The older we get, the better care we have to take of ourselves – that’s the message drummed into us by everyone from doctors to TV personalities. But, while it’s well known that your risk for serious conditions such as cancer and cardiovascular disease increases as you age, it’s also a universally acknowledged fact that getting older goes hand in hand with putting on weight, slowing down and finding it harder to get energised and motivated.

Obviously, this isn’t the case for every person in middle age – especially if you’re someone who has always had an interest in exercise, healthy eating and fitness – but according to recent statistics, it does affect a worryingly large percentage of the population.

As reported by The Guardian here, eight out of 10 Brits aged between 40 and 60 are not taking good enough care of themselves. To be more specific, 87% of men and 79% of women in this age range have been found to weigh too much, drink too much or be too physically inactive.

Perhaps most concerning is the high percentage of middle-aged adults who are overweight or obese (77% of men and 63% of women). Being overweight or obese is a high risk factor for serious conditions like type 2 diabetes, heart disease, breast cancer, bowel cancer and stroke. It’s often closely linked to an inactive lifestyle and drinking too much – but the experts also believe there may be some other factors at play.

Reasons for the Middle Age Health Crisis

In the past 20 years, obesity in adults has increased by 16%, which is something that flags it up as a general health crisis, not solely specific to older age categories. One of the worrying effects this has had is that it has warped the average person's ability to distinguish between a healthy and an unhealthy weight – a particular problem for parents with overweight children.

Another factor to consider is that more and more people work in jobs requiring them to sit in front of a computer screen all day; as detailed by the NHS here, a sedentary lifestyle is associated with all kinds of health risks.

Generally speaking, we also live in a fairly ageist society that often devalues or ignores people over a certain age. As a result, many older people who are looking to get fit may find it more difficult to start exercising than those from younger generations; gyms and fitness classes tend to be populated with young people, and this can be really alienating if you do feel you are "too old" and out of shape to be there.

How to Lose Weight and Get Healthy in Middle Age

Whatever age and weight you are, there is always a way to get fitter, healthier and happier. For most people, this will involve three simple things:

• Eating a healthier diet
• Starting to take more exercise
• Cutting down your alcohol intake

Many people will read those words and assume that means cutting out carbs, joining and gym and going teetotal. But in fact, getting healthier is often about making a series of small, manageable changes that can be easily adopted into your daily routine.

The first step is to take a look at what you eat and drink every day, and whether it largely adheres to the recommended guidance from the NHS. The second step is to start exercising a little more each day. This can mean taking the stairs instead of the escalator, getting off the bus or train one stop early and walking the rest of the way, and even standing up from your desk chair once every hour to stretch your legs.

From there, you can implement bigger changes, like taking up an exercise class; there are many tailored specifically towards older people. If you’re struggling to control your eating, consider signing up for a healthy diet programme or visiting a nutritionist.

If you find that these tactics aren’t effective, you can also talk to a doctor about getting a prescription for weight loss medication such as Orlistat or Saxenda. As part of a healthy lifestyle, this can be a very effective tool for gradual weight loss. Learn more by visiting The Online Clinic’s Weight Loss Tips page.

With so little in the UK/EU pipeline in terms of weight loss treatments, there is a great focus now on the phase III trials of Beloranib, a prospective obesity drug made by Zafgen. Xenical is currently the only treatment on the market for weight loss and is a lipase inhibitor rather than a fat burning drug or appetite suppressant.

The mechanism by which the drug works is very different to other obesity drugs in that Belnoarib redirects the way the body deals with fat. It encourages the release of fat stored in adipose tissue and restores the ability of the liver to deal with fat. As well as working as a fat burner, the drug works independently of the hypothalamus, as an appetite suppressant. Previous clinical trials have shown that the drug is very successful and approval by the Food and drug Administration (FDA) looks promising.

For initial approval, Zafgen are not looking to approve the drug as an out and out obesity drug, and rather, a treatment for a condition known as Prader-Willi Syndrome. This syndrome is a genetic disorder which can cause an insatiable hunger in patients and eventually, very serious and life-threatening obesity. Patients who suffer from this syndrome can choke on their food, overeat to dangerous levels and rupture their stomachs. The average life span for sufferers is on average, only 32 years of age.

The latest phase III study is looking at obese adolescents and adults with the condition in a placebo controlled, double blind, randomized, trial. 84 patients with this condition are being tested, some who will receive the drug and others who will receive a placebo. Phase 2a results were encouraging so good results are expected here too.

All going well, it is likely that the drug will be approved for patients with this condition. Zafgen also suggest that the drug will be appropriate for patients who have suffered from hypothalamic injury, and therefore, have issues with weight control as a result. Perhaps patients who are at the upper end of obesity and who are at high risk of mortality might also benefit in time, but not right now. Now the focus is on this particular syndrome and perhaps those with obesity problems related to brain damage. However, plans are in place for a drug that might be better suited to the broader population. Here’s hoping that exciting results are on the way. In the meantime, Xenical is still available for obese patients to try and is the only weight loss treatment on the market. This drug does not work on the central nervous system and is not an appetite suppressant but can work well with some patients.

You can read more here.

We often talk about the complex issues related to the development of obesity, both on an individual and societal level. Recently, we were frustrated to read an editorial on the importance of genetics in the development of obesity that seemed to interpret research findings in this field far too narrowly.

In general, the three most commonly discussed genes have been the so called- Mrap2 gene, the FTO gene and the SIM1 gene. We are aware of many studies, using both animal and human participants, which have shown intriguing results as to what genes may play a role in the development of obesity.

Naturally these findings are encouraging as they may one day lead to the development of treatments targeting those genes, or even develop treatment that can complement current treatments. This is unlikely to happen in the near future, as establishing research findings is a lengthy process followed by an even longer process of treatment trials.

There is little denying that some individuals may be more likely to become obese due to their genetic make-up. However, not all individuals that could become obese actually develop obesity, and not all obese individuals have “obesity genes”. This is probably due to that fact that obesity is a result of the interaction between an individual’s vulnerability (certain genes etc.) and their environment (easier access to certain foods, inability to exercise due to time constrains, obesity side effect of other treatment etc.). To say that an individual is obese as a result of their genes is passive and implies that all that is required is the right treatment or just accepting obesity.

This is why a wide range of research into obesity, from understanding community interventions to looking into adipose tissue, is warranted. Obesity has never been a simple issue, and it is our hope that individuals struggling with obesity never assume that it is not possible to treat obesity as a result of their genes. It is not easy to treat obesity, but from our experience we certainly know it’s not impossible.

The list of health risks related to obesity seems to be growing with findings in research. A recent unexpected finding comes from a study suggesting that there is a relationship between obesity and osteoporosis.

The study, which was published in Radiology, included a total of 106 obese men and women between the ages of 19 and 45. All of the participants underwent body scans, provided various tissue samples and completed exercise questionnaires. The key findings indicated that obese individuals had above average amounts of bone marrow fat in areas where they ought to have had bone marrow. As a consequence of this, they were at higher risk of having weaker bones and even developing osteoporosis.

Although past studies have indicated that individuals with osteoporosis have above average levels of bone marrow fat, the current findings appear counter-intuitive, as osteoporosis is a condition that has generally been linked with frail individuals. As such, we have to admit that the findings from the current study were somewhat surprising.

