Obesity and Life Expectancy in Older Diabetes Patients

The treatment of choice for obese type 2 diabetes (T2D) patients is weight loss.

The majority of patients with T2D have a high BMI of ≥ 30kg/M2. Weight loss leads to increased insulin sensitivity and an enhanced metabolic control in obese patients.

Although obesity is seen and characterized as a risk factor for many conditions such as hypertension, coronary heart disease and chronic kidney disease, there is a lack of direct correlation. Being overweight is associated with twice the risk of developing cardiac and metabolic morbidities. This risk increases in proportion to the BMI.

Statistics used in this metanalysis study were hazard ratio, and 95% CI for each study, I2 statistic was used to determine heterogeneity of the studies. Statistical significance was determined using P < 0.005. This study had a total of 250,016 patients and produced results that indicated a decreased all-mortality risk for patients who were obese compared to normal weight patients. These results were not statistically significant (HR 0.87, 95% CI, 0.75 – 1.01, P = 0.058, I2 = 91.8%).

Further analysis of the studies revealed that significantly lower risk of death was only observed in elderly patients but not in younger patients. (HR 0.69, 95% CI, 0.63 – 0.75, P = 0.0001, I2 = 50.4%). A lower mortality was also evident in studies that had a follow-up time of less than 10 years compared to studies that had a follow-up time of more than 10 years (HR 0.78, 95% CI, 0.65 – 0.93, P = 0.0006, I2 = 85.5%). Two more studies that were used to analyze all-cause mortality for high BMI vs normal weight patients showed consistent results of high life expectancy in older obese patients vs normal weight older patients (HR 0.84, 95% CI, 0.77 – 0.91, P = 0.0001, I2 = 91.5%). Studies that looked at BMI in relation to cardiovascular death in diabetes patients indicated a 15% reduction in risk of death in obese patients compared to normal weight patients. (HR 0.85, 95% CI, 0.74 – 0.97, P = 0.015, I2 = 12.9%).

This meta-analysis demonstrates a significantly reduced risk of death in obese patients than in normal weight patients, but longer follow-up periods reduced the benefits. This benefit of decreased risk was only observed in the elderly obese patient population. The finding of opposite relationship between obesity and mortality confirm earlier finding of a meta-analysis by Liu et al. In another study by Zoppini et al, 3,400 T2D patients were observed for 10 years and it was shown that patients who were over 65 years of age had a reduced risk of death from increased weight compared to younger obese T2D patients.

Studies suggest that increased muscle mass is associated with decreased insulin resistance. As one ages, muscle mass decreases, which results in lower body weight in the elderly patient and thus worse outcome.

This was originally published by Diabetes in Control.

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Leigh Hardingham Shares His Journey with Obesity in New Documentary Series

A new locally produced documentary series explores obesity in the Hastings by following the journey of  Port Macquarie man Leigh Hardingham.

The team, headed by surgeon Dr George Petrou, took the initiative to offer the series as a gift to the community.

Lee Hardingham journey with obesity

Photo: article supplied

“We were driven to do this project because there is so much misinformation out there about obesity perpetuating constant myths about the disease,” says Louise Petrou, executive producer.

The touching stories of motivational Taree mother of three Mary-Clare Dangel and a Charles Sturt University student also feature. The theme is upbeat and educational.

The Mid North Coast has twice the number of people battling obesity (and the diseases associated with it) than that in the Eastern Suburbs of Sydney. It’s no different over the mountains in remote areas and rural cities and towns. With it travel killer diseases such as Type 2 diabetes and sleep apnea.

‘Let’s Talk About Obesity’ is the first film in the series of four documentaries.

“Obesity is a disease that takes over the entirety of a person’s physiology,” says bariatric surgeon Dr Petrou.

“There is a misconception in our community that being obese is the fault of the person. This is simply untrue.”

The series was created by film maker Scott Tompson who is responsible for programs like Poh & Co, Bush Doctor and the Destination Flavour series on SBS.

Leigh Hardingham is a former ABC Radio sports commentator and director at Port City Bowling Club who features throughout the documentaries.

Leigh battled obesity for years before turning to surgical treatment.

He was on 11 different medications before his operation.

Leigh discusses his many weight loss attempts with gimmicky products and expensive, hard to sustain gym program goals.

“Anyone who lost weight on one of those vibrating things… well it must have been a bloody accident!” he said.

The series also features opinion from two respected Port Macquarie GPs. Dr Andrew Williams and Dr Adam King who treat serious weight related health issues daily in their practices.

This article was originally published by Port News.

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Pretty Pressure From Peers, Parents, and the Media

The 2017 National Eating Disorders and Obesity Conference is being held at the Mantra on View Hotel, Gold Coast next week!

Dr Haley Webb, Research Fellow / Psychologist at Griffith University will be joining us to discuss ” ‘Pretty pressure’ from peers, parents, and the media: a longitudinal study of appearance-based rejection sensitivity”.

Dr Haley Webb pretty pressure

Dr Haley Webb

Drawing from the tripartite sociocultural model of body image, we examined whether appearance-related messages and modeling from peers, parents, and media (i.e. “pretty pressure”) were concurrently and prospectively associated with young adolescents’ (Mage = 12.0 years) concerns about being accepted or rejected by their peers due to physical appearance (referred to as “appearance-based rejection sensitivity”or “appearance-RS”).

