Obesity

Physicians writing on KevinMD about obesity: whether it is a disease, what the GLP-1 drugs from Ozempic to oral Wegovy have changed, what happens when patients stop them, who should take them and who pays, teenagers, compounded versions, bariatric surgery, and the stigma patients describe in the exam room. One maintained record draws on this archive: GLP-1 drugs: what physicians say about Ozempic and its successors, in their own words.

To better treat obesity, doctors need to change their own diets

Shivam Joshi, MD

Conditions and Diseases

November 29, 2015

Several weeks ago, I was running late to my afternoon clinic. Literally, I could not move my feet fast enough. Reminiscent of 1990s childhood computer games, my Oregon Trail tempo was somewhere between strenuous and grueling. Lunch in hand, I slid into clinic just as the nurse was readying the chart of my first patient. I stuffed my lunch into the desk drawer, read the name off the chart, and …

Simplify your life: A philosophy that should be applied to weight loss

Barbara Berkeley, MD

Conditions and Diseases

November 19, 2015

I was intrigued by David Brooks’ column in the New York Times recently. It speaks to a renewed interest in an old idea: simplifying life.

Living in a less complicated way is not a new concept (think Walden Pond), but it has gained a greater magnetism in the setting of the hugely complex and acquisitive world in which we now find ourselves.

I personally have enjoyed and benefited from Marie Kondo’s “The …

Defining obesity: Disability or disease? Or neither?

Skeptical Scalpel, MD

Conditions and Diseases

September 29, 2015

In 2013, the American Medical Association recognized obesity as a disease. Dr. Peter Ubel, writing in his blog on the Forbes website, thought this was a bad idea. He feared that calling obesity a disease will result in people having less motivation to lose weight and cited a study which found that people who were told that obesity is a disease tended to be less concerned about their …

The first step to combat the nation’s obesity epidemic

Vincent DeGennaro, Jr., MD, MPH

Conditions and Diseases

September 17, 2015

“I’m doing my part. I want to get better and go home,” Dorothy says as she looks up at me from the hospital bed. We talk about her family and work life, and she tears up several times during the conversation especially when she talks about how her mother died of cancer. “I’m afraid to go that way,” she divulges. Her 450-pound body fills the oversized bed entirely, and the …

Nutrition tips for custodial grandparents

Keith-Thomas Ayoob, EdD, RD

Conditions and Diseases

June 26, 2015

As a pediatric nutritionist in a clinic that serves children with special needs, I see all kinds of family situations and all kinds of caregivers. Usually, the primary caregiver is a parent. But for a variety of reasons, the primary caregiver may be a relative who cares for the child during much of the day or even has full legal custody of the child.

The latter can happen if both parents …

Exercise for kids is more than just dance class

Claire McCarthy, MD

Conditions and Diseases

June 2, 2015

shutterstock_220684471

When you send your kid to dance class, it’s reasonable to think that not only are they learning how to dance, but that they are getting exercise. Most parents think that way; dance class certainly gets mentioned when I ask parents in my practice what their children do for exercise.

Not so much, says a study just published in the …

Dr. Oz: I have met the enemy. It is us.

David L. Katz, MD

Physician

May 20, 2015

dr oz

Enough already about Dr. Oz. Whichever side you happen to be on, we might collectively acknowledge that much of the noise being made about what is, at worst, a symptom, is itself an indication of a culture-wide disease. The fate of Ozymandias comes to mind.

Science is Ozymandias. Soundbites are the ruin of it.

In the case of …

Read more…

Dr. Oz: I have met the enemy. It is us.

A belief in exercise can become dangerous

Peter Ubel, MD

Conditions and Diseases

May 9, 2015

Can beliefs make you fat?

The answer to this question might seem pretty obvious. If I believe that the best way to lose weight is to super-size five meals a day at McDonald’s, while consuming bags of Doritos to tide me over between meals, that belief is probably going to make me fat. If I believe that the best way to get in shape is to watch other people exercise, I’m …

The dietary guidelines are for which Americans, exactly?

David L. Katz, MD

Physician

May 7, 2015

We received the report of the 2015 Dietary Guidelines Advisory Committee some weeks ago. Some months from now, that science-based report, politics, and a whole lot of pestering will come together, and we will get the actual Dietary Guidelines for Americans 2015.

That’s how it works, which I presume most people in this country at least already know. We have Marion Nestle to thank for first shining …

MKSAP: 48-year-old woman with gradual weight gain

mksap

Conditions and Diseases

April 25, 2015

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 48-year-old woman is evaluated during a routine examination. She is concerned about her gradual weight gain over the years and requests counseling on how she can most effectively lose weight.

Over 8 years, she has gained approximately 18 kg (40 lb). With several commercial diets, she has lost weight but always gains …

Cupcakes are being banned from school parties. And that’s not a bad idea.