Yet it is hard to ignore what the study found, given that several advanced tests were carried out. If the results were to be replicated in other populations, then it would raise questions about the underlying cause of osteoporosis, and potentially have an impact on how treatments of both osteoporosis and obesity are being conducted. However, this scenario is a long way from what we know today and is only one of several potential scenarios.

The current study can be found here.

It should come as no surprise that the obesity epidemic is not restricted to the adult population. Whilst reports on adult obesity have tended to focus on endocrinology, inappropriate diets and obstacles to exercise, reports on childhood obesity have sought to explore whether socioeconomic status and neurological processes could account for the development of obesity. Here we consider the most recent study in this field, which explored the potential relationship between body weight and ADHD.

The study, which was published in PlosOne, assessed 284 children with ADHD between the ages of six to twelve. It came as an extension of a previous study, which had conducted less thorough neurocognitive assessments of children with ADHD. The initial study, which was not done by the same team, had concluded that both ADHD and obesity could be due to impaired self-regulatory processes. However, as this study had used crude measures on a limited sample, and even tested the children who were currently taking ADHD medications, there was limited support for the findings.

In an attempt to address all of those limitations, the researchers of the current study ensured that all the participants had not taken their medications for at least a week before taking part. They then assessed them using a battery of tests, which included a more realistic reflection of typical neurocognitive characteristics, motivational styles and motor profiles that could be useful to explain the findings. In addition to that, the data was adjusted for demographic characteristics, so as to account for environmental influences. The key findings indicated that there was little evidence for the relationship between neurocognitive deficits and obesity, but that socioeconomic status was a useful predictor for obesity. This led the researchers to argue that the effects of socioeconomic status, such as not having access to exercise or a regular healthy diet, were better predictors than self-regulatory processes.

It is not hard to understand the rationale behind this study as it comes within a context of reports of patients with eating disorders having attention difficulties that were analogous to ADHD. Clinically, there have also been some neuroimaging studies that have suggested that patients with ADHD exhibit the dopamine dysregulation that can be seen in individuals with food addiction.

However, it is worth mentioning that the food addiction model is questionable at this stage, and that the comparison between clinical disorders is far too superficial. ADHD, obesity and eating disorders are complex multifaceted phenomena that are not yet fully understood. Consequently, for this line of reasoning to be considered, more extensive large-scale studies need to be put in place.

Having said that, there are still aspects of the current study that should not be ignored. Understanding how lower socioeconomic status affects the development of obesity is crucial as there may be a way to address these risk factors socially. Therefore, this study may be a cause for optimism in the battle against childhood obesity.

The difference between white and brown fat cells is well documented in both animal and human research to date. However, what was not known until recently is that there appears to be two forms of brown fat cells. Here we consider the implications of those findings.

The key difference between white and brown fat cells is that white fat cells turn extra energy into fat, whereas brown fat cells turn extra energy into heat. It appears that there are two types of brown cells, with one type having been found in previous research and the other type (which appears to disappear after adolescence) not being noticed in past research. This is an important finding, as there have been numerous studies that have aimed to develop ways of stimulating existing brown fat cells so that fat tissue could be converted into heat. It goes without saying that in order to do this it is vitally important to understand what type of cells would be susceptible to this process. If successful, then this method would be a useful alternative treatment for fighting obesity and co-morbidities associated with it, including diabetes.

Recently, a few studies have concentrated on the correlation between different drinks and how they can affect our health.

New research has tried to answer the question: Do artificially sweetened fizzy drinks correlate with diabetes type 2 and if so, how?Dr. Romaguera-Bosh from Imperial College London, along with researchers from the InterAct Consortium, has found that even after accounting for body-mass index (BMI) and energy intake, the risk of diabetes type 2 increases 18% with a daily consumption of 336 ml. The figure is 22% without making the adjustment for known risk factors. This suggests that an individual has a 1 in 5 increased chance of getting type 2 diabetes just because of drinking a fizzy drink a day (336ml). The study has a very substantial sample size, as it is based on data from 350,000 people living in eight different European Countries. The findings correlate with a previous American study, which had found 25% increase of type 2 diabetes when drinking daily a sugar-sweetened drink.

Another study from last October by Beulens et al, published by the Journal of Internal Medicine, had looked at the link between alcohol and type 2 diabetes. Results suggested that moderate alcohol intake for women and normal alcohol intake for men can decrease the risk of diabetes. This inverse association (alcohol intake and lower diabetes risk) was more evident when looking at overweight individuals, with wine being the alcoholic drink most strongly associated with the reduced chance of developing type 2 diabetes. I need to emphasise that this study should not be used as a green light to go out and get bladdered on alcohol. The results were interesting and the health benefits associated with moderate alcohol consumption are well documented but the operative word here is “moderate”!

Our advice to all patients is to avoid artificially sweetened fizzy drinks on a regular basis. This advice is especially appropriate for overweight or obese patients. Many people focus only on their food intake, blissfully ignorant of the damaging impact of the large quantities of sugars in their cans of pop. This study (and the wide currency that it is receiving) may help to alert the public to the risks.

The causes of obesity can be discussed on many levels, whether it is societal or biological. One neurobiological model that has received significant attention is the so-called food addiction model, which stipulates that the effects of certain foods on the brain are comparable to the effects of drugs. In addition to that, this model argues that there are many similarities between obese individuals’ food behaviours and the way drug-addicted individuals behave. Needless to say, the controversies from these claims have been discussed at length within the research community. The most recent contribution to this debate comes from a review that challenges the usefulness of the food addiction model.

The review, which was published in Obesity Reviews, considered the four key areas of evidence that have been put forth so far. First, they considered the clinical overlaps in addiction behaviour and noted that similarities between the obese and addiction groups were difficult to establish. This is mostly due to the fact that food is an essential part of our survival, and as such is not a habit that can “be kicked” in a similar way to drug addiction. It would be absurd to consider each meal a relapse, as there is no other alternative. Secondly, the authors looked at the genetic vulnerability to both addiction and obesity that family studies had argued exists. In short, the authors argued that there were too many elements of the underlying processes that were dissimilar for it to be consistent. Thirdly, the findings from animal research were reviewed. This is the field that had the strongest evidence for food addiction. Essentially, studies where rats where overfed with high sugar diets or high fat diets pointed to their behaviour rapidly changing to addictive behaviours and overeating. However, the same has not been found in human studies. Lastly, neurobiological research considering how our brains’ reward system reacts to certain foods. These complex findings, which were often obtained using fMRIs, are leaning towards not supporting the food addiction model.

We were not surprised to read about these findings. On the face of it, it is understandable how useful the model would have been clinically if it were found to be valid. However, there are too many disparities that reflect that the model is too limited to explain such a complex phenomenon as obesity. The model, as it is described today, tries too hard to encapsulate several heterogeneous groups into one simplistic, reductionist version of a multi-layered problem. It does not give reasonable weight to the complex and rich interaction between nature and nurture and pathologises obese individuals. Having said this, it still has the potential to be useful for a small sub-group of people if it is defined in depth. However, establishing such a precise model is a long and painstaking process that is not likely to happen within the near future. Until these flaws are addressed, we see little use for comparing obesity to addiction.

As the deep and serious consequences of obesity continue to spread in Britain, the criticism of the government’s effort to tackle the obesity epidemic also increases. In an attempt to suggest more aggressive tactics, the think tank Demo has published a report where controversial recommendations include a points system that rewards healthy behaviour.

