Obesity and Pharmacologic Management of Weight Loss

(For the rest of us)


Obesity rates in the United States are staggering.  It is estimated that by the
year 2030, 86.3% of adults will be overweight or obese, and by 2048
all American adults will be overweight or obese (Kanaya, Vaisse, 2011).

With these statistics and the common knowledge that exercise and proper diet
are necessary to maintain weight, yet are blatantly disregarded, what can
primary care providers do pharmacologically to reduce obesity?


 

weight-loss

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5210

Haverty, Amy015210-Ever hear those numbers? No, it’s not your middle school student’s locker combination, or one of an endless list of passwords.

Do you wish you could help your family eat healthier but feel overwhelmed by all the advice and information out there? Each seemingly contradicts the other.  Do you worry about your children’s health, but are too busy with taking care of them, school, activities, work, etc., to be able to figure out and commit to the best way to make some changes? If so, there is a very easy way to help.  It’s called 5210.

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Obesity and diabetes: Is your gut in control?

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

Your body is like a forest, providing a home to microscopic flora and fauna. In fact, your body is home to up to 100 times more microbes than your own cells, which make up your microbiome. While we provide them residence, these microbes help us out by providing a first line of defense against disease trying to invade our bodies, even breaking down food during digestion and producing vitamins. Now, the microbes that live in the digestive tract are helping us understand diabetes better.

According to the Human Microbiome Project sponsored by the National Institutes of Health, the microbiome plays a huge role in human health. When the microbiome is altered or unbalanced, it can cause conditions like obesity, irritable bowel syndrome, skin disease, urogenital infection, allergy and can even affect emotion and behavior. Continue reading

Move On

Dr. Victor Sierpina

Dr. Victor Sierpina

A recent ode to the benefits of tennis by a 74-year-old writer caught my eye. Citing various classical authors, philosophers, and the gradual improvement of his game since his 20s, the author championed the power of vigorous sport on his writing and his mind. Riffing off a Robert Frost poem that ended “Here are your waters and your watering place. Drink and be whole again beyond confusion,” the author concluded: “The tennis court is my watering place where I drink and am whole again beyond confusion — at least for a couple of hours.”

As an aging tennis player myself, I found his essay in The Wall Street Journal’s opinion page uplifting as he described “tennis as a refuge from the racket of everyday life.” We all need some kind of healthy activity and discipline to allow us to shut down the grinding gears of our minds for brief periods and refresh it with the drink of stillness and the water of life.

The Physical Activity Council recently reported 28 percent of Americans over 6 get no physical activity meaning they are totally sedentary in the past year. This report is also included a sharp increase in inactivity for those over 65. These are unhealthy trends. Continue reading

A body in motion

Dr. Victor Sierpina

Dr. Victor Sierpina

In high school physics class, I learned from Sir Isaac Newton that a body in motion will stay in motion. The opposite is true and it is called inertia. The other day in clinic, I went in to see Dylan, a 12 year old. He didn’t look up or say hi to me as I came into the room as he was intently working his thumbs on a handheld device. His mother told him to be polite and say hello. He raised his head briefly, said, “Hi,” then back to the gaming thing. She shrugged apologetically and helplessly. I won’t dwell on how we should socialize the digital generation to learn polite human interaction, though it is quite relevant to bodies in motion.

Dylan’s complaint was a minor one and he basically came in needing a school excuse. It could have been a 5 to 10 minute visit but I noticed he was a bit chunky. In fact, his BMI at 29 was close to the obese range. At mom’s request, we ran a urine and blood test to make sure he wasn’t diabetic. He wasn’t, fortunately, at least not yet.

I asked Dylan what kinds of sports or other activities he liked to do. Mom motioned to me with both thumbs moving rapidly to mime the reality of his activity. Continue reading

The real skinny on holistic bariatric surgery

Dr. Victor Sierpina

Dr. Victor Sierpina

I recently read a really well-done book by a highly successful bariatric surgeon in Dallas and former UTMB medical student.

