Obesity

What are the physical stresses of weighing more than 500 lbs, and what steps can reverse it?

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Obesity Less Harmful to Self-Esteem in Black Women: Study

TUESDAY, Dec. 13 (HealthDay News) -- Obese black women have a better weight-related quality of life than white women with the same weight, according to a new U.S. study.

The researchers found that black women are more likely to be concerned about possible physical limitations caused by overweight and obesity, rather than the potential psychological consequences.

In the study, investigators analyzed data collected between 2000 and 2010 from 172 black and 171 white obese women. The women filled out a questionnaire that examined five quality-of-life areas: physical function, self-esteem, sexual life, public distress and work.

Among all the women, quality-of-life fell as body mass index (BMI) rose. BMI is a measurement of overweight and obesity. However, at similar BMIs, black women consistently had higher quality-of-life scores than white women and self-esteem was particularly high among black women, according to Tiffany Cox, of the University of Alabama at Birmingham, and colleagues.

The study authors noted that black women are typically more accepting of larger body sizes, which may explain why their quality of life is less affected by weight.

The study was released online in advance of publication in an upcoming print issue of the journal Applied Research in Quality of Life.

"The implications of this relationship between weight and quality of life in black women remain unclear. While the highest quality of life is desirable as an indicator of overall well-being, black women's perception of experiencing a high quality of life despite having a high BMI may also dampen motivation for attempting weight loss. Additional research is needed to understand the potentially bidirectional relationship between weight and quality of life in black women," Cox commented in a journal news release.

In the United States, about 80 percent of black women over the age of 20 are overweight or obese, according to background information in the news release.

More information

The U.S. National Heart, Lung, and Blood Institute has more about overweight and obesity.

Diabetes, Obesity After 60 May Drive Up Breast Cancer Risk

TUESDAY, Dec. 6 (HealthDay News) -- A woman's risk of developing breast cancer appears to rise if she has diabetes or is obese after age 60, a new study indicates.

Previous research has linked obesity and increased breast cancer risk, but "the diabetes link had not been clearly shown," said researcher Dr. Hakan Olsson, a professor of oncology at Lund University in Lund, Sweden.

He is scheduled to present his findings this week at the 2011 San Antonio Breast Cancer Symposium.

The diabetes link held even after he accounted for obesity and levels of blood lipids, such as cholesterol. It is an association, however, not proven cause and effect.

A strength of the study, Olsson said, is that it looked at the population as a whole, not only women with breast cancer. He studied the medical records of more than 2,700 patients for up to 10 years before they developed breast cancer and also records for about 20,500 patients who never developed cancer.

Obesity after age 60 boosted breast cancer risk by 55 percent, Olsson said. To put this in perspective, while 15 of 100 obese women, at the most, would get breast cancer, fewer than 10 of 100 women in the general population would be expected to get breast cancer, Olsson explained.

Up to four years after a diabetes diagnosis, women of any age had a 37 percent higher risk of developing breast cancer, he said.

Olsson also found a link between abnormally low levels of blood lipids or fats, mostly cholesterol, and a 25 percent higher risk of breast cancer. Women with higher cholesterol levels had a lower risk, he found.

This puzzling finding needs to be studied more, the researcher noted.

The type of diabetes drug a woman takes also seemed to influence breast cancer risk, Olsson said. Glargine (Lantus) was linked with a nearly doubled risk of breast cancer. However, metformin (Glucophage, Fortamet, others) was linked with a slightly lower risk.

"If a woman has diabetes, she should be aware that certain cancer forms might appear [more often], and one is breast cancer," Olsson said.

Women with diabetes might also ask their doctor which diabetes drug is best for them and will minimize their cancer risk, he said. However, the study numbers were too small to conclude these drugs directly affect cancer risk, he added.

The new finding is the diabetes and cancer link, said Dr. Suzanne Steinbaum, director of women's heart disease at Lenox Hill Hospital in New York City. But it doesn't surprise her, she said.

"We've known that obesity is associated with breast cancer," she said. "A lot of obese people have diabetes."

The take-home message for women, she said, is that minimizing their breast cancer risk -- now, trying to maintain a healthy weight and avoid diabetes -- will also help their heart health, Steinbaum said.

Olsson will continue the research and explore the lipid level and breast cancer link. Meanwhile, women should watch their weight and aim for a body mass index (BMI) of less than 25, Olsson said. BMI is a calculation based on height and weight. A BMI of 25 or higher is considered overweight, and 30 or over is obese.

Because this research was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

More information

To learn more about obesity and cancer, visit the U.S. National Cancer Institute.