According to the report, there ought to be incentives for maintaining a healthy lifestyle that includes exercise and healthy eating. These include: giving priority to non-emergency treatments to individuals who are able to demonstrate that they exercise and eat healthily, for individuals to earn points when they buy healthy groceries, and for individuals on benefits to receive extra payments if they go to the gym.

While we understand the intention of the report is to increase personal and collective responsibility in our society, it is hard to see how these recommendations could be implemented. We do not agree that patients should be prioritized according to their lifestyle, because ultimately the treatment should be based on clinical need rather than political arguments. Similarly, rather than giving individuals points that may or may not be used some day, why not put pressure on the big chains to have offers and competitive prices in place that encourage a healthier diet? But the recommendation that angers us the most is to reward individuals on benefits for going to the gym. This disregards the circumstances that bring many individual to receive benefits. It is also rather ignorant of the obvious fact that gyms tend to be extremely expensive, so some individuals may choose cost-effective types of exercise such as running.

There is zero chance of any of this happening so there is really no point in commenting further.

Every now and then we hear about a specific gene that may be the key for developing a condition. Although this type of reporting tends to simplify complex disorders and the specific processes required for them to develop, it also often highlights some specific areas worthy of additional attention within research. One protein that has been considered in various studies by both GlaxoSmithKline (GSK) and Palatin Technologies is the so-called MC4 receptor.

The MC4 receptor, which has been linked to erectile dysfunction and insulin resistance in the past, is also known for being the most consistent finding in genetic research on early onset obesity. There appears to be some evidence that MC4 has a role in the regulation of metabolism and some individuals may have several mutations of this receptor. The current view suggests that the more mutations of the MC4-receptor, the higher the risk of developing obesity.

Given the complexity of how the MC4-receptor works, there have been no successful studies to date that have developed an obesity treatment that could be safe for humans to use. Specifically, within studies that have centred on the use of drugs that directly activate MC4-receptors there have been some concerns about increasing blood pressure (we have previously written about Bremelanotide, which falls into this category). However, in an attempt to potentially circumvent the blood pressure risks, GSK has utilised a different strategy where the researchers would rely on so-called positive allosteric modulators to activate the MC4-receptors rather than activating them directly.

In contrast to what has been reported by some news outlets, the treatment GSK is seeking to develop would not be an all-round cure for obesity. Instead, it would be a treatment to manage the obesity some individuals have developed due to a genetic vulnerability. No matter how pleased we are to hear that medical companies are pursuing obesity research, we cannot stress enough that a genetic vulnerability does not mean that environmental factors can be ignored. Developing obesity occurs as a result of a multitude of factors, but the most common cause is that energy consumption over time is greater than energy expended. No matter what medications are developed to assist weight loss in obese patients, we cannot pretend that a lifestyle change is not essential for most people who are obese.

It is unlikely that the treatments GSK is developing will be on the market within the near future. The study itself is expected to run for 3 years and once the findings have been published further clinical trials will be needed to establish the safety of the treatment and corroborate the study’s findings.

Although the relationship between obesity and diabetes is unlikely to be a surprise to most individuals today, the exact underlying processes for this link are still largely unknown. Now, a study has come out to suggest that two specific proteins (called TBK1 and IKKE) may play an important role in the inflammatory response that is common in obesity and insulin resistance as well as maintaining metabolic balance. In addition to that, the findings of the study indicate that the medication Amlexanox may be useful to inhibit these responses in mice. Here we briefly consider the implications of this research.

The research, which was recently published in Nature Medicine, was an animal study where mice were either given a high calorie diet or a calorie restricted diet. Within the former group, where the mice became obese over time, some mice were given a pharmacological treatment called Amlexanox whereas others were given alternative treatments (which did not produce remarkable results). The key findings indicated that mice given Amlexanox exhibited reversible weight loss, improved insulin sensitivity and attenuated hepatic steatosis (i.e. fatty degeneration). These findings were found both in mice that were obese due to dietary obesity and mice that had genetically induced obesity. This led the researchers to suggest that there is a need for future studies with humans to establish whether Amlexanox would be a suitable treatment for obesity or diabetes.

We were not surprised to read about these findings, as we are aware of substantial evidence that supports the idea of a potential association between diabetes and obesity being inflammatory in nature. But, as previously mentioned, it is not clear to date where this inflammatory response would occur. Nevertheless, when inflammatory pathways have been disrupted via pharmacological means in past studies, the results have indicated that the link between obesity and insulin resistance has also been disrupted. Therefore it is fair to say that although the findings may not be novel, they do appear to have a sound theoretical basis grounded in findings from past studies.

What makes the findings from this study interesting is the suggestion that inhibiting two specific proteins (TBK1 and IKKE) leads to improving metabolic dysfunctions in mice. This opens up several areas worth investigating. Intuitively, the first area may be to consider whether Amlexanox is an effective treatment for humans to use in this area and if there is a suitable dosage. On a more cynical note, it is worth questioning whether it would be realistic to maintain the effects in the long term without adverse side effects in humans. Another area appears on a deeper scale, where the role the aforementioned proteins in an inflammatory response (i.e. primary or secondary, mediating or moderating) is investigated in depth. Lastly, it is worth asking whether the role of these proteins play in processes among mice is equal to the role these proteins may play in human processes.

If these findings are shown to be true, it is likely that it will be a while before Amlexanox is recommended as a treatment for obesity or diabetes. However, given that Amlexanox is an off-patent medication used to treat asthma in humans (though not in the UK), the cost-benefit of researching and marketing it for further use may work as an incentive to hasten future research.

The consequences of obesity to both the affected individual and our society are becoming clearer and clearer every day. However, no study to date has considered whether paternal obesity can directly affect the health of their offspring. Perhaps, this is not surprising given that research considering prenatal development has typically focused on mothers, whose diet, smoking and experience of stressors affects the unborn baby during its development. However, a new study has now gone a step further by suggesting that epigenetic factors (such as being obese, experiencing stress etc.) may affect the sperm of the father, which in turn could affect the offspring’s health status.

The study, which is due to be published in BMC Medicine, assessed a total of 79 infants and their parents. In order to do so, the researchers took samples from the umbilical cord and examined the DNA from the blood leukocytes. They also assessed parents using questionnaires, which were compared to medical records. The key findings indicated that paternal obesity was associated with DNA hypomethylation of the insulin growth factor (IGF2) gene in offspring. Specifically, it was lower among children whose fathers were obese than among children whose fathers were not obese.  Although these findings are at risk of being sensationalised, the researchers concluded that further studies are needed to fully understand the implications of the study.

We find this study interesting, although it is clear this field is still in its infancy. It is known that DNA methylation regulates some genes and IGF2 has been linked to the risk of some cancers. However, in order to establish that obese fathers’ spermatogenesis is affected by their obesity which in turn affects DNA hypomethylation of the insulin growth factor (IGF2) gene in offspring many more studies need to be done. These studies would need to include other factors such paternal presence of diabetes or nutrition affecting the outcome of the study. They would also need to include a larger sample size, and more advanced statistical methods than several regressions.

We never cease to be surprised at all the risks obesity brings with it, and feel that it would be unfortunate if these findings were shown to be true. If these findings were substantiated, then we would be keen to see whether these risks would be reversible with paternal weight loss.