Results showed that appearance-RS was higher among adolescents who concurrently reported more appearance-related teasing and pressure by peers, more parent teasing, and greater acceptance of appearance ideals portrayed in the media. In prospective analyses, greater increases in appearance-RS over one year were found for adolescents who perceived higher levels of parental appearance-related teasing and negative attitudes about their own appearance.

Moderation analyses indicated the positive prospective association between parental negative appearance attitudes and appearance-RS was found in younger but not older participants, while gender did not moderate associations.

Overall, these findings emphasize the significance of “pretty pressure”experienced within peer, family and media contexts, and highlight the role of the family environment in particular (especially among younger adolescents) in shaping appearance concerns over time. The family may represent an important social context in which adverse and salient sociocultural messages about physical attractiveness to which adolescents are exposed on a daily basis can be minimized, through parental facilitation of adaptive eating behaviors and parental modelling of positive appearance-focused attitudes and inter-family interactions.

The 2017 National Eating Disorders and Obesity Conference focuses on the specific issues of eating disorders and obesity, the co-relationship within the context of mental health, the challenges surrounding public health in our current and future population and the role of physical health in maintaining our positive wellbeing.

‘Food Approach’ and ‘Food Avoidance’ Eating Behaviours in Adults

Time is running out – secure your spot at the 2017 National Eating Disorders and Obesity Conference, held on the Gold Coast from 7-8th August.

Dr Kimberley Mallan, Lecturer at Australian Catholic University will be joining us this year to discuss “‘Food Approach’ and ‘Food Avoidance’ Eating Behaviours in Adults: Measurement and Associations with BMI”.

Eating Behaviours in Adults

Dr Kimberley Mallan

The aims of this study were to evaluate the factor structure of the newly developed Adult Eating Behaviour Questionnaire in an Australian sample, and examine associations between the four food approach and four food avoidance appetitive traits with body mass index (BMI). Participants (N=998) recruited via a university research participation scheme and online social network sites completed an online version of the AEBQ and self-reported demographic and anthropometric data. Of the sample, 84.8% were females and the overall mean age was 24.32 years (SD=8.32).

Confirmatory factor analysis (CFA) was used to test three alternative factor structures (derived from issues raised in the original development study): the original 8 factor model, a 7 factor model with Food Responsiveness and Hunger scales combined, and a 7 factor model with the Hunger scale removed. The CFA revealed that the original 8 factor model was a better fit to the data than the 7 factor model in which Food Responsiveness and Hunger scales were combined. However, while reliability estimates for 7 of the 8 scales were good (Cronbach’s α between 0.70-0.86), the reliability of the Hunger scale was modest (0.67) and dropping this factor resulted in a good fitting model. All food avoidance scales (except Food Fussiness) were negatively associated with BMI whereas Emotional Overeating was the only food approach scale positively associated with BMI.

The study supports the use of the AEBQ as a reliable and valid measure of food approach and avoidance appetitive traits in adults but suggests that the Hunger scale may be problematic. Longitudinal studies that examine continuity and stability of appetitive traits across the lifespan will be facilitated by the addition of this measurement tool to the literature.

The 2017 National Eating Disorders and Obesity Conference focuses on the specific issues of eating disorders and obesity, the co-relationship within the context of mental health, the challenges surrounding public health in our current and future population and the role of physical health in maintaining our positive wellbeing.

Register here.

Instafake: Female Emerging Adults and Their Instagram Experiences

The 2017 National Eating Disorders and Obesity Conference is being held at the Mantra on View Hotel, Gold Coast 7 – 8 August.

Miss Carmen Papaluca, PhD Candidate at the University of Notre Dame, Fremantle, will be joining us this year to discuss “Instafake: a focus group study of female emerging adults and their experiences with Instagram”.

Instagram and its affect on females

Carmen Papaluca

Evidence is currently limited surrounding Instagram use; however preliminary studies have suggested it may be contributing to lower levels of wellbeing due to its sole focus on images. To date, no published research of Instagram alone has used qualitative methodology.

The current study aimed to assess the impact of Instagram on the attitudes, motivations and behaviours in female emerging adults between the ages of 18 and 25. Focus group methodology was employed in order to assess participants’ experiences with Instagram through lived experience.

Fifty-one females took part in seven groups. Audiotaped and transcribed discussions were systematically coded for themes. Instagram was reported to exert significant pressure surrounding body shape, diet, exercise, fashion, style and general appearance. Feelings were particularly negative of body-related imagery, with many participants regularly experiencing insecurity, body dissatisfaction and social pressure. Participants reported more criticism of their peers as opposed to celebrities, who were either idolised or seen as irrelevant comparison targets.

Participants were extremely media literate and displayed a sophisticated level of understanding of photo editing, although this appeared irrelevant when discussing how these images make them feel. It was commonly reported that Instagram creates unrealistic pressure about how life should look; yet participants still felt the need to conform to having an Instagram account and emphasising their own highlights.

These findings suggest that young females are aware of the potential fakery of Instagram, however they are still internalising its content and desiring to look and live differently regardless. The current study has uncovered important information surrounding the omnipotence of the Instagram world, the pressure it exerts on young females and what their motivations are for continuing to use it.

This information may be useful for educators and policy makers when discussing healthy Instagram use, as well as creating interventions surrounding its potentially harmful effects.

The 2017 National Eating Disorders and Obesity Conference focuses on the specific issues of eating disorders and obesity, the co-relationship within the context of mental health, the challenges surrounding public health in our current and future population and the role of physical health in maintaining our positive wellbeing.

Register here.