Day 1 :
- Track 1: Overweight & Obesity Track 2: Weight gain and contributing factors Track 3: Eating disorders and obesity and Weight gain and Health risks
Chair
Nikolai Reynolds
Ipsos Healthcare and Ipsos InnoQuest
Co-Chair
A.P.J. Houdijk
Trial Holland Health, The Netherlands
Session Introduction
A.P.J. Houdijk MD PhD
Trial Center Holland Health, The Netherlands
Title: Weight loss: What is the best outcome measures ??
Time : 11:20-11:50
Biography:
A P J Houdijk is a gastrointestinal/endocrine surgeon with a special interest in metabolic derangements related to body composition and complications after surgery. A hallmark of metabolic derangements after surgery is insulin resistance as a result of the stress response. This response is influenced by body composition. The parallels with the insulin resistant state in overweight and obesity has triggered his interest in studying the impact of different body stores in various disease states. The last few years he is engaged as the Program Director of the Trial Center Holland Health tackling overweight related problems.
Abstract:
The treatment of the world-wide obesity epidemic remains a problem. Despite many new approaches targeted at dietary improvement and restriction combined with increased physical activity programs, obesity numbers are rising. Body mass index (BMI) and weight assessment are frequently used to monitor weight loss programs. BMI and weight are influenced by weight gain or loss from body stores that have significant different effects on health. An increase in healthy muscle mass as a result of physical activity will obscure the loss of unhealthy visceral fat (VF) and despite health gain will reduce adherence to the program. In recent years much progress has been made on the causal factors involved in the benefit of muscle and the down side of VF in relation to health risks. Muscle has to be regarded as a hormone-producing organ influencing fat and glucose metabolism and VF induces an inflammatory state causing the metabolic syndrome. Health risk is dependent on the balance between muscle and VF. The measurement of VF is important in risk profiling and in follow up of interventions. Combining VF measurements with BMI has identified risk sub-phenotypes in surgical patients corresponding to the lean fit, lean unfit, fat fit and fat unfit phenotypes. These new parameters will help to monitor weight loss programs in the context of loss or gain of health in a particular sub-phenotype.
Edwin C.M. Mariman
Maastricht University Medical Center, The Netherlands
Title: Adipocytes as biological promoter of weight regain after weight loss
Time : 11:50-12:20
Biography:
Edwin C M Mariman completed his PhD in 1983 at the University of Nijmegen. In 1985, he was appointed as Senior Scientist at the Department of Human Genetics. In 1990, he became Head of the Research Division of Multifactorial Disorders. From 1995, he was Head of the Medical DNA-diagnostics Division. In 2001, he moved to the University of Maastricht as full Professor of Functional Genetics to study molecular and genetic aspects of obesity. He is coordinator of the Maastricht Proteomics Center, member of the committee for NWO-TOP grants, Editorial Board Member of several journals, (co)author of about 200 peer-reviewed articles.
Abstract:
Overweight is one of the major problems of modern day societies. Although weight reduction is fairly easy, maintenance of the reduced weight is the true challenge. Research has mainly focussed on psychosocial factors as a cause for weight regain, but also biological factors may play a role. We are investigating the possibility that adipocytes act as driving force behind weight regain after weight loss. Mature adipocytes are surrounded by a strong extracellular matrix (ECM). When adipocytes shrink during weight loss, the ECM should adjust in parallel. However, under conditions of energy restriction, this process is hampered, leading to mechanical stress between the adipocyte and the surrounding ECM. We hypothesize that this adipocyte cellular stress is a promoter of weight regain. Using genetic variation in 124 ECM genes as part of the pan-European DiOGenes GWAS, association was found between the risk for weight regain and five ECM genes. In addition, we quantified eight stress proteins in adipose tissue and found some of them to be significantly increased in persons who regained weight, but not in persons who remained weight stable. Together this supports our hypothesis. Moreover, we found that adipocytes during weight loss or shortly thereafter, increase their capacity for fat uptake and storage. A model for weight regain will be presented in which adipocytes try to get rid of their cellular stress by lowering the secretion of leptin to induce food intake by the host followed by re-filling of the adipocytes. As a consequence the host will regain weight.
U. Deniz Dincer
Bezmialem University School of Medicine, Turkey
Title: Does new approach regarding “Reversing adipocyte inflammation in obesity really worthy?â€
Time : 12:20-12:50
Biography:
U Deniz Dincer received her MD, Ankara University School of Medicine, 1986 and her PhD, Ankara University in Pharmacology, 1995. She completed her training as a Postdoc in USA (Indiana University School of Medicine) 1997, 1999-2000. She worked at Ankara University between 2001-2005 as an Associate Professor. She also worked at LSUHSC, New Orleans, USA and IUPUI, Indiana, USA as a faculty (Assistant Prof.) between 2004-2010. Between 2010 and 2012 she was department chair of Pharmacology, Ufuk University School of Medicine, Turkey. She is working as a Professor and Department Chair of Pharmacology, Bezmialem University School of Medicine, Istanbul, Turkey.