One of the most consistent criticisms of the current food labelling systems in the UK has been that there is not a uniform version that can be found in every supermarket regardless of the food supplier. Currently, there are vast differences in terms of color-coding and where the nutritional information can be found. It is therefore to be welcomed that new food labelling system is due to be introduced that will be consistent across all supermarkets.

The new system is to be like a traffic light system, where the amount of a sugar, salt, fat, saturated fat, and calories will be rated as low, medium or high. The hope is to provide consumers with a simple, fast and reliable indicator of the nutritional contents, which will help them choose healthier options. Although the design is yet to be established, it is likely to be in use by next summer.

The importance of a healthy diet is not to be underestimated. Small changes in diet can lead to big changes in outcomes. One of the big challenges we face as doctors dealing with overweight patients is helping them to change their diet to something healthier. It is amazing what people fail to realise about the foods that they consume. Anything that makes life easier for consumers is to be welcomed, especially with UK obesity rates close to the top of the European table.

NICE (National Institute for Health and Clinical Excellence) has expressed its opinion that the word ‘obesity’ is a derogatory one and health care professionals have been asked to refrain from using the word to describe those who are, well, how shall we put it: obese. The statistics show that one quarter of British people are obese and NICE says that using this word is not helping the situation.

The organisation suggest that rather than refer to obese patients as ‘obese',it would be in the best interests of both the patients and the health professionals to lay the emphasis on their potential to achieve a healthy weight. Despite the fact that the organisation deems the word suitable for use among doctors and other health care workers, they feel that use of the word should be avoided when dealing with obese patients directly.

It really does not matter what word is used to describe the obese, so long as they are made absolutely fully aware of how harmful being obese actually is to their health. If the point of this is to mollycoddle patients who might be offended by being told that they have a serious health condition, then the recommendation is misplaced. Language is dynamic and we would never support the continued use of a word that, outside the medical community, had become a derogatory term, but patients must be made aware of the consequences of persisting with the unhealthy lifestyle that got them to that position in the first place. The word used to describe the condition is immaterial.

New research shows that 39% of the American population are thought to be just slightly over the recommended weight and this percentage has been gauged using the Body Mass Index (BMI) but the real figure is thought to be higher. Researchers think that BMI is inaccurate and have renamed it the Baloney Mass Index.

This research reveals that evaluating someone’s height in relation to their weight is inaccurate and will not account for the level of fat on the individual. The study’s authors found that out of 9,000 adults, 65% were classed obese by Dual Energy X-ray Absorptiometry Scans (DXA scans). These expensive scans measure accurately fat on the body (and its distribution), bone density and muscle mass all at the same time. Out of these 9,000 patients, only 26% were classified as obese using BMI as a method of calculation.

The author’s suggest that instead of expensive scans, levels of leptin, a natural protein in the body, should be evaluated since these levels are strongly linked to body fat. Using this measure with the BMI calculations will provide for a more accurate estimate of whether someone is obese or not.

Whilst interesting, this is not exactly news. We wrote about this years ago and suggested that a hip/waist ratio was actually a more accurate measure of whether a patient is overweight or not but BMI continues to be used.

Rates of kidney cancer have reached an all-time high and according to the experts, this is directly related to the currently increasing obesity rates. In 2009, Cancer Research tells us that there were slightly more than 9,000 cases of kidney cancer reported. In 1975, there were only 2,300 cases!

Obesity will increase a person’s risk of developing cancer by 70%. This percentage increase is even higher than the 50% increased risk a smoker will have of developing kidney cancer. Smoking has a direct impact on the chances that one will develop this form of cancer. Extra weight will contribute to the risk of other cancers too because it has an impact on increases in certain hormone levels in the body.

Over 70% of the population of men in Britain have a BMI of over 25 and 60% of women have a BMI greater than 25. The number of overweight people in the UK is not declining in anyway in fact, it is rising steadily and contributing to the development of other lifelong medical conditions.

Cinematic depictions of the traditional school yard bully often follow the same rule in that characters are typically skinny, rather attractive, well dressed and, above all, popular. However, a team of researchers at Queen’s University beg to differ with this perspective. Their study has shown that obese female teens are three times more inclined to bully than their thinner contemporaries. The study is published in The European Journal of Obesity.

The height and weight of 1,738 students, in 16 schools, was recorded along with information on their experience with bullying and the results made for an interesting reframe of the bullying stereotype.

Girls who were obese were 1.32 times more inclined to be victimized physically than those who would be considered a normal weight. These obese girls were also 1.52 times more than likely to be the bully.

Obese boys however, were on the receiving end of bullying with 2.11 times likelihood of them experiencing bullying in the form of teasing, taunting and being ignored (relational bullying). Their weight did not make them more likely to get involved in such forms of bullying. These facts came as a surprise to the researchers who thought that a bigger physical size among men would indicate being stronger and more likely to be the bully or deter bulling attempts.

Obese girls were 1.76 times more likely than thinner girls to be on the receiving end of such forms of bullying as mentioned above but they were 3 times more likely to bully in this way.

The study really highlights how cyclical this sort of behaviour is. It shows how those who are bullied often retaliate in this way and project what is happening to them on the inside. These tactics certainly won’t improve the growing problem of obesity and young people. Rather than changing their diet and exercise habits, they are finding ways to remain comfortably the same.

A frightening statistic released by the NHS Information Office reveals that one in three children leaving primary school is considered obese. This is a terrifying statistic considering the work that has gone into the fight against obesity over the last ten years. The National Measurement Programme showed a surge in the number of 10 and 11 year olds who are overweight.

Measurements were taken from over 1 million children and shows that they are getting fatter rather than healthier. In 2006 31% of children between the ages of 10 and 11 were overweight or considered obese but now 33.4% of children are considered unhealthily overweight and boys are considered the more overweight of the two sexes.

The figures also show that the majority of children were not overweight before they started school, a revealing fact. In fact, this number has decreased. There are fewer children starting school obese so something is going right but what is going wrong?

The statistics revealed that the more deprived the areas, the more overweight the children. At the end of the day, it is up to parents to ensure that their children are eating nutritious food. If the schools are serving inappropriate food then the parents should be taking that up with the schools.

Sales of the favoured clothing material of the 70s, spandex, have recently been blamed for facilitating if not influencing the obesity epidemic in the United States since it was announced that that rate of production of the stretchy material has doubled over the last decade.

According to fashion industry experts, clothes that were highly structured and not made with comfort in mind have lost their popularity and an increasing number of items with the ability to expand for comfort are being manufactured instead and have been gaining popularity. In fact, National Public Radio (NPR) in the States has stated that 80% of the garments bought last year were made from stretchy material. This is 80% of 20.5 billion pieces of clothing.

The material is also popular because it is inexpensive but unfortunately, rather than fitting the body, it will adapt to the size of the body and those at NPR have expressed that there is worry regarding the direct effect this contribution to fashion is having on the increasing waist lines of the general public.

Whether the material is responsible for influencing an increase in obesity is questionable but the real issue here surely relates to the recent popularity of spandex in the first place since the only person who ever looked good in stretchy pants was Olivia Newton John.

