size or weight. It is very common in the united states and shows up in a lot of different settings including healthcare but also in school employment and at home. It's amazing right. Even in healthcare what we have physicians who are trained to help people kind of have this bias and it may be just because of the fact that it's kind of become culturally accepted in society. What do you think about that. Absolutely in the healthcare setting. It is very common to see weight bias. And i think that a lot of this is based on beliefs that are passed on. Among physicians and other healthcare providers many physicians nurses dietitians and other healthcare providers have stereotypical beliefs related to wait relate often saying that people with obesity are lazy or they have no willpower. A lot of times. Physicians are actually direct sources of harmful comments. And they think that by saying some of these things that actually motivates patients to lose weight. I think it's so important to understand. There's right because it's not just about wait a lot of times when we make negative comments we may have good intentions but that may not necessarily be what will work for the other person and it's so important to realize that may actually have an opposite effect on the person absolutely. The studies show that when patients are experiencing weight bias. They feel berated disrespected. They're reluctant to talk to their doctors about wait. They feel blamed dismissed. And it actually can lead to more maladaptive eating behaviors right. And i'm just curious you know. Do you know how it started in the society. What causes to develop so wait by. This is caused by negative beliefs in society and a lot of the big drivers for weight..
Decoding Obesity
"obesity" Discussed on Decoding Obesity
"Let's help our listeners understand. What exactly weight bias absolutely weight bias is the negative attitudes beliefs preconceived judgements and discrimination based on someone's body size or weight. It is very common in the united states and shows up in a lot of different settings including healthcare but also in school employment and at home. It's amazing right. Even in healthcare what we have physicians who are trained to help people kind of have this bias and it may be just because of the fact that it's kind of become culturally accepted in society. What do you think about that. Absolutely in the healthcare setting. It is very common to see weight bias. And i think that a lot of this is based on beliefs that are passed on. Among physicians and other healthcare providers many physicians nurses dietitians and other healthcare providers have stereotypical beliefs related to wait relate often saying that people with obesity are lazy or they have no willpower. A lot of times. Physicians are actually direct sources of harmful comments. And they think that by saying some of these things that actually motivates patients to lose weight. I think it's so important to understand. There's right because it's not just about wait a lot of times when we make negative comments we may have good intentions but that may not necessarily be what will work for the other person and it's so important to realize that may actually have an opposite effect on the person absolutely. The studies show that when patients are experiencing weight bias. They feel berated disrespected. They're reluctant to talk to their doctors about wait. They feel blamed dismissed. And it actually can lead to more maladaptive eating
Decoding Obesity
"obesity" Discussed on Decoding Obesity
"You know you should really consult your doctor before. Starting any physical activity regimen. You know this is important stuff because people who are suffering from the railway or are suffering from obesity before taking on eastern was from nineteen ninety s very strenuous so any strenuous activity even moderate intensity activity. Really it puts stress on your heart and all of your body. And we have to make sure that you'll ready for starting a rigorous exercise routine. So that you're not hurting yourself. You know obviously wouldn't would you not want to be starting that with the intent of hamas but we just need to make sure that you don't end up doing that unintentionally so it's always better to start slow and build upon it also and it's not great you know just go gung ho in one go and start with something very very extreme because you know this is a journey really is not a one thing that you do and that's the end of it. You really have to gradually build up on whatever you're doing. So how has that changed for you. Now how has Your routine change or has it remained the same throughout its has remained the same. I've been still working out six days a week. And because i also found out that my work out i don't have as many autism meltdowns i might still get periodically annoyed at something like google breaking my website. Because it's totally uncalled for. How much power does company need right. So i decided you know. I want to stay with this because i like working out. And it's an idea. Three days of kickboxing and analysis three days of beach by on demand and might not daring Their new one of their new workout programs called ten rounds by jill freeman. And it's all a bunch of boxing. I i must have a really big thing with boxing..