Abstract:
Visceral fat is thought to be the source of adiposopathy, which is characterised by chronic inflammation and necrosis. It produces and releases many bioactive peptides named adipokines, which play important roles in energy production, vascular homeostasis, immunity and metabolic syndrome. When healthy adipocytes are transformed to “sick adipocytesâ€, all the hormones, cytokines, chemokines and growth factors released from fat may change. Thus, a new perspective related to developing new approach against obesity and metabolic syndrome focuses on “reversing inflammation in adipose tissueâ€, which could break the link between inflammation and adiposopathy-associated complications. When clinicians and scientists aim to create an “avant-garde†human body, obesity cannot include on that picture; it is more than aesthetic outfit but certainly related associated complications. Reversing adipocyte inflammation is a “new therapeutic approach†which could reverse adiposity-associated complications in metabolic syndrome, type II diabetes and atherosclerotic cardiovascular disease.
Rebecca Cooper
Rebecca’s House Eating Disorder Treatment Programs, USA
Title: Neurobiology Implications of Obesity and Disordered Eating
Time : 14:00-14:30
Biography:
Rebecca Cooper is the leading expert in disordered eating, eating disorders and food addictions. She received her Master’s degree in Clinical Psychology from Pepperdine University and is a Licensed California Therapist, Licensed Professional Clinical Counselor, Certified Eating Disorder Specialist and holds a World Certificate for Psychotherapy. She authored the book, Diets Don\'t Work®, CDs, DVDs, Eating Disorder Workbooks, and numerous published articles. She created the first transitional living program for people with disordered eating, Rebecca\'s House Eating Disorder Treatment Programs in California. Her recovery program for disordered eating is used throughout the USA at treatment centers and by therapists.
Abstract:
Many people have a dysfunctional relationship with food wheretheir obsession with food, weight, dieting and body image is impacting their health and quality of life. New advances in weight loss procedures, programs and research into the disruption of the energy homeostasis caused by dieting and the mutation of inheritable genes are resulting in an epidemic of obesity and disordered eating. Disordered eating creates a complex interaction that involves genetics, environmental factors, psychological disturbances, neurochemical and biochemical changes, and disturbed thinking patterns. The world’s top scientists and researchers are studying the physical, behavioral, emotional, and mental effects of foods, lifestyle, and experiences that create a dysfunctional relationship with food. Research has shown that neurochemical and genetic expression can be altered and are implicated in obesity and disordered eating. It has also been shown that some people have genetic programming for fewer dopamine receptors. To compensate individuals may use substances (or some foods) to increase dopamine levels in the reward system of the brain.
Nikolai Reynolds
Ipsos Healthcare and Ipsos InnoQuest, Germany
Title: International Study on Weight Reduction Strategies
Time : 14:30-15:00
Biography:
Nikolai Reynolds completed his PhD at the University of Bonnin Germany at the Chair for Market Research and is today, an appointed Lecturer at the same chair. In the private industry, at Ipsos - an international market research company - he heads two business units as a Director: Ipsos Healthcare and Ipsos InnoQuest. He has published more than 30 papers and has been for four years a member of an advisory board for an EU Commission co-financed international research program focusing on supply chain relationships in the LATAM and the EU.
Abstract:
The objective of this study was to assess factors determining the reaction of individuals to the threats of overweight and obesity. Its aim is also to examine the interdependencies between weight-reducing strategies. The study encompasses a cross-country survey covering 19 countries and 13,155 interviews. Data were analyzed using a bivariate probit model that allows simultaneously analyzing two weight-reducing strategies. Results show that weight-reducing strategies chosen are not independent from each other. Findings also reveal that different strategies are chosen by different population segments. Women are more likely to change their dietary patterns and less likely to become physically active after surpassing a weight threshold. In addition, the probability of a dietary change in case of overweight differs considerably between countries. The study also reveals that attitudes are an important factor for the strategy choice. It is vital for public health policies to understand determinants of citizens’ engagement in weight reduction strategies once a certain threshold is reached. Thus, results can support the design of public health campaigns and programmes that aim to change community or national health behaviour trends taking into account, e.g., national differences.
Amalan Karthigeyan
Peterborough City Hospital, UK
Title: The use of pharmacotherapy in the treatment of binge eating disorder
Time : 15:00-15:30
Biography:
Amalan Karthigeyan attended medical school at the University of Debrecen in Hungary. He obtained his MD from there in 2012 and is now working as a junior doctor in the UK. He spent a short period of time working in an eating disorders unit in the town of Grimsby. During this time he had a case report published and participated in an audit analysing cardiac abnormalities in anorexia nervosa patients. The findings of this audit were presented at the 16th World Congress of Psychiatry which took place in Madrid in September 2014.