The NHS has resorted to entertaining the idea of using talking plates in order to aid the fight against obesity. This is not such a new idea believe it or not and despite how novel it sounds, the mandometer has been proven to be successful in the past for treating of eating disorders and will now hopefully help obese people lose weight and prevent obesity in those at risk. The plate is costly however. At approximately £1,500 per plate, it works to both monitor the amount of food one eats and the speed at which the food is eaten. In addition, the device asks questions relating to how full one is or, if the eater is eating too fast then the plate will ask the person to slow down.

600 families who have at least one obese parent and one obese child will take part in this study. A separate trial will take place assessing 12 adults and children who are unable to tell when they are full due to a genetic mutation.

Trials in other countries have demonstrated that after one year participants ate between 12 % and 15% less than they did at the trials outset. The Food and Drug Administration approved this device for treating eating disorders in 2011. If this goes ahead on a wide scale there will be public outcry at the cost of this device to the public purse.

According to a recent study, obese children would be exercising more if the days were longer. This would seem like an obvious assumption considering how early on the darkness falls these days however; this does provide the evidence needed to once again promote the awareness of the changing of daylight savings for those who think this is necessary. Research published in the Journal of Physical Activity outlines the value of such an endeavour.

The study was carried out at the London School of Hygiene and Tropical Medicine and 325 children in the south-east between 8 and 11 years were observed in terms of their activity levels. It was found that on brighter evenings, children were more active between the hours of five and eight o’ clock in the evening.

The researchers feel that if there were more hours of daylight than it would be an excellent way to promote a fit and healthy lifestyle and would also aid the prevention of childhood obesity.

The Daylight Saving Bill is being discussed at the House of Commons and it is proposing to have the clocks put forward by one hour for the entirety of the year. This would mean less of a disparity between the 22% of time spent outside the house on longer days compared with the 13% spent engaging in physical activity on shorter days. The study also showed that this was the case regardless of weather conditions.

This would also help business owners in terms of saving money on heating and lighting costs and their employees. This will also mean that Britain will have more hours of trading with Europe on a day to day basis. Estimates on savings UK businesses would make are colossal and are expected to reach around $3.5 billion.

The government want this change to take place throughout Britain so requires the consent of Wales and Scotland before any trial period is implemented. If the Daylight Saving Bill was passed, the UK would be on the same time as Central Europe and this would be on trial for three years.

We have previously written about the existence of a gene that predisposes us to being obese or overweight. Recent studies have now demonstrated that exercise can inhibit the action of the obesity gene meaning we can no longer blame our parents and our grandparents for our ever increasing waistlines. Researchers at the Medical Research Council revealed that having a copy of this particular gene, the FTO gene (a gene associated with fat mass and obesity), will have 27% less of an effect on overweight people who are active compared with those who are inactive.

This level of activity includes simple exercises such as taking a walk or taking the stairs rather than the lift according to the study’s authors and it does not suggest that one needs to put in 2 hours a day at the gym in order to stymie the function of the fat gene.

Those with a copy of the FTO gene will eat 100 calories more for every meal than those without it. The researchers looked at information they had on genes, weight and exercise in relation to 220,000 people from all over the world. An association was spotted between the FTO gene and obesity but furthermore exercise seemed to substantially decrease the effectiveness of the gene.

This is an interesting study but not exactly ground-breaking. Every time that I read about this FTO gene I always think to myself that it is a bit weird that it is not affecting the people that I see down the gym or on my morning run around Clapham Common. While we cannot argue that there is not a genetic predisposition to a particular body type, getting off your backside and doing a bit of exercise and controlling what you put in your mouth is definitely going to help. You don’t need to be a doctor to work this out.

Last Saturday in Denmark, a tax on fat was introduced to the consumer in order to increase the life expectancy of Danish people. Any product that contains in excess of 2.3% of saturated fats is being taxed, for example, it will now cost the consumer 25 pence more to purchase butter and 8 pence more for a packet of crisps. The money made from this price increase will go into funding the fight against obesity. The equivalent of £1.85 will be taxed on ever kilo of saturated fat that is contained in a product so it looks like a substantial amount of money will be invested in weight loss treatment research and obesity prevention campaigns.

Hungary has a similar tax in place known as the ‘Hamburger Law’, a tax on fizzy drinks, cakes and pastries and food with high levels of salt. Trans fats have been completely banned in Denmark, Switzerland and Austria and other European countries are considering this implementation. Campaigners in Britain are trying to persuade the government to take a similar action. A spokesperson from the National Obesity Forum has stated that if something has not been put in place before 2050, 70% of the British population will be obese and overweight.

Medical News Today report that over half a million overweight or obese children in the UK are at great risk of fatty liver disease. This condition is also called non-alcoholic fatty liver disease and develops when fat gathers in the liver causing inflammation and scarring. Often there are no associated symptoms but it is known that the disease in young people is due to being overweight or obese.

This disease increases ones risk of having a heart attack or stroke, developing cirrhosis of the liver and diabetes. Fatty liver disease is also caused by long term alcohol consumption and in this case is called alcoholic fatty liver disease which later becomes alcoholic hepatitis and cirrhosis.

With approximately one fifth of 4 year olds and one third of all those aged between 10 and 11 years obese or overweight, the numbers are much too high despite levelling off.

The National Clinical Director for Liver Disease warns that as there are no symptoms until the disease is in its advanced stages. The only way to prevent the development of fatty liver disease is to get children more active and to get them losing weight now so they can avoid remaining overweight or becoming more overweight as they get older.

It is thought that this disease will become the main cause of cirrhosis overtaking alcohol as the main cause. England is known to have high rates of binge drinking and alcohol abuse so if young people start drinking alcohol, especially in excess when they have existing liver problems, this could cause serious problems for them.

A study published in Nature Genetics has revealed that a gene, referred to as the master regulator gene, is the cause of obesity and related health conditions. The discovery of the gene means that the quest to find better treatment for diseases such as diabetes will be greatly aided.

The discovery was made when a research team from Kings College and the University of Oxford took fat biopsies from sets of female twins from beneath the surface of the skin. The samples were examined along with the 20,000 genes found inside the fat cells. They exposed a gene called KLF14 which they found to control the levels of distant genes that were found within the fat cells.

The second part of the study involved harvesting 600 fat samples from a group of people in Iceland in order to prove and cement initial findings.

The team discovered that the gene has a massive effect on one’s predisposition to: obesity, diabetes and heart disease and is inherited from the mother. The father’s KFL14 gene is inactive and not passed on. Much research will now be carried out in the area and hopes are high for a treatment that will control the KFL14 gene.

Malaysian schools will be taking control of the ever worsening problem of obesity by adding comments about the weight of their students to the end of year report cards. The government has decided that along with grades, the school report will also comment on the weight of the student and state whether the student is at an ideal weight, overweight or obese. The health minister explains that the report cards will include the BMI of the student so that their diets can best be monitored by teachers and parents alike. Additionally, a ban has been placed on school cafeterias from supplying junk food and sugary drinks. The students will now have a range of healthy meals to choose from.

Malaysia is sixth in the list of Asian countries which rank most highly for obesity rates with 30% of the population overweight and another 30% obese. A massive 15% of the population over 30 years of age have been diagnosed with diabetes. As well as monitoring weight, the government will introduce awareness programmes focusing on healthy eating and the ‘Less Sugar Intake’ campaign of 2010 will continue throughout 2011.

Hopefully monitoring students in this way will help make parents more aware of the dangers associated with being overweight and place the responsibility back on them when it comes to the healthy diet of their children.