Dr. Nick Nicholson’s book, “Weight Loss Surgery: The Real Skinny,” is an essential read for those of you who might be contemplating surgery for your weight problem, as well as for your family and friends. Such surgery has become the second most common general surgery procedure after gallbladder removal. So if you haven’t met someone who has had this surgery, you surely will.

Bariatric means relating to weight loss, thus bariatric surgery involves one of several types of procedures to help people lose weight. This is not a minor event. If your six-pack has turned into a 12-pack, you are 10-30 pounds overweight, don’t fit into your favorite dress or jeans, bariatric surgery is likely not for you. It is not a cosmetic treatment like getting a face-lift or getting a boob job.

Your BMI needs to be over 40, or over 35 if you have certain obesity related medical conditions to even qualify for this kind of surgery. Additionally, most insurances, if they cover this treatment, require psychological evaluation, documentation of failed attempts at diet, exercise, and the usual approaches to losing weight. Continue reading

Testosterone plays role in obesity for men

Dr. Victor Sierpina

Dr. Victor Sierpina

Men, there is now a simple medical biomarker at-home test for you called CYCYP.

Look straight down and see if you can see your … mmm, anatomy. If not, likely you are suffering from visceral or belly fat, or maybe you have a vision problem.

For many years, we guys have thought of the obesity issue as something that mainly troubled the fairer sex.

It seems it has always been culturally appropriate for the ladies to be concerned about their shapely figures and how to stay attractive for us guys.

We men rarely, if ever, seem to be concerned or even discuss such matters outside of the gym.

However, the surprising news is that obesity or overweight rates for men are at 72 percent and rising, and for women it is 64 percent and stable.

Men also have a higher risk of cancer, diabetes and heart disease with a life expectancy of 76 years compared to 81 for women. Continue reading

Yes, there is a weight-loss microbe living on and in us

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

John Donne wrote, “No man is an island.” Scientists would agree — man is more like a forest.

And just like the flora and fauna that call the forest home, each human body houses tons of other species in the form of microbes. In fact, most people have 10 times more microbes in and on them than their own cells!

These microscopic organisms live on skin, within the gastrointestinal tract, and inside mouths, helping the human body function and keeping it healthy. Now, new research shows that a certain microbe has huge influence on a person’s weight.

Science is just beginning to understand how the relationship between microbes and human cells, tissues, and organs contributes to good health. The key here is mutualism — the cooperation that benefits both the microbes and the human. Continue reading

A top 10 list to die for

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

How are you going to die?

The Centers for Disease Control would answer that life expectancy depends greatly on where someone lives. Life expectancy in the United States ranks 40th in the world with 77.97 years. That addresses when someone might die but what about how? Most likely, it will be from one of these top 10 causes, based on how many Americans they kill each year.

10) Suicide – 38,285. Many factors are now known to influence suicide: mental illnesses, genetics, certain pharmaceuticals, traumatic brain injuries, drug and alcohol abuse and chemical or hormonal imbalances. To decrease these rates, education about the signs preceding suicide and accessible treatment is necessary.

9) Kidney Disorders – 45,731. Although dialysis can help people survive a little longer without a kidney, it is no cure. Kidney damage can occur from infection, high blood pressure, or toxic reactions to drugs, leading to chronic kidney disease that affects more than 26 million Americans. Continue reading

Healthy Grilling: Barbecue can be good for you

Drs. Victor & Michelle Sierpina

Drs. Victor & Michelle Sierpina

Down here in Texas, barbecue is pretty much a religious ritual. You name it, from shrimp and seafood to the basic beef, pork, chicken and game meat, there is rarely a person who doesn’t love the smoky smells, social conviviality, and opportunity for creative cookery that grilling brings.

We love to soak wood chips, mesquite, cherry, apple or hickory and put them in a tray inside our gas-fired grill. The smoke smells so nice we usually open the screen to let it blow into the house for a “barbecue incense” experience!

Grilling is a fun, inexpensive form of home cooking, keeps the house cooler in the summer than cooking indoors, and can be a great time with family and friends. Sometimes, these intangible benefits are more important to our health and well-being than any other factor related to the foods themselves. Happiness and joy are good for our health. Continue reading