Decoding Obesity
"obesity" Discussed on Decoding Obesity
"But for me it's been about an experiment. One living journey actually going from an baseman to a normal white. That has been more experiment and tweet things along the way and to help me but it's also important to know the science of what's happening saw raid pipe boy through the you england journal of medicine that you may know with them. Dr mark medicine. The two thousand and nineteen study all the. He was a combination of studies that he put out a summary off which i found really fascinating Obviously dr jason work with obesity code. And i'll watch so many videos with jason final on almost now. I'm personally but it's mike. Date learning talking to other obese people and learning about this struggle which has been great to and you see real correlations and base pistons journey. And i think when somebody that's base reads about or here's about someone else's journey they just start shaking. You hated green because they simony things that resonate with them. Yeah that's important now. The only thing that i wanted to ask your grandma's what did you do about your weight. Lotto did you change anything in your strategy other than just increasing the exercise and going into the maintenance fees or did you do something else to kind of break that plateau now. It didn't really just sorta trusted the process and at that stage was eight months in module and thought will. Whatever i'm doing is being working and you know obviously i think your body gets that point win you released a main samanta white and it has to be as a sort of a race period. If you like will somewhere where your body sinai. I we just to get used to this. Might be you might know more about this than me. Obviously but for me. I just felt like it. Sydell here for a minute. I'm just gonna trust the price. Do what i'm doing. I did increase the soysa bitten. One thing i will. We're not lost at a hundred pounds. Initially all wasn't really doing a lot of exercise because for me the focus was on food head to rewire. what price in my mindset is to how. I was going to change the why how. I was going to gravitate towards more windy. Woody type food high quality food. And i'll head to learn how to shop for that and so one of the things ought go to the supermarket or the big box store and a length are shopped around the perimeter of the store. And that really really helped me and for anybody. That's trying to cut down on. Sugar rule kaba hydrates in just shopping around the outside in going to the fruit and veg section section dairy section or found that sort of naturally cut that down. Look so yeah. That was some of the things that i did along the way but with exercise when i got white off i started exercising more when i say all the white today. Eight hundred pound point. And i started walking more started. Swimming started rowing. And because i could win all this exercise was a drag on. I didn't want to do. It just felt like. I didn't wanna go down jim. When i was one hundred sixty he'll go out. Didn't want to be the central people's attention for the wrong reason on be..
Decoding Obesity
"obesity" Discussed on Decoding Obesity
"Have their pain get better. Yes definitely i think. The challenge that patients with obesity have is that they see their doctor and a lot of times. They're told well lose weight. And your pain is going to go away. And i think sometimes that leaves them frustrated. It doesn't give them a lot of really. You know i guess actual plans and tips that they need to actually get there. So i try to really break it down and make small goals make table goals. And i've seen people lose weight. Just changed their diet and that in itself have profound impact on reducing their pain. So absolutely i've seen the weight loss and just lifestyle changes alone have really really really strong. Impacts right bonding. The patients who are suffering from severe to be city as we say who may find it difficult to start exercising initially. Do you see the other people who's gonna start getting physically active. You see that playing a role in their pain or pain getting better. Yes definitely so. I think that for this goes for all of us. That are sedentary lifestyles right. Now we're not helping our chronic pain issues because the less we are using our muscles the more imbalances we have and the more prone. We are to put extra stress on our joints and if patients are able to get active. I recommend a lot of either physical therapy or aqua therapy makes. It's really nice kind of pain. Free way you can get moving without putting extra pressure on your joints that by doing that. If you strengthen all those muscles that are supporting your back your knees. Your hips patients can get a lot better in a lot stronger pretty quickly. Yeah i think that's very important to understand. People who have obesity really have a lot of stress on their. We'd been joined some like. The hip joins the knee joints and working in doing out in water like a swimming pool in a shallow swimming. Could really help because that really takes a lot of the weight off of these joins and actually just moving them there and usually. That's a good place to start especially for people who are suffering from severe obesity so that they can at least start getting some physical activity going to strengthen those muscles. Do you walk with a physical therapist treats them specific physical activities or is it just whatever they can do. Yes so. I work with a number of physical therapists very closely and we also have a aqua therapy facility that i work with close by actually has warm water therapy which is even better especially for those people with severe joint issues to get in a warm water and be able to do their therapy that way. I mean they just