Analyzing Obesity as a Disease

http://now.tufts.edu/articles/watching-your-weight

  

Dateline 2013: Now

Obesity Is a Disease

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Evelyn E. Smith

MS in Library Science, 2012, University of North Texas

This year, the AMA decided that obesity not only contributes to chronic diseases, but it is a disease. 

Pollack, Andrew. (2013, June 18).  A.M.A. recognizes obesity as a disease.  Business Day.  New York Times.  Retrieved from http://www.nytimes.com/2013/06/19/business/ama-recognizes-obesity-as-a-disease.html?_r=0

In a move that might induce insurers to pay for weight loss treatments, this summer the American Medical Association recognized obesity as a disease—a decision that also might ramp up the fight against Type 2 diabetes and heart disease (Pollack, 2013, June 18, para. 1-2). 

This vote could also improve the changes for reimbursement for obesity drugs and counseling (Pollock, 2013, June 18, para. 5).  Coincidentally, two new obesity drugs--Qsymia from Vivus and Belvia from Arena Pharmaceutical and Eisai--have come on the market during the first half of 2013.  However, Qsymia can cause birth defects (Pollock, 2013, June 18, para. 7-8).  The Internal Revenue Service has also said obesity treatments can qualify for tax deductions (Pollock, June 18, para. 10).

When the AMA classified obesity as a disease, this automatically classified one-third of all Americans as suffering from a chronic disease.  This move also resulted in an unintended consequence--giving physicians the permission to prescribe surgery and drugs rather than to recommend life style changes that would accomplish similar results through diet and daily exercise (Pollock, June 18, para. 19).

Should the American Medical Association have classified obesity as a disease: Debate Club.  News Opinions.  U.S. News & World Report.  Retrieved from http://www.usnews.com/debate-club/should-the-american-medical-association-have-classified-obesity-as-a-disease

The purpose of declaring obesity as a disease is “to advance obesity treatment and prevention”, according to the official stance of the AMA (Should the AMA, 2013, para. 1). Thus, the AMA may be trying to preempt trends since 42 percent of all Americans will be obese by 2030 if current tendencies continue (Should the AMA, 2013, para. 2).  This would pave the way for insurance companies playing for treatment (Should the AMA, 2013, para. 3).   However, those who argue against this decision decry it as a form of lookism while others call for more preventive measures (Should the AMA, 2013, para. 4).

Obesity Poses a Health Risk

Health risks of obesity (2013, May 14).  MedlinePlus.  U.S. National Library of Medicial.  National Institutes of Health.  Retrieved from http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000348.htm

This Website lists the health risks of obesity: High blood sugar, or diabetes, high blood pressure (hypertension), high blood cholesterol and triglycerides, coronary heart disease (heart attacks, heart failure, and strokes), osteoarthritis, sleep apnea, and gallstones (Health risks, 2013, May 14, para. 1). Subsequently, it defines how medical science defines obesity—by measuring the patient’s Body Mass Index (BMI) and/or his or her waistline (Health risks, 2013, May 14, para. 2).

Overweight and Obesity.  CDC Centers for Disease Control and Prevention.  Retrieved from http://www.cdc.gov/obesity/data/databases.html

This CDC-sponsored Website takes users to links that will help users control their own weight, supervise their family’s weight, and even help their community combat obesity.  Thus, the “For Me” link urges users to Know Your BMI, to maintain a Healthy Weight, to Move More, Be Active, and Get Started.  As for children, the CDC provides advice on Keeping Children Active, Tips for Parents, Breastfeeding, and Learning about BMI in Children. Among the preventive measures for keeping a community healthy, the CDC is publicizing a grant to implement a school salad bar. 

Data and statistics might also convince most Americans living outside of New England, California, and parts of the Intermountain West that they need to eat more green and leafy vegetables, exercise, and push themselves away from the dinner table.  Adults 18 to 64 years of age, for example, need to engage in moderate aerobic exercise for two hours and 30 minutes weekly or participate in one hour and 15 minutes of vigorous aerobic exercise weekly.  They additionally need to perform strength training exercises for at least two days per week.  Children need to participate in aerobic exercise for at least an hour daily and perform strength training activities like gymnastics or push ups three days a week for a total of 60 minutes weekly or aerobic exercise. 

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America's Health Rating. (2013).  United States Overview: 2013.

Overall: Weighted sum of the number of standard deviations each core measure is from the national average.

   State Map Key

The healthiest states are light green while the least healthy are dark blue. 

• 1 - 11   Light green
• 12 - 21 Dark green
• 22 - 30 Light blue
• 31 - 40 Aqua
• 41 - 50 Dark blue

- See more at: http://www.americashealthrankings.org/Rankings#sthash.pTvlwS2c.dpuf

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The Whys Behind Obesity

Balentine, Jerry R.  (2012, July 18). Obesity. Medicinenet.com. Retrieved from

http://www.medicinenet.com/obesity_weight_loss/article.htm

Obesity Facts (Summary):  For adults over 35, medical science defines obesity as having a Body Mass Index of over 40.  Obesity is a chronic medical disease that can lead to diabetes, high blood pressure, heart disease, gallstones, and other chronic diseases.  Therefore, anyone who wants to lose weight and keep it off needs to commit to a nutritious diet and regular exercise.  But even a modest weight loss of between five to 10 percent of the individual’s ideal weight can have “significant health benefits” (Balentine, 2012, July 18, p. 1).