In 2009, 22% of men and 24% of women over the age of 16 years were reported as obese in the UK. These figures might be smaller if the problem of obesity is tackled in childhood. Weight assessment at school will put pressure on both children and parents and seems like a very good idea to me.

Due to a rise in the number of obese pregnant women over the last 20 years, 100,000 babies every year are at risk of being born with defects, health problems and are also at risk of death. The study published in the International Journal of Obesity reveals that an unbelievable 1 in 6 women are deemed clinically obese when they conceive a child. The study was the first long-term study carried out on obesity and pregnancy and the data was gathered from 38 hospitals and included 600,000 women who gave birth.

Other research shows that half of maternal deaths are associated with obesity and related illnesses. One of the authors of the report suggested that women simply do not know the risk they put themselves and their babies at by getting pregnant and being so overweight. Half of these women will have a Caesarean section.

Furthermore, the problem is costing the NHS dear. For example, a hospital in Gateshead is purchasing an operating table that can withstand forty stone in addition to strengthened beds capable of holding the weight of obese pregnant women but the cost is secondary to the serious health risk associated with obesity and pregnancy.

The April edition of Current Anthropology has published a study that indicates that stigma associated with obesity has spread to parts of the world where a larger figure not so long ago had positive connotations such as wealth, success and fertility. The study, conducted by Arizona State University does not really come to any conclusion other than there is a globalization in attitudes but we do not think that this attitudinal change will influence behaviour to any great degree. In the world’s most overweight territories such as the US and the UK, we have long associated being overweight with negative images such as ugliness, laziness and undesirability but this has not led to any reduction in obesity rates, which continue to rise apace.

It is National Obesity Week this week. NOW runs from the 17^th January to the 30^th January and will promote awareness of weight problems and associated diseases such as diabetes.

A recent study shows that approximately half of all adults do not know their own weight. NOW wants to push people into finding out what weight bracket they fall into whether it is underweight, healthy, or over the healthy weight. People are not making healthy lifestyle choices because they do not know that they need to according to NOF (National Obesity Forum), the organisers of the annual awareness programme. They hope that pharmacies will participate in helping customers calculate their BMI in store. The Online Clinic is doing its bit by publishing a BMI calculator on our website. All you have to do is weigh yourself, check your height and then enter the details into our online calculator.

New US research published in Obesity, analyses the relationship between social influence on weight and weight loss goals in young adults. Research carried out on 288 young adults between the ages of 18 and 25 suggests that family and friends and other social relationships whether they be work related or peer related have a huge influence on weight gain and management among young adults. 151 of these people were considered a normal weight and 137 were deemed obese.

Health behaviours form in pockets within social networks. 18 to 25 year olds who are obese are more likely to be romantically involved with partners of the same weight and spend most of their time with those of a similar weight. Even friends that are not so close would tend to be as overweight as each other. Furthermore, those who had a greater number of peers looking to lose weight, were themselves more inclined to actively manage their weight.

The study states that 40% of young people in the US are obese and that they are representative of a population of young adults who reveal the largest rates of weight gain every year. Additionally, when these young people do engage in programmes or weight loss groups, they tend to lose less weight than older obese people.

The study concludes that there are clusters of obese among this age group and social norms do not differ between those who are overweight and those who were obese. Both groups expressed that they experienced low levels of acceptability for their weight, eating badly and doing little or no exercise. The study may have a positive effect on further analysis of the social influences in relation to obesity and how it can be manipulated for change and furthermore, tackling the problem of obesity among this age group.

Although the research is interesting, it is not exactly ground breaking. We wrote about another obesity study done by researchers at Harvard back in November.

The latest in weight loss treatment for the morbidly obese comes in the form of a new device called the Abiliti system, an electronic implant which is inserted into the body below the ribs and controls eating behaviour.

Human clinical trials in Germany (2009) discovered that the implant led to a reduction in the patient’s food intake by 45% per meal. In some cases, a half a stone weight loss was reported per month within the first year.

The device detects the presence of food in the stomach and sends signals to the brain indicating fullness. The operation is now available in Britain but is not available on the NHS and costs up to to £15,000.

Researchers at Oxford University have found a relationship between fat mass, excess weight and a gene that is associated directly with obesity, the FTO gene. The gene appears to be responsible for obesity and overeating. We have written about this subject before but the latest research provides further evidence that the FTO gene is directly related to obesity.

In a previous study it was revealed that people with 2 copies of these genetic variants were approximately 3kgs heavier on average compared with those who did not have this gene.

The researchers bred mice that had extra copies of the FTO gene. These mice ate more and were heavier than mice that did not possess the gene.

This discovery will allow research and development for weight loss drugs to be more focused but it will take some time to figure out how to make this gene less active through drug therapy. This study presents valid proof that obesity is at least in part caused by the FTO gene. It is only a matter of time before we see how effectively this information is put to use.

A Harvard study has made some predictions concerning obesity figures and suggests that they will reach 42% of the population before they become stable in the US.

This idea contrasts with the predictions made by the Centre for Disease Control and prevention when they reported that obesity would stabilise at 32%, the figure it had remained at for the past 5 years. The Harvard study estimates that the stabilization of obesity will occur in another 40 years.

Despite the decrease in the rates of people becoming obese, it is predicted that it will still increase over time. This pertains to the idea that the risk of becoming obese increases if one is in contact with obese people. This was another facet of the study based on a model concerning the spread of the condition throughout social networks like the spreading of the flu virus for example. The information collected reveals that the dynamics for this type of spread is the same as that of the flu even though the mechanisms differ.

The 3 main factors affecting the rate of obesity include personal contact within social networks, lifestyle choices regarding diet and exercise and the rate at which the obese lose weight.

Data from the Framingham heart study which included 75,000 participants show that the average person has a 2% chance of becoming obese any year of their lives due to factors relating to a lack of exercise or poor choice of diet. The possibility increases by 0.5% per obese family member/ friend/ colleague that one is in contact with.

None of this should be interpreted to suggest that obesity is a contagious disease; the study is merely stating that there is a relationship between your body shape and the company that you keep. Put simply, if you hang around with fat people who take no exercise and gorge themselves on Big Macs with incessant regularity then you are likely to have a similar lifestyle and a similar body shape.

Exciting results for the glucagon-like peptide 1 agonist named Exenatide were presented at Obesity 2010 this week. In studies, this diabetes treatment caused a weight loss in obese non-diabetic patients of an average of 2.4kgs over 16 weeks whereas those taking the placebo gained weight.

The drug is used for patients with diabetes and associated with weight loss in this regard but nothing was known of the effects of the drug on patients without diabetes who simply want to lose weight.

A team at Beth Israel Deaconess Medical centre carried out a trial in which 41 women without diabetes took part. These women were obese and weighed on average 88.9kg with a mean BMI of 33.

The results showed that 31% of the women experienced greater than 5% weight loss and this was experienced early on, roughly 3.3 kg during the first 4 weeks of study - an average weight loss of 7.3kg. 34% of those deemed modest responders, lost an average of 1.9kg and 35% did not respond to this treatment but did gain 1.7kg.

Further studies will be carried out and so far the future looks bright for Exenatide, another diabetes treatment to be considered for the treatment of obesity. We look forward to an update this coming year on the progress of Liraglutide in trials. The type-2 diabetes treatment that we reported on earlier this year and is also a GLP 1 analogue, has also presented positive results in the way of weight loss.