found that it's really enjoyable and they're also able to get a lot better stockton me about dietary changes that help schumer so the main thing to remember is that you know the standard american diet that we're eating right now with very very pro inflammatory. The thing about diet is it's a very personal choice either many diets that have research behind it. And then you'll find another article that kind of refute set. So what i usually tell. My patients is general principles. Try to eliminate or cut down sugar. Try to minimize processed packaged foods. Try to eat anti inflammatory type of diet. Nita's many fruit and vegetables as you can as much food as you can in its natural state and that alone is usually enough to really impact notches inflammation but also their weight over time. I see so. How quickly do people start seeing these results with increasing the fruit and dig the vegetable intake. How quickly have you seen. Your patients see results in terms of getting their pain better. Yeah so usually when they're making changes like this you know we're not looking for the massive amounts of weight loss very quickly but more like working slowly towards it so i had one patient that all she did was it was too much for her whole upheaval of her diet so we decided the first month we were just gonna cut out soda to cut out soda. Started drinking water in. That's the only change. She made that in itself. I think it was an eight pound weight loss by the time. I saw her six weeks later. And she felt super encouraged and then continued. Most of my patients will lose about five to ten pounds a month and after two or three months they start to feel significantly better. I see and have you had any patients who felt that are independent of the weight loss with the bane of the integrative site of the management. Yeah definitely see how some people do have a hard time with the weight loss. But they're still able to get more active. They're still able to do a lot of mind. Body therapies depression does go along with chronic pain and along with obesity sometime so incorporating. Some of that into their life has helped as well. we're just their pain levels and then sometimes people just need procedures and they need to feel better in the short term and that kinda gets them over the hump where they're feeling better and then they're really motivated to do these other things. These lifestyle changes. I see yeah that's interesting. Because are you still doing the procedures or you just purely. Integrative still do procedures yes and some of them work really well of course for certain joint issues like this. Yeah i mean. They're all most of the procedure evidence based so that's definitely there but i was as bay curious. About how are you patients reacting to the dietary changes and have you had any patients who've been kind of resistant initially to these changes. And how did you talk to them. I think like i said i. It is a very personal choice. I mean sometimes. I met with some resistance. Because it's maybe it's cultural or maybe it's something that they don't want to change or they feel like they can't change. I've also had some patients say they can't afford some of these other options. So we've the process. I would say in part of it is is just introducing the idea coming up with very very small minor goals like i said with the other patient Just cutting out the soda and replacing it with water trying to meet the patient with where they're at i think is really important because you really can't force something like this and new. Sometimes i also asked like a nutritionist to help to and that can be really helpful so other than the nutrition ovaries or anything else involved in all of this from your integrative and functional medicine standpoint. Is that anything else that you employ to help patients with pain. Yes there's definitely a lot so the different aspects. Are you know i i start out. With addressing physical things like we talked about the physical therapy but a big component of chronic. Pain is mind body therapies so stress reduction. Mindfulness meditation these type of incorporating physical activities like yoga tight t that have a mind body aspect to them really does a huge plays a big role in chronic pain in terms of kind of resetting those chemicals stress hormones and that really does help a lot of pain yet. I think it's also about developing that tolerance to that certain level. That happens once you become more physically active and you know the body gets used to some of the pain as you're getting better and i believe that meditation some of these mindfulness activities. Also help with that. I could be wrong here. What are your thoughts on that. No you're definitely right. They've done thousands of studies. I would say on on different types of the kind of the mind body. Impact of pain and mindfulness. There's been a lot of studies to show the mindfulness daily meditation cognitive behavioral therapy for one. Biofeedback these are different. Approaches that a pain psychologists retrain your thought process retrain those negative emotions into positive emotions. Kind of retrain. Your body's physiologic. Perception of pain for exactly and that itself has profound impact on pain. Yeah i mean that's very interesting because that's a very different way of looking at how you're going to treat pain one. Is you give medication to help. We either the inflammatory mockus. For example we use end sets and basically decrease the inflammation. That's one type of pain. You have the. Opiates that really work on the opioid receptors. And just mazda pandals are the pain receptors right but then know looking at the other thing is building up that resilience and that resistance to pain. Psychologically how much pain you feel..