Abstract:
In treating binge eating disorder (BED), pharmacological treatment has proven beneficial. Multiple antidepressants including desipramine and fluvoxamine have demonstrated a decrease in the frequency of binge eating episodes as well as a decrease in the weight. For example, a placebo controlled trial of desipramine demonstrated a 63% decrease in binge eating frequency and mean weight loss of 3.5 kg for patients on desipramine compared to 16% decrease in binge eating frequency and mean weight loss of 1.2 kg for patients on placebo. Four previously published placebo-controlled trials on the effect of selective serotonin reuptake inhibitors (SSRIs) on BED demonstrated a minimum 50% decrease in the frequency of binges by SSRIs compared to placebos. Studies have also shown that in binge eating disorder, there are abnormalities with serotonin and norepinephrine. Anticonvulsants such as topiramate and zonisamide have also proven beneficial as they have been associated with anorexia and weight loss. One placebo controlled trial for topiramate demonstrated that 64% of patients treated with topiramate stopped binge eating while only 30% of patients on placebo demonstrated this. Both of these particular anticonvulsants act by inhibiting glutamate transmission. Anti-obesity agents including orlistat and sibutramine are also being used. An open trial of sibutramine on 10 obese patients over 12 weeks demonstrated that seven out of the ten patients had a reduction in their body weight while a placebo controlled trial on 60 patients demonstrated decreases in binge eating frequency and body weight. New options for pharmacological treatment such as atomoxetine and acamprosate are also emerging.
Bo Werner
Orebro University School of Medicine Sweden
Title: Increasing Rate Of Weight Loss For Schoolchildren Within The Epidemic Of Obesity – A Swedish Paradox?
Time : 16:00-16:30
Biography:
Bo Werner is currently working as a paediatrician in the Division of Social Medicine at the Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden. Werner\\\'s research shows that a population\\\'s health may well be described by child and school health records. She has published many papers based on her survey and research on the development of body mass index (BMI), overweight, obesity and weight loss among the schoolchildren in Sweden.
Abstract:
This paper contrasts two findings from the same national covering material in Sweden for children born in 1973 and 1981 from age 7y to 18y. For both boys and girls obesity is increasing in both prevalence and severity and at the same time there is an increasing rate of weight loss episodes especially among girls. Two questions are put: Does this simultaneously development challenge public health work and can these findings be replicated elsewhere? Like in most of the world, the obesity epidemic among children and adolescents is also present in Sweden. Longitudinal surveys of two national representative samples born in 1973 and 1981 have shown that over a period of eight years the rate of obesity among boys and girls, age 7 to 18y, has increased both in prevalence and severity. The last decade’s discussions on whether weight loss and eating disorders, especially among girls, is a growing problem have been ongoing in many countries, but nevertheless it has never been shown convincingly as an increasing phenomenon. In Sweden, by investigating the same data-set as in the study above, it has been shown that there is an increasing rate of weight loss episodes among both boys and girls, especially girls.
Ana Rodrigues Costa
University of Évora, Portugal
Title: How saliva can be useful in weigh management programs.
Time : 16:30-17:00
Biography:
Ana Rodrigues Costa has completed her PhD in Biochemistry from Évora University in 2012, studying the contribution of Na, K-ATPase to pancreatic B-cell dysfunction in DT2. She is currently Assistant Professor of Biochemistry in the Department of Chemistry at Évora University, Portugal. She developed investigation in ICT research center, as Senior Investigator of the Functional Biochemistry group. Her main scientific interests include: i) Physiopathology of DT2, ii) signal transduction studies in cellular models of disease; iii) the identification of salivary biomarkers in pathology.
Abstract:
Saliva contains cells and compounds, of local and non-local oral origin, namely inorganic, organic non-protein, protein/ polypeptide, and lipid molecules. This body fluid offers a non-invasive and stress-free alternative to serum, which can reflect real-time levels of biomarkers. In the last few years, steroids and non-steroid hormones have been investigated in saliva, providing particularly useful biomarkers for physical exercise behavior or psychosocial stress evaluation (e.g. cortisol, testosterone, leptin). In recent years, the attention turned also to the non-hormonal protein components of saliva. Salivary ï¡-amylase is one of the major protein components of saliva and its main function is the enzymatic digestion of carbohydrates, but it is also important for mucosal immunity in the oral cavity, as it inhibits the adherence and growth of bacteria. This enzyme is considered a marker for SNS activity and for metabolic energy balance, sensitive to physical exercise and stress. In this context, its activity/expression in overweight and obesity is of interest. Saliva proteome is being analyzed by 2DE in several physiological/pathologic situations in order to identify potential biomarkers. Additionally, saliva can also be useful to follow lipidemic profiles, since a correlation between levels of total cholesterol and HDL has been demonstrated. Despite the convenient assessment, some characteristics of salivary components also entail some pitfalls that might complicate study design and interpretation of results. To overcome some of these problems, the establishment of standard protocols for collection, analysis and expression of results is a priority.