Claire McCarthy, MD

Physician

March 13, 2015

When my older children were in elementary school, I sent in cupcakes for their birthdays or for class parties.

My youngest is in elementary school now, and for his birthday, I sent in pencils and temporary tattoos for classmates — because the school doesn’t allow us to send in sweets anymore.

When the change was first made, my reaction was: For real? Banning …

No, it’s not the broccoli: What to make of the new dietary guidelines

David L. Katz, MD

Conditions and Diseases

March 10, 2015

The ink hadn’t yet dried on the report of the 2015 Dietary Guidelines Advisory Committee before the assaults began. I guess in this day and age, that’s not much of a big, fat surprise.

Despite all the over-heated rhetoric I’ve seen about not trusting this report because the “government” can’t be trusted, this report is not from the government. While we may, indeed, need to worry about what the political authorities will …

Food insecurity is an undiagnosed medical problem

John La Puma, MD

Conditions and Diseases

March 6, 2015

My last patient, Joyce, a 45-year-old single mother of four with high blood pressure and diabetes, is late. She was in the emergency department last week with dizziness and blurred vision, a blood sugar of 345 and a blood pressure of 190/110.

Her last office visit was a month ago, when weighing in at 222, she joked that she wished she could pull those numbers at the casino’s slot machines. She …

PubMed misses the big picture when it comes to nutrition

Eric Rumsey and Janna Lawrence

Conditions and Diseases

February 26, 2015

As medical librarians, we’re certainly the first to say that PubMed is a superb database, elegantly crafted at the National Library of Medicine to do fast and efficient searches for almost all medical and health subjects. Much of the power of PubMed is that it makes it possible to search broad subjects easily. When the user searches “cancer,” for example, PubMed quickly finds thousands of citations on all types of …

Sitting is a major health risk. But don’t panic.

David L. Katz, MD

Conditions and Diseases

February 8, 2015

The big medical news recently was that sitting hours a day is taking years from our lives, whether we exercise or not. We have heard similar things before, so the now reiterated message is: Yes, we are sitting on a major health risk. Sitting is the major health risk! The new study, a meta-analysis in the Annals of Internal Medicine, purportedly adds precision to the estimate of risk.

There …

Inactivity kills more than obesity: Let’s go beyond the headline

David L. Katz, MD

Conditions and Diseases

January 29, 2015

A new study about physical activity, obesity, and mortality has been propagating so many headlines and so much commentary, it’s pretty much a given that if you are seeing this, you have seen something like: “Inactivity kills more than obesity.”

As is generally true in such cases, few of the people opining about the study seem to have actually read it. I suppose that’s understandable — once you get to particulars …

What is the best diet? Examining the US News rankings

David L. Katz, MD

Conditions and Diseases

January 21, 2015

The Lumberjack World Championships, coming up for those interested in Hayward, Wisconsin in late July 2015, appear to be very impressive. Contestants are judged on a diverse array of aptitudes, from chopping and sawing to pole climbing and log rolling. One presumes the criteria for winning each of these are clear and as objective as possible. There is a panel of master lumberjacks to help oversee the judging.

In short, as a …

The complete guide to health and wellness [/sarcasm]

Ali Kashkouli, MD

Conditions and Diseases

January 21, 2015

No pain no gain.

Pain is weakness leaving your body.

What’s your excuse?

Have you seen these? The ubiquitous fitness themed motivational memes foisted upon us by corporations and Internet bloggers alike. You know what these all have in common? Aside from the fact that they typically aren’t associated with the funny cat videos that comprise roughly 94 percent of Internet traffic, they all do one thing: They make you feel more inadequate …

A PA’s deeply personal journey to lose 130 pounds

Richard Bottner, PA-C

Conditions and Diseases

January 17, 2015

I am a recovering addict.

My compulsion started when I was 10-years-old. I remember thinking about when I would get my next fix. These feelings got in the way of my ability to perform scholastically and socially. I yearned not for marijuana, cocaine or heroin, but for something with much easier access and profound availability.

My drug was food. By the time I was …

Nutrition research has a huge blind spot

Lucy Hornstein, MD

Conditions and Diseases

January 9, 2015

News non-flash: A comparison of various diets (low-carb/Atkins, low-carb + low fat/South Beach, low calorie/Weight Watchers, and whatever-the-hell-the-Zone-diet is/protein-carb ratio) shows no difference in long-term outcomes, defined as sustained weight loss, with the attendant presumed decrease in cardiovascular risk factors and events.

Sorry, no great surprise here. But I think it’s because nutrition research has a huge blind spot: not adequately controlling for type 2 diabetes/metabolic syndrome.

Let me explain.

I have a hypothesis that …

Obesity

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