Decoding Obesity
"obesity" Discussed on Decoding Obesity
"Aches and pains which increase as we age people suffering from obesity are more prone to getting these body paints being medications have their own well established side effects. Wouldn't it be amazing if we could help. Alleviate these with minimal use of medications. I am pleased to welcome dr. She told the carrier to discuss how we can do this. She's a board certified anesthesiologist and a pain physician. Who dealt with her own pain issues a few years back. She decided to get education in integrative and functional medicine and use these methods to heal without medications and injections she's also a bestselling author of the new book break the chronic pain cycle a ninety day program to diagnose and eliminate your pain. Welcome sheetal thank you. Thanks for having me yet. It's great to have you so you know. She took people with obesity. Often suffer from gender body aches and joint pains. What are the common aches and pains that you see in people who are suffering with obesity in your practice. Sure so there's actually two different. I would types of pain that i see so. The first is mechanical pain. And that's what you kind of expect to see. In obese patients due to the extra weight. Some additional stresses on their joints so in those patients. We see a lot of hip pain. Knee pain back pain. And that's a result of just the extra stress causing kind of an accelerated arthritis and bone breakdown of their cartilage and early onset arthritis. But then we're also seeing a lot of other syndromes that happen. In a higher likelihood in an obese patient versus a non obese patient and those are things like headache fibromyalgia of domino pain and nerve pain actually have nothing to do with the mechanical causes right and all these beans really depend on the movement or lack there of or is there something else that also precipitates. These paints sure so joint pain. A lot of times is dependent on movement especially the hip and the knee joint pain however as their kind of arthritis of the joint really progressiveness to becoming end stage or bone on bone arthritis in those people. I actually see them having pain even at rest. The other types of pain. I talked about like the fibromyalgia. The nerve pain. Those can happen at any time because those are actually more related to biochemical ties to obesity rather than just the mechanical resents. Let's talk about the biochemical pot of it because that's very interesting very commonly. We see that the pains that are there are very commonly we think about the pins that are there with. Obesity are primarily because of the stress on the joints or the weight bearing joints that we would see. But let's talk about the biochemical factors at play over here. What really causes all of these other pains sore. So they found that in studies done on both humans and animals that obese patients have higher inflammatory markers in their blood versus people that are not obese so one example of this is something called. Crp and this is c reactive protein. It's an inflammatory marker so it's elevated in patients that are obese and that leads to a lot of extra joint pain and different types of pain syndromes just from the inflammation itself. I see so. Tell us about your journey. How did you get involved with pain medicine. And how did you finally get involved. A of medicine. Sorry so i decided at some point during medical school that i wanted to go into pain management. My father was a pain management. Doctor so i was introduced to it early on and spent time in his clinic and i was like this is what i wanted to do. Because it's truly helping people healing people. And i just saw him make such an impact on people's lives so i decided to go into it but i have never actually experienced pain until i finished my training and then i experienced chronic pain myself about two months after i finally finish my board exams. And that's how. I kind of went down this path of learning more about pain through integrative medicine because i had my conventional side. But that wasn't enough for me to figure out how to help myself. He'll see and then. What did he figure out from the side. So when i initially had my pain it started out as foot pain and then progress to hit pain and back pain. I started out going through the conventional medicine side of things. You know i had xrays. Mri's i saw the regular doctors. I did physical therapy. But i wasn't getting better and after about a year or so of of doing that. I was very frustrated. I don't like to take medications. I didn't want any of the injections offered. And so. I actually did a one year. Integrative scholars program. And i started to learn about all of that stuff you know i was trying acupuncture. I was doing all these different therapies and slowly. But surely i started to get better. I see in the take for you to see these effects of very long time. I think i have pain about three. And a half years to be honest it took a long time for me to figure out every single lifestyle change and every single aspect of my life that i needed to address before i was able to like completely get rid of the pain. So obviously you're trained in pain medicine. And i'm sure you were treating patients would be that the conventional medicine that you learn. What are you seeing patients that were not really happy with the conventional medicine and did dot impact at all in getting this integrated medicine training. Absolutely so the thing. That i you know when i first started residency i kind of thought. Conventional medicine was the only way and everyone was going to get better. And then when i actually went and did my pain fellowship and i started to see people. I realize we were just placing bandaids. Bandaids would last for maybe a week maybe a month maybe a year and it would fall off and people were getting worse instead of better and it was really frustrating to watch. That happen and know that. I wasn't really addressing their root cause. I wasn't helping them heal and we were just masking issues and patients were frustrated for me. It was really important that i went kind of beyond what i was taught in my conventional training so that i could really help people and you know. Get rid of their pain and not just mask it. Yeah it's funny though because this country we have this epidemic of opioid use and that's primarily used for pin management and. It's important to understand that there are so many different ideologies and so many different causes of pain and distracting. The pain itself may not be enough. You need to find out the underlying cause of the pain as they had mentioned that an obesity. There's a lot of inflammation it is a pro inflammatory state which we know very well And you know treating that would probably help with the or do you see any patients where they're suffering from obesity and common. You advise them to lose weight per se. Have you seen patients who've lost we'd get.
