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Pro/con: New biomedical efforts could bring relief to the obese

Sunday, September 8, 2013
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BALTIMORE -- Now that the American Medical Association has declared obesity a disease, it’s time to consider our longstanding failure to address it responsibly.

America’s war on fat is entering its fourth decade and it’s stunning that 98 percent of obese Americans haven’t been significantly helped. A recent report by the World Health Organization found severe obesity still affects 15.5 million adult Americans.

Despite years of government warnings and new efforts to reduce consumption of unhealthy foods by taxing, limiting the proportions that can be served and, in some cases even banning them, obesity has become the health crisis of this generation and quite probably the most pressing health concern in human history.

The problem is particularly acute in the United States, where the WHO recently estimated that 77 percent of females and more than 80 percent of males aged 15 and older are overweight or obese.

Excess fat causes untold numbers of premature deaths and afflicts Americans with such serious maladies as heart disease, diabetes and even forms of cancer that could, in many instances, be avoided. Not to mention the negative mental effect of unneeded and useless angst.

How can we be spending billions and billions of dollars each year on the fight against fat and still be losing it?

One likely reason: We’ve been setting ourselves up for failure by raising expectations far beyond the norms of reality. Obese Americans are bombarded with messages that suggest shedding pounds will turn women into bikini models and men into super athletes bristling with muscles.

The truth is that the only really good reason for shedding weight is improving your health — not your looks.

If a 250-pound woman loses 22 pounds, or about 24 percent of her excess body weight, it may not sound like much, but from a health perspective it can be profoundly important. The question is how to do it without the possibility of suffering unhealthy side effects.

Few Americans want to go through some of the traditional surgical interventions modern medicine has come up with to trim weight — and who can blame them?

Most come under the rubric of major surgery with a possibility of significant complications.

Procedures like sleeve gastrectomy, which removes more than 80 percent of the stomach and is irreversible. Or gastric bypasses, which reroute the intestines to reduce the digestion of food and can also come with severe complications.

Even the more benign lap-band surgery chosen by New Jersey Gov. Chris Christie to restrict his stomach’s capacity comes with a laundry list of warnings. Reoperation may be required if the band slips or if too rapid weight loss occurs. Recipients may experience difficulty swallowing, infections, nausea and vomiting.

Better solutions?

Fortunately, medical scientists in many countries around the globe, including the United States, are working overtime to come up with better solutions.

One small medical device company in Minnesota — EnteroMedics — is working on one that could prove a winner. Its so-called VBLOC therapy is delivered by a small, implantable device that uses electrodes that deliver low-energy electrical impulse to the vagal nerve that help patients control hunger sensations.

Studies soon to be scrutinized by the U.S. Food and Drug Administration have shown that blocking the vagal nerve signals help patients control hunger sensations — resulting in a feeling of early fullness at meals. The device may be turned off and is designed to be reversible, programmable and adjustable from outside the body.

In the biotech arena, MedImmune, a Gaithersburg, Md., biotech company, just announced it will work with NGM Biopharmaceuticals to develop a new treatment for obesity and diabetes which is focused on enteroendocrine cells that are naturally found in the gastro intestine I tract.

Other companies are also pursuing new therapies and treatment options. If some of these efforts eventually pass muster at the FDA, one or more may finally bring relief to the millions of Americans who haven’t yet been liberated from the physical pain and financial suffering of obesity.

Whitt Flora is a former chief congressional correspondent for Aviation Week & Space Technology magazine.

 
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