NYC Sees Drop in Child Obesity; Can Other Cities Do Same?

THURSDAY, Dec. 15 (HealthDay News) -- In what might serve as a hopeful sign for all children in the United States, a new study finds that obesity rates among New York City's school children have dropped slightly in the past five years, particularly among the youngest.

Although the relative decline in obesity rates is only 5.5 percent, it's still the largest drop seen yet in any major U.S. city, the researchers noted, and many of the programs that New York City health and education officials implemented to combat rising childhood obesity rates are being tried in other parts of the country.

"This is really good news, but there are still one in five children in grades K-8 who are obese, which is still a huge number of children," said study author Magdalena Berger, a city research scientist in the New York City Department of Health and Mental Hygiene. "We are on the right track, but we still have a very long way to go."

Obesity among children has been increasing since the 1970s, Berger said. "In the last decade, nationally, we have seen a leveling off of obesity, but this is the first well-documented decline in obesity among children that we have seen."

The drop in obesity is statistically significant, because of the large number of children in New York City's public schools, Berger said. "Whether or not it's actually meaningful is another question," she added.

"I think it's meaningful in the sense that it's not going up, and that's good news, it's not staying stable, and that's good news," Berger said. "I would characterize this as a slow sustained drop over five years; it's not a dramatic drop."

Although the reasons for the decline in obesity among these school children isn't clear, Berger speculated that policies implemented by the New York City departments of health and education, along with more public awareness of the problem, may have played a role.

Study co-author Cathy Nonas, director of Physical Activity and Nutrition Programs in New York City's Department of Health and Mental Hygiene, said several changes in city schools probably contributed to the drop in obesity rates.

"There are significant changes in school food," she said. "There is no whole milk in the schools anymore, it's only 1 percent and the chocolate milk is skim and low sugar," she said. "That saved 4.5 billion calories, just by making that change."

In addition, food served in schools has reduced fat and no trans fats and reduced salt, and the level of fiber has been increased, Nonas said. Drinks and snack foods sold in schools are also healthier, she said. Similar policies were also instituted in early child-care centers, she added.

Also, the city has trained K-5 teachers on how to increase physical activity in the classroom, Nonas said.

"It's a layering effect" that all contributed to reducing obesity rates, Nonas believes. These and similar policies are being implemented throughout the country, she noted.

The report was published in the Dec. 16 issue of the U.S. Centers for Diseases Control and Prevention's Morbidity and Mortality Weekly Report.

For the study, Berger's team used data on the more than 900,000 children in kindergarten to eighth grade in New York City public schools. The city's school system collects fitness data on these students every year, Berger said.

The researchers found the relative obesity for these children, aged 5 through 14, dropped 5.5 percent, from 21.9 percent in 2006-07 to 20.7 percent in 2010-11.

The biggest drop was among children aged 5 to 6, where the relative decline was 10 percent, from 20.2 percent in 2006-07 to 18.2 percent in 2010-11, they noted.

These declines in obesity were seen in all race and ethnic groups, the researchers added.

Obesity expert Dr. David L. Katz, director of the Prevention Research Center at Yale University School of Medicine, said that "this report, showing a decline in obesity among New York City school children over the past five years is, to be sure, a glass half full. But I wouldn't get carried away with the celebrations just yet."

The absolute decline in the overall obesity rate is roughly 1 percent in five years, he noted. "At that rate of progress, it would take a century to fully reverse the damage done over the past several decades. The rate of obesity is still over 20 percent, and the gains are uneven."

This is a window to a very small part of a nationwide obesity problem, Katz added. "The resources of New York City may be sufficient to produce some good news, but that is not generalizable. We have a long way to go, and will need to build diligently on these modest gains to get there," he said.

"Obesity is still a major health issue in children," Dr. Achiau Ludomirsky, chief of pediatric cardiology at NYU Langone Medical Center, New York City, added in a statement. "We can definitely see that the decline in obesity among [New York City] school children is the result of early intervention for better diet, opportunity for physical fitness and the education of students and parents. It is a three-tier effect."

What kids eat and learn away from school is also key. "We can't reduce obesity levels without working closely with the families of students to help them offer better diet options at home and limit a child's time in front of the television, computers and video games," Ludomirsky said.

"But we still have a long way to go," he stressed. "If we don't address the childhood obesity epidemic more proactively right now, it will become a major health issue for the next generation of Americans."

More information

For more on childhood obesity, visit the U.S. National Library of Medicine.

NYC Sees Drop in Child Obesity, Can Other Cities Do Same?