Decoding Obesity
"obesity" Discussed on Decoding Obesity
"Provide the even with a lower dose Again patients detention experienced side effects to that. That's what i've seen but scientifically it makes sense because you have other avenues. That are mitigating site of tits so university. It's very interesting. That marijuana increases artigas. Chris the appetite great and one would think that because it increases the appetite it will probably cause an adverse effect on obesity. If anything and i was researching this because i wanted to record this episode and i was actually surprised. So you want to elaborate on that on how this.
Decoding Obesity
"obesity" Discussed on Decoding Obesity
"Friend have you left me review on apple podcast yet if not. I request you to do so. I'm aiming for a thousand reviews by the end of this year and your view will certainly help. It helps me understand. How i'm doing because i want to be able to provide the best possible content to you so if you would just leave me review or comment on our podcast. I would really really appreciate it. We all try to eat foods that make us feel well internally but what about eating foods based on the precise needs of your body ever wondered if the food you're eating alliance with your specific physiology and with your specific genetics. This is another field of interest in relation to quantities. Now this is nothing new. For example we commonly hear of people with food allergies and they need to avoid certain foods patients with the disease. Avoid gluten those with peanut allergies of what peanuts etc. How does this translate to be city. The problem of obesity is different from food allergies food allergies and abnormal reaction of the immune system triggered by the ingestion of a food protein antigen which is not the case with obesity. There has been some debate on this actually. In the scientific community the most commonly associated gene with obesity is the f. t. o. gene. There was a study looking at whether dietary factors macro nutrient intake and fiber intake time physical activity modify the association between the genetic variation and fdr and body mass index. So listeners are genes. Do very little bit from individual to individual so what the research actually wanted to do was look at different variants off the fda gene and see how it associated with the different macro nutrient intake. And is you know. Body mass index is something that we use to measure obesity so the analyze the data from forty eight hundred thirty nine people and they showed an increase association of be seeing the people with a particular variant of this fda gene with a high fat diet and low level of physical activity which they did not observe in subjects with a high carb diet. The biggest problem that i see with this study was the fact that it was based only on the recall of food that the patients eight. Now i'm sure you all must have experienced this as i have that. It is very easy to forget. Even what we eat a day prior another big limitation was that they were unable to examine the effect of gene type among individuals with extreme diets. Such as a diet with very low carbohydrate so the diet may have been relatively higher carbohydrates or higher in fat diet but did not address extreme diets like a very low carbohydrate or ketogenic diet now. Let's talk about another big study that showed quite the opposite result. Now this was a much better planned and carried out study called the diet fit study. that is d. I e. fit. There were some important things about the study which you will suddenly find helpful. This study again. Compared the utility of matching a high fat was says a high carb diet to the specific gino type. When i started reading about this study i wondered. How did they figure the specific genetic pow. Well this was based on the smallest done earlier which showed that the people with some jeans did better with one diet or the other so. The researchers in this study decided to conduct large study looking at if matching the microbes to these. You notice was really helpful. Some things that i think were key in this study. And we've discussed all of this in the past. I wanna point out because they form a very important piece of the puzzle. You see we all talk about calories but in this study no explicit instructions for energy restriction will give. This is very important to understand. They did not ask. The subjects are the participants to restrict the amount of calories. They were eating. And i want to point you to episode six. If you haven't listened to it already where. We discussed the whole concept of calories in and calories out so if they did not have a calorie goal. How did they manage nutrition in this study now. Both the died. Groups were instructed to number one maximize the vegetable intake number to minimize the intake of added sugar refined flaws and transfats and number three focus on whole foods that were minimally processed nutrient dense and prepared at home whenever possible. All of these techniques are so important when we talk about changes in the lifestyle the focus has to be unsustainable long-term changes and. Here's the best part despite not being instructed to follow a calorie restriction. That reported reduction in calorie intake was about five hundred or six hundred calories per day for both groups relative to the baseline. So you see just by concentrating on whole foods the calorie intake went down making this a