Mayor Bloomberg of New York City is asking for federal permission to ban the purchasing of soda and sugary drinks using food stamps. In 2004, the Agricultural Department denied Minnesota this request stating that it would stigmatise those who were using food stamps and brand them as making irresponsible choices. In 2008, it was denied again but this year, the chairman of the House of Representatives agricultural committee has said that the obesity epidemic has been fuelled over last 30 years and that soda drinking was one of the primary causes.

The value of the food stamps would remain the same meaning that there would be more money spent on nutritious food. In New York City, trans-fats are banned and all restaurants are required to produce a calorie count on their menus. This is yet another important step in taking control of their obesity epidemic and must be preferable to spending millions of tax payer’s income on gastric band operations like we seem to be doing in the UK.

20,000 men and women from the ages of 39 to 79 participated in a study which dismissed the claims that obesity, if genetic, may not be controlled. The researchers discovered that obese patients could work off 40% of their genetic excess fat if they exercised. The Medical Research Council’s Epidemiology Unit stated that living a healthy life with lots of exercise can fight the effects of genetic inheritance.

Among the 20,000 men and women on this cohort study, they looked out for 12 genetic markers, all known for their ability to increase BMI (Body Mass Index) and increase the risk of becoming obese. Each person was scored depending on their genetic predisposition and then questioned about their physical activity. The study proved that even those who have a high risk of developing such problems with their weight due to their genetic make-up, can live healthier lifestyles with exercise and a healthy diet.

The British Medical Journal has reported that operations for gastric banding and bypasses have increased in numbers from 238 in the year 2000 to 2,543 operations in 2007. There are a number of different types of operations that people can have to help them lose weight, known collectively as bariatric surgery. Each works by restricting the amount of nutrients that can be digested in the intestine. Gastric banding involves surgically placing a band around the stomach to reduce its size and a gastric bypass sends food to another sack created by surgeons. A third method is not used very often and this involves the removal of part of the stomach. There is another technique called gastric ballooning, where a surgical balloon is inflated in the stomach to reduce its size.

Researchers from Imperial College London discovered that 75% of the operations were carried out using keyhole techniques and that there seemed to be low risk involved with this type of surgery considering the results and the increase in patients seeking this type of operation.

Between the years 2000 and 2008 there have been 6, 953 bariatric operations carried out by the NHS in the UK and the researchers suggest that primary care trusts should be encouraged to pay for it as it is a viable way of treating morbidly obese patients. Imperial College tells us that it also reduces the effects of other illnesses associated with obesity, such as diabetes, heart disease and high blood pressure.

Peter Sedman, a bariatric surgeon, claims that whatever money is put into these surgeries by the NHS will help prevent problems that would otherwise be out of control in years to come. Chrissie Palmer from the British Obesity Surgery Patients Association, states that despite advice from the National Institute for Health and Clinical Excellence, these operations are not available in certain areas around the UK. She explains that public opinion remains a little negative regarding surgery for the morbidly obese, despite the preparation and commitment required.

NICE recommends that although these surgeries are beneficial, they should only be a last resort and that individual trusts should commission various services to meet the needs of their community.

More obesity news and this time it is not about suppressing our hunger with medical treatments but actually about what we feed ourselves that may be the answer to beating obesity. Researchers are investigating the effects of certain types of fibre found in particular vegetables and how they help suppress hunger.

Most will be happy to hear that the fibres in question are found in asparagus, artichoke, garlic and chicory – so nothing too vile-tasting! These fermentable carbohydrates in these vegetables activate hormones in the gut which suppress appetite. Due to their ability to produce additional sensitivity to insulin, the fermentable carbohydrates have a positive effect on glucose levels. Finding out more about how these foods affect our bodies may help us to prevent the onset of Type 2 diabetes according to Nicola Guess of Imperial College. The carbohydrates will be given to the participants of the study in the form of a daily supplement.

Dr. Iain Frame of Diabetes UK, states that although it is unlikely that any one preventative measure will be successful, the research being carried out at Imperial College is important and that they may result in innovative ways of preventing Type 2 diabetes.

Researchers from the University of Cincinnati, in a study they carried out earlier this month, have found that the best way to motivate obese individuals is to emphasise the immediate benefits they will enjoy from exercise and eating right rather than warning them about the more long term effects they are leaving themselves open to by not changing their diets and amending their lifestyle choices.

One of the greatest sources of pain for those who suffer from obesity is the immense strain of weight on the musculoskeletol system. According to Susan Kotowski, study collaborator, increasing the level of focus on the pain reduction benefits associated with exercise and a change in diet, the more motivated sufferers become.

The researchers found that of those involved in the local weight loss programme, 21% felt a considerable relief from pain in the back and lower part of the body after losing ten pounds. Furthermore, the results showed that even the smallest amount of could benefit those who experience great pain daily. The researchers believe that this will influence an entirely different approach to weight loss programs.

So, what is the best way to approach diet and exercise? The media is full of different potions and lotions but how do we pick which one is best for us? Doing a little bit every day and making small changes is the best approach and fad diets do not keep the weight off.

It is said that we should be pumping money into the preservation of ‘wellness’ as well as obesity. An estimated £3 billion is spent by the NHS each year on obesity. By funding anti-obesity campaigns and programs, we are not getting rid of the problem, we are maintaining it. According to Dr. Weiler of Imperial College Healthcare Trust, London, only 1 in 20 people are exercising the recommended daily amount and yet most of the money goes into helping those who already have a weight problem.

A recent survey revealed that one in five children do not receive any encouragement from their parents to join in with after school sports or other physical activities outside of the mandatory physical education classes. But so many factors affect this type of behaviour like psychological factors relating to the parents’ own level of activity, physical situations- such as distance from after school activities, attitudes, socioeconomic status…. the list goes on. This is why campaigns which seek to teach healthy youngsters on a large scale are making giant steps in the eventual combat of obesity.

In the new government’s first indication of how they will be tacking the obesity crisis, Health Secretary Andrew Lansley has said that government funding of the Change4Life public health campaign is to be withdrawn.

He has said that he is hoping to see businesses take on responsibility for paying for the TV ads and marketing materials handed out in schools and public centres that have been directed at children, parents and at-risk groups. So far, the Labour government spend £50 million on the program.

Mr. Lansley has said that it would be in the interests of businesses to be associated with the Change4Life brand, adding that commercial food manufacturers did not want their products to be seen as ‘harmful’ but products that can be incorporated into a healthy diet.

The Health Secretary said that though the brand had achieved a lot, with nearly 9 out of 10 mothers recognising it, the time had come for a new approach.

There was also an indication that he wants to move from the ‘nanny state’ approach to obesity, promising to focus on changing behaviour rather than the ‘lecturing’ attitude that he said characterized Labour’s approach.

While clearly there will be cutbacks left, right and centre and Change4Life was a fairly obvious target, the prospect of businesses funding the campaign is a little bit disturbing. If it is sponsored by brands with unimpeachable healthy living credentials, such as sports companies, then it could work well – but it could also descend into a hypocritical farce, which junk food makers pushing both the foods that are causing obesity and the message that diet is the key to avoiding the same problem!