THURSDAY, Dec. 15 (HealthDay News) -- In what might serve as a hopeful sign for all children in the United States, a new study finds that obesity rates among New York City's school children have dropped slightly in the past five years, particularly among the youngest.

Although the relative decline in obesity rates is only 5.5 percent, it's still the largest drop seen yet in any major U.S. city, the researchers noted, and many of the programs that New York City health and education officials implemented to combat rising childhood obesity rates are being tried in other parts of the country.

"This is really good news, but there are still one in five children in grades K-8 who are obese, which is still a huge number of children," said study author Magdalena Berger, a city research scientist in the New York City Department of Health and Mental Hygiene. "We are on the right track, but we still have a very long way to go."

Obesity among children has been increasing since the 1970s, Berger said. "In the last decade, nationally, we have seen a leveling off of obesity, but this is the first well-documented decline in obesity among children that we have seen."

The drop in obesity is statistically significant, because of the large number of children in New York City's public schools, Berger said. "Whether or not it's actually meaningful is another question," she added.

"I think it's meaningful in the sense that it's not going up, and that's good news, it's not staying stable, and that's good news," Berger said. "I would characterize this as a slow sustained drop over five years; it's not a dramatic drop."

Although the reasons for the decline in obesity among these school children isn't clear, Berger speculated that policies implemented by the New York City departments of health and education, along with more public awareness of the problem, may have played a role.

Study co-author Cathy Nonas, director of Physical Activity and Nutrition Programs in New York City's Department of Health and Mental Hygiene, said several changes in city schools probably contributed to the drop in obesity rates.

"There are significant changes in school food," she said. "There is no whole milk in the schools anymore, it's only 1 percent and the chocolate milk is skim and low sugar," she said. "That saved 4.5 billion calories, just by making that change."

In addition, food served in schools has reduced fat and no trans fats and reduced salt, and the level of fiber has been increased, Nonas said. Drinks and snack foods sold in schools are also healthier, she said. Similar policies were also instituted in early child-care centers, she added.

Also, the city has trained K-5 teachers on how to increase physical activity in the classroom, Nonas said.

"It's a layering effect" that all contributed to reducing obesity rates, Nonas believes. These and similar policies are being implemented throughout the country, she noted.

The report was published in the Dec. 16 issue of the U.S. Centers for Diseases Control and Prevention's Morbidity and Mortality Weekly Report.

For the study, Berger's team used data on the more than 900,000 children in kindergarten to eighth grade in New York City public schools. The city's school system collects fitness data on these students every year, Berger said.

The researchers found the relative obesity for these children, aged 5 through 14, dropped 5.5 percent, from 21.9 percent in 2006-07 to 20.7 percent in 2010-11.

The biggest drop was among children aged 5 to 6, where the relative decline was 10 percent, from 20.2 percent in 2006-07 to 18.2 percent in 2010-11, they noted.

These declines in obesity were seen in all race and ethnic groups, the researchers added.

Obesity expert Dr. David L. Katz, director of the Prevention Research Center at Yale University School of Medicine, said that "this report, showing a decline in obesity among New York City school children over the past five years is, to be sure, a glass half full. But I wouldn't get carried away with the celebrations just yet."

The absolute decline in the overall obesity rate is roughly 1 percent in five years, he noted. "At that rate of progress, it would take a century to fully reverse the damage done over the past several decades. The rate of obesity is still over 20 percent, and the gains are uneven."

This is a window to a very small part of a nationwide obesity problem, Katz added. "The resources of New York City may be sufficient to produce some good news, but that is not generalizable. We have a long way to go, and will need to build diligently on these modest gains to get there," he said.

"Obesity is still a major health issue in children," Dr. Achiau Ludomirsky, chief of pediatric cardiology at NYU Langone Medical Center, New York City, added in a statement. "We can definitely see that the decline in obesity among [New York City] school children is the result of early intervention for better diet, opportunity for physical fitness and the education of students and parents. It is a three-tier effect."

What kids eat and learn away from school is also key. "We can't reduce obesity levels without working closely with the families of students to help them offer better diet options at home and limit a child's time in front of the television, computers and video games," Ludomirsky said.

"But we still have a long way to go," he stressed. "If we don't address the childhood obesity epidemic more proactively right now, it will become a major health issue for the next generation of Americans."

More information

For more on childhood obesity, visit the U.S. National Library of Medicine.

Obesity rise prompts Wash. ferries capacity change

SEATTLE (AP) — The Washington state ferry service isn't going to start turning away hefty passengers, but it has had to reduce the capacity of the nation's largest ferry system because people have been packing on the pounds.