more sustainable change. Another important thing about this study. Was the participants did not change their physical activity levels during the study period. One important thing that was done in this study was that the participants were given behavior to support now. This may sound a bit confusing but this does not necessarily mean that there was something psychologically wrong with the participants behavioral counseling entails. Helping people become more aware of their behaviors and how to change them for the better. One thing that i must point out here is that why the cup group had lower carbohydrate intake relative to the other group this did not fall into the ketogenic range or even the traditionally accepted low lacob range so the only thing was that the kabul headed in dick was relatively lower compared to the high carb low fat at the end of one year. The researchers did not find any difference in weight loss whether the diet was master. A specific gino diaper now. There's another big study that i really want to highlight over here. It was called the pound lost. All of these studies. Certainly have very interesting names now. This also looked at a certain gene locus and how it interacted with the diet with regards to changes of body composition weight etc. I don't want to bore you with the details of the study but this was a randomized trial which is what we want to study this analyze data over two years which is also very good because this shows us how sustainable the died was over. Two years interestingly this study did show some correlation between the genotype response to a high akabusi. Carb diet the data and interaction of genes with specific macro nutrient. Compositions is very conflicting at the moment. Another thing complicating the holy show. Personalized nutrition is the gut microbiome which also varies from person to person. Recently there was a study called the predict one trial that was published. You gotta love these names. The study showed that genetics plays a minor role in dominate the personal nutritional response as the actually enrolled identical twins into this study and even with the same foods. The identical twins responded very differently in other interesting thing that this study found. Was that the optimal time to eat for. Nutritional health also depends on the individual and is not fixed. And it's not like a perfect meal that you have optimal milken in terms of fat carbohydrates proteins and fiber is also highly individual. The relationship between calories consumed in a meal and nutritional responses week. The form of food is consumed in whether it's cooked chalk. Ground produces drastically different results. This was however funded by a private company selling product based on this study so that definitely needs to be taken into consideration here but it was published in a very prominent journal. So there's that too. I know this all sounds very confusing and boring but my friend is a science one one. It takes time and effort to find an answer. The good thing is that we do have some leads. I remain hopeful about finding some answers to this in the future. One important thing to understand. Is that while this. Individual centered approach is what we are now aiming for in medicine at diagnose. The population causes of obesity. We have seen the rise of obesity globally in the past few decades despite these inter individual differences and we cannot ignore this fact. So despite these differences in our genetic makeup gut microbiome. I think one shorting. We do need to start eating more healthy and more clean. Another important thing to do is to listen to your body. It will tell you what it needs. It will tell you in one way or the other. What is going to nourish it. Well that's all for today my friend. I hope you're enjoying this. Please don't forget to leave mir.
Decoding Obesity
"obesity" Discussed on Decoding Obesity
"Lower risk of type two diabetes by middle adulthood. And so i mean. The evidence is clear right and so basically the earlier. We introduce a diet higher and vegetables. The lower risk of developing type two diabetes and obesity later in adulthood. That's very true. I it wasn't the cardia study that i was actually referring to..
Decoding Obesity
"obesity" Discussed on Decoding Obesity
"Nisha patel is a practicing. Boats are defied internal medicine physician and obesity medicine specialists. She actually currently got both certified and obesity medicine. She is currently enrolled in a calorie medicine program. Through health meets food. She hopes to him by will have patients and others with the knowledge and tools to make practical sustainable lifelong healthful eating habits dr patel who also goes by the doctor plan tell is also passionate about addressing food insecurity in the us and helping others understand how it relates to the development of chronic diseases. Now my other guest. Dr dish around is board certified endocrinologists and she also recently got boats divide and obesity medicine. She also has enrolled in the connery medicine program. The same one as dr patel. She completed undergraduate and medical education at vanderbilt university prior to competing her internal medicine residency and chronology fellowship at the university of chicago. She has a special interest in the management of diabetes and obesity and culinary medicine. She strides to emphasize the dodge food as medicine throughout of medical practice. Welcome ladies for.