Genetics, overeating, a diet high in simple carbohydrates, how often a person eats, and whether he or she suffers from a slow metabolism as well as the emotions of boredom, sadness, stress and anger all can contribute to obesity as in some instances, so does hypothyroidism, insulin resistance, PolyCystic Ovary Syndrome, and Cushing’s syndrome (Balentine, 2012, July 18, p. 3).

As for forecasting just who most needs to worry about becoming overweight, African American and Hispanic women tend to gain weight earlier than their Asian and European counterparts.  Also, if children are overweight, this often indicates that they might be overweight as adults. Women also put on weight while pregnant or while experiencing menopause.   Physicians officially confirm whether patients are overweight by using calipers or by performing a Bioelectric Impedance Analysis (Balentine, 2012, July 18, p. 4).

However, anyone can look at the weight tables furnished by insurance companies to determine if he or she has an acceptable weight based on gender, height, and frame size or else measure the waist (Balentine, 2012, July 18, p. 5).

http://www.news-medical.net/health/What-is-Obesity.aspx

Ordinarily, overweight women are shaped like pears, for they gain weight in their hips, while overweight men usually are shaped like apples since they gain weight in their bellies (Balentine, 2012, July 18, p. 6).

While even modest weight loss can improve health, most dieters regain all the weight they have lost within five years (Balentine, 2012, July 18, p. 7).

Surprise! Couch potatoes who don’t exercise are more likely to gain weight while physical activity helps to burn cavities as well as to control blood sugar levels, reduce triglycerides, increase HDL or “good cholesterol”, lower blood pressure, and reduce the risk of heart disease.   Everyone should therefore exercise for at least 20-to-30 minutes daily five to seven days a week.  However, the individual can break physical exercise into 10-minute segments.  Men over 40 and women over 50 also need to consult a physician before beginning a strenuous exercise program (Balentine, 2012, July 18, p. 8).

Initially, dieters should set a goal of losing from 10 to 15 percent of their ideal weight.  However, a relatively painless way of losing weight is to include low energy, dense foods, like vegetables, fruits, lean meats, fish, grains, and beans in menu plans and to cut out red meat, egg yolks, fried foods, foods high in sugar, fast foods, sweets, pastries, butter, and high fat salad dressings.  Dieters should also stay away from diet drinks, always read food labels, and learn how to estimate calories and serving sizes (Balentine, 2012, July 18, p. 9).

Moreover, they should only consider turning to pharmaceutical prescriptions if health risks preclude exercise.  The U.S. Food and Drug Administration has additionally issued a warning about the herbal diet aid fen/phen since one of its ingredients, ephedrine, can cause high blood pressure, heart rhythm irregularities, strokes, insomnia, seizures, tremors, and nervousness.  Over the counter “fat burners” many also contain dangerous chemicals (Balentine, 2012, July 18, p. 10).

Physicians ordinarily consider surgery, whether bariatric or restrictive surgery, to help the overweight lose weight unless the patient either has a BMI of 40 or a BMI of 35 along with a medical problem (Balentine, 2012, July 18, p. 12).

Thus, no truly easy way to lose weight exists.  Even so, any diet undertaken should be safe and contain the recommended daily allowance of vitamins, minerals, and proteins, be slow and steady, taking off only a pound or so a week, plan for long-term weight maintenance, and be undertaken after the dieter consults a physician (Balentine, 2012, July 18, p. 13).  

Kolbert, Elizabeth. (2009, July 2.  XXXL: Why are we so fat?  The New Yorker, pp. 1-4.  Retrieved from http://www.newyorker.com/arts/critics/books/2009/07/20/090720crbo_books_kolbert?currentPage=1

Since the Eisenhower Administration, the Centers for Disease Control and Prevention have interviewed and randomly selected participants to participate in its National Health and Nutrition Examination Surveys.  In the early 1960s, the CDC determined that 24.3 percent of all Americans had a Body Mass Index of 27 and so were overweight.  In the early 1970s, the percentage of overweight adults had increased to 25 percent, and by the late 1970s, it had edged up to 25.4 percent.  Then during the 1980’s, the percentage of overweight adults had zoomed; and by the 1990s, the rate of overweight adults was 33.3 percent. Men now averaged 17 more pounds than they did in the 1970s, and women were 19 pounds heavier.  Additionally, as the average American became heavier, the truly heavy became even heavier. While this was happening, a genre of books attempting to explain why Americans were gaining weight expanded as well (Kolbert, 2009, July 2, p. 1).

In The Evolution of Obesity (Johns Hopkins University Press, 2009), Michael L. Power and Jay Schulkin propose an evolutionary explanation:  In good times, early humans stored fat in their bodies to sustain them through the bad times when they had little to eat.  Austerity was the norm both among hunter-gatherers and in farming communities.  By way of contrast, post-modern humans living in industrialized countries don’t have to worry about fulfilling their daily energy requirements, so what worked on the savannahs of Africa doesn’t work in the urban jungle (Kolbert, 2009, July 2, p. 2).

 Eric Finkelstein and Laurie Zuckerman, in The Fattening of America (Wiley, 2008), however, propose an economic reason for this weight gain.  Americans started to pile on the pounds during the 1980s