Coast Guard vessel stability rules that took effect nationwide Dec. 1 raised the estimated weight of the average adult passenger to 185 pounds from the previous 160 pounds, based on population information from the Centers for Disease Control and Prevention.

During the past 20 years, there has been a dramatic increase in obesity in the United States and about one-third of American adults are now considered obese, the CDC says on its website.

The state ferry system has complied with the new stability rules by simply reducing the listed capacity of its vessels, Coast Guard Lt. Eric Young said Wednesday.

"That has effectively reduced the amount of passengers by about 250 passengers or so depending on the particular ferry," said Young, who is based in Seattle. "They generally carry about 2,000, so it's down to 1,750 now."

With that many passengers, the ferry wouldn't tip over even if everyone ran to the side at the same time to look at a pod of killer whales, he said.

The state operates 23 white and green vessels on 10 routes across Puget Sound and through the San Juan Islands to British Columbia. Carrying more than 22 million passengers a year, it's the biggest ferry system in the United States and one of the four largest in the world, Coursey said.

The ferries themselves could be contributing to passenger girth. The galleys cater to customers looking for fast food they can eat while looking out the windows at the scenery and seagulls. Calorie counters typically aren't buying the hamburgers, hot dogs and chicken strips.

"We do serve light beer," said Peggy Wilkes who has worked 20 years for the food concessionaire, Olympic Cascade Services, which serves food and drinks on 12 of the state ferries.

News reports of overloaded ferries sinking in other parts of the world are sometimes a topic of discussion, she said.

"I think it's cool the Coast Guard is keeping up on that," she said. "Not that we overload them. A couple of times, like for a Seahawks game, we've had to cut off passengers and had to leave them at the dock."

Carol Johnston, who has been riding the state ferries since 1972, said she found the rule change perplexing.

"The ferries are not listing, they are not sinking," said Johnston, who was onboard a Seattle-bound ferry from Bainbridge Island Wednesday afternoon. "How are you going to establish how much weight there is on the ferry?"

Johnston worried about the potential loss in revenue, which could cause ferry fares to increase further. And she joked she may alter her eating habits.

"That means I will not have popcorn with my wine," Johnston said.

The reduced passenger capacity is unlikely to have much practical effect on the spacious ferries, system spokeswoman Marta Coursey said. The ferries often fill up with vehicles, but the number of passengers, especially walk-ons is seldom a problem, she said.

The new stability rules may have a bigger impact on the smaller charter fishing boats, such as those that take anglers fishing out of the Pacific Ocean ports of Westport and Ilwaco, Young said. Any vessel that carries more than six paying customers has to be inspected and certified by the Coast Guard as a passenger vessel.

Obesity rise prompts Wash. ferry capacity change

SEATTLE (AP) — The Washington state ferry service isn't going to start turning away hefty passengers, but it has had to reduce the capacity of the nation's largest ferry system because people have been packing on the pounds.

Coast Guard vessel stability rules that took effect nationwide Dec. 1 raised the estimated weight of the average adult passenger to 185 pounds from the previous 160 pounds, based on population information from the Centers for Disease Control and Prevention.

During the past 20 years, there has been a dramatic increase in obesity in the United States and about one-third of American adults are now considered obese, the CDC says on its website.

The state ferry system has complied with the new stability rules by simply reducing the listed capacity of its vessels, Coast Guard Lt. Eric Young said Wednesday.

"That has effectively reduced the amount of passengers by about 250 passengers or so depending on the particular ferry," said Young, who is based in Seattle. "They generally carry about 2,000, so it's down to 1,750 now."

With that many passengers, the ferry wouldn't tip over even if everyone ran to the side at the same time to look at a pod of killer whales, he said.

The state operates 23 white and green vessels on 10 routes across Puget Sound and through the San Juan Islands to British Columbia. Carrying more than 22 million passengers a year, it's the biggest ferry system in the United States and one of the four largest in the world, said system spokeswoman Marta Coursey.

The ferries themselves could be contributing to passenger girth. The galleys cater to customers looking for fast food they can eat while looking out the windows at the scenery and seagulls. Calorie counters typically aren't buying the hamburgers, hot dogs and chicken strips.

"We do serve light beer," said Peggy Wilkes who has worked 20 years for the food concessionaire, Olympic Cascade Services, which serves food and drinks on 12 of the state ferries.

News reports of overloaded ferries sinking in other parts of the world are sometimes a topic of discussion, she said.

"I think it's cool the Coast Guard is keeping up on that," she said. "Not that we overload them. A couple of times, like for a Seahawks game, we've had to cut off passengers and had to leave them at the dock."