We have just heard that Novo Nordisk is to reinitiate Phase III clinical trials for Liraglutide as an anti-obesity drug. Liraglutide is already licensed as a treatment for diabetes and has shown great promise as an anti-obesity agent.  A trial in 2009 appeared to demonstrate efficacy and safety. A wider trial of 5000 people is to begin in 2011. The company behind the new drug wanted to wait until they had a marketing authorization for the drug as a treatment for diabetes in the US before it pursued further obesity trials.

Liraglutide is marketed under the name Victoza and is a glugogonlike peptide (GLP-1). Liraglutide appears to be highly effective as a weight loss drug but one likely drawback is that it cannot be taken in tablet or capsule form – it must be injected subcutaneously. This could lead to patient compliance issues but studies are afoot to determine whether the administration regimen can be reduced to once a week.

The study into Liraglutide as a weight loss medication is an exciting development but do not expect it to be licensed before 2013.

The Health Watchdog has claimed that junk food is costing 4000 lives each year. They have suggested that the government should pay food companies to manufacture healthy foods, estimating that this would save tens of thousands of lives.

NICE – or the National Instititute of Clinical Excellence – has called for sweeping changes in the way that food is produced and how it is sold to consumers. They have demanded that manufacturers reduce the amount of salt and sugar in the food.

They have also recommended that companies and public bodies, such as hospitals and schools, push workers to ditch their cars by abandoning subsidised car parking.

In the document, officials from NICE set out a list of measures they believe should be implemented, including eliminating trans fats from food in order to bring down average salt intake and saturated fat consumption.

They call for there to be guarantees to ensure that low-fat, low-salt foods are cheaper than the unhealthy equivalent and recommend that the government consider legislation and fiscal levers to change pricing on food. Studies have shown that poorer people are more likely to eat badly, as unhealthy food tends to be the cheaper option.

However the Food and Drink Federation has criticised NICE, who are better known for making decisions about which drugs should be used in the NHS, for overstepping the mark. They said that the guidance  was out of touch with the current situation and that the food industry was voluntarily trying to make popular brands healthier.

A new study has shown that not only is obesity damaging health-wise, but it also seems to have a strong negative impact on sexual behaviour.

French researchers have shown that women who are obese are less likely to ask for advice on contraception or use the pill. They were also more likely to have unplanned pregnancies, despite having fewer sexual partners than those who did not have weight problems. The rate of unplanned pregnancies was 4 times higher amongst obese women than in the rest of the group. Obese women when compared to the women of normal weight were 30% less likely to have had a sexual partner over the past year.

Men who were obese reported a higher incidence of erectile dysfunction. However though they were engaging in sexual contact less, they were more likely to contract a sexually transmitted disease.

Overall, data was collected on the sexual behaviour of over 12,000 French men and women.  From this group, 1010 women  and 1488 men were overweight and 411 women and 350 men were obese.

Lead researcher Nathalie Bajos, research director at Paris’ National Institute of Health and Medical Research and professor at the London School of Hygiene and Tropical Medicine, said that obesity strongly influenced people’s sex lives.

She said that the research had revealed that social stigma meant obese women were more likely to find sexual partners online, as they were ‘not comfortable meeting men through friends, through work, through parties’.

She also noted that doctors were less likely to prescribe and discuss contraception with the women.

Dr. Sandy Goldbeck Wood, who wrote the accompanying editorial in the British Medical Journal , urged that the data be treated with cautious interpretation. She said that more needed to be understood about how obese people feel about their sex lives, though the complex biological, psychological and social factors would require a qualitative research approach.

It seems that advertising for junk food has had a strong impact on the number of children who are obese the UK. Researchers from University College London believe that adverts are connected to ‘devastating consequences’ for children’s health.

In a report, the team said that banning junk food adverts could cut rates of childhood obesity, which are rising all over the country, by as much as 14%. The report concluded that food advertising had an unhealthy impact on how children aged between 6 and 11 eat.

In the report, which was lead by Dr. Emmanuel Stanatakis, the authors call for a total ban on junkfood advertising aimed at children. Currently, such adverts are banned during programs aimed specifically at children.

Children were described as being particularly vulnerable to adverts, and were likely to develop artificial needs and respond well to inappropriate role models.

Recently, parents campaigned against adverts by Kelloggs for Coco Pops, which tried to rebrand the chocolately cereal as an appropriate snack for any time of day. Many parents said they already found it difficult enough to resist the calls of their children for unhealthy snacks after school.

A test scheme has shown that dieters who are paid to lose weight are far more likely to succeed than those who are not.

The scheme is called Weight Wins and so far has paid dieters tens of thousands of pounds in a bid to tackle obesity. Dieters sign up for a pound-for-pound scheme, where they get paid for every pound they lose and then are given a cash bonus after a certain number of months if they manage to keep the weight off.

The scheme is supported by the NHS, which means that dieters have access to NHS dieticians and are given help choosing how they want to lose weight.

Those taking part see their rewards vary depending on how long their weight-loss plan is. Monies received ranged from £80 to £3,000. When the program was audited by the independent University of Hertfordshire, it was discovered that the 745 people taking part in the scheme lost 1 stone on average, compared with the 5lb 4 oz lost by those following traditional diet methods without monetary compensation.

45% of patients lost 5% or more of their body weight – the benchmark regulators use to judge whether a scheme or medication is effective – and 1 participant lost 8 stone.

However, a spokesperson for the NHS Eastern and Coastal Kent said that ¾ of participants dropped out of the scheme before it was completed. 

The scheme may seem fairly repellent, but it is likely that if participants do keep the weight off, the taxpayer would actually be better off. The cost of treating obesity-related illnesses is huge and it has been suggested that within 20 years obesity could cripple the NHS.

The Department of Health strategy for tackling obesity has already suggested that financial incentives to lose weight could be introduced. America has already brought in similar schemes and many U.S businesses are giving staff bonuses if they manage to lose weight.

In a statement, a DoH spokesperson said that any nationwide scheme to pay people to lose weight would only be introduced with ‘sound evidence’ to back it up.

A leading health expert has come out publicly and said that he thinks teenagers and perhaps even children should be fitted with gastric bands.

Professor Nick Finer of University College Hospital is an expert in obesity and earlier in the year told the Royal Society of Medicine that severely obese children should be permitted to undergo bariatric surgery, such as gastric banding.

He says that as excess fat  can affect the blood vessels in children as young as 6, the ethical issues regarding surgery for children are outweighed by the dangers of not taking action.

The former chair of the UK Association for the Study of Obesity told The Times that the current guidelines set out by the National Institute for Clinical Excellence (NICE) which say that a patient must have a body mass index of over 40 (or 35 in cases where there are severe health problems) and that surgery for under-18s should only be considered in the most extreme circumstances are too conservative.

He added that the treatment of obesity could be likened to the attitudes regarding treating children with leukaemia, as when chemotherapy first became available people argue that it was unethical to subject children to the suffering chemotherapy causes when it might only extend life by a year. That life expectancy has now been significantly extended with 70% of cases of childhood leukaemia being cured, and he believes that similarly doctors should see whether surgery could be successful in helping prevent diabetes and liver disease in children.

The Times article comes in the same week that a report was published in renowed medical journal The Lancet, in which health experts said that surgery should only be considered in the most severe cases and only when diet and exercise treatments had failed.

The report pointed out that in 9 out of 10 cases of childhood obesity, lifestyle was the cause of the problem rather than hormonal problems or genes.