Carol Johnston, who has been riding the state ferries since 1972, said she found the rule change perplexing.

"The ferries are not listing, they are not sinking," said Johnston, who was onboard a Seattle-bound ferry from Bainbridge Island Wednesday afternoon. "How are you going to establish how much weight there is on the ferry?"

Johnston worried about the potential loss in revenue, which could cause ferry fares to increase further. And she joked she may alter her eating habits.

"That means I will not have popcorn with my wine," Johnston said.

The reduced passenger capacity is unlikely to have much practical effect on the spacious ferries, said Coursey, the system spokeswoman. The ferries often fill up with vehicles, but the number of passengers, especially walk-ons, is seldom a problem, she said.

The new stability rules may have a bigger impact on the smaller charter fishing boats, such as those that take anglers fishing out of the Pacific Ocean ports of Westport and Ilwaco, Young said. Any vessel that carries more than six paying customers has to be inspected and certified by the Coast Guard as a passenger vessel.

Obesity Linked to Worse Outcomes With Early Breast Cancer

WEDNESDAY, Dec. 7 (HealthDay News) -- Obese women with early stage breast cancer are less likely to survive than other women who are of normal weight, new research suggests.

Researchers from Baylor College of Medicine are slated to present their findings Wednesday at the 2011 San Antonio Breast Cancer Symposium.

"The findings add to the body of evidence indicating that obesity, in general, increases a patient's chance for having a worse prognosis," lead researcher Dr. Sao Jiralerspong, an assistant professor of medicine at Baylor, said in a symposium news release. "Obesity is a probable risk factor for worse breast cancer outcomes, and ours is the latest study to suggest it has an effect on treatment outcome as well."

In conducting the study, researchers analyzed the link between weight and treatment of 4,368 women with early-stage breast cancer over the course of 25 years. The investigators found that the participants who were overweight had survival rates that were similar to the women of normal weight, but those who were obese had an increased risk for shorter time to recurrence, and worse disease-free and overall survival.

Although the obese women who received no additional chemotherapy or endocrine therapy had worse outcomes, the study noted that obese patients who received chemotherapy fared significantly worse than normal-weight patients.

Jiralerspong suggested that biological factors linked to extra weight -- such as higher blood insulin and estrogen levels, inflammation and growth factors secreted by fat cells -- could help explain these findings.

The researchers also revealed, however, that obese women treated with endocrine therapy, primarily tamoxifen, had significantly better survival rates than women who were of normal weight.

"Finding that overweight patients have a better outcome than normal-weight patients after tamoxifen treatment is surprising. We are examining the possible reasons for this," noted Jiralerspong.

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

In addition, more research is needed to understand how obesity affects treatment for breast cancer, particular since new treatments have been introduced since the study was conducted, the researchers added.

More information

The U.S. National Cancer Institute has more about the link between obesity and cancer.

Obesity Linked to Higher Esophageal Cancer Death Rates

FRIDAY, Dec. 23 (HealthDay News) -- Obese people who have had surgery to treat esophageal cancer are twice as likely to have a recurrence of the disease or die from cancer within five years as patients of normal weight, according to a new study.

In the study, published in the Dec. 1 issue of the Journal of Clinical Oncology, researchers from the Mayo Clinic in Rochester, Minn., suggested their findings could change the way some doctors treat obese patients with this type of cancer.

The investigators followed 778 people who had surgery for esophageal cancer and found that those who were classified as obese (a body mass index of 30 or higher) had a five-year survival rate of 18 percent. That survival rate jumped to 36 percent among people who were not overweight.

"Obesity is considered a risk factor in the development of this cancer, which is known to be both highly lethal and increasingly common," the study's lead investigator, Dr. Harry Yoon, an oncologist at the Mayo Clinic Comprehensive Cancer Center, said in a Mayo news release. "But prior to this study, we did not really understand the impact of obesity in this upper gastrointestinal cancer."

The study authors pointed out that their findings applied only to nonsmokers who had their esophagus removed. Yoon added that previous research has linked obesity to greater risk for cancer as well as increased risk of death from other types of tumors because extra weight results in a chronic inflammatory state.

The researchers noted their findings could change the approach they take with obese patients with esophageal cancer.

"As an oncologist, I did not typically speak to my patients about excess body weight as part of their care, because we are more often concerned about weight loss and maintaining proper nutrition, but that may change," said Yoon. "It would be helpful to be able to offer patients some measures that they can take to possibly impact their prognosis."

More information

The U.S. National Cancer Institute has more about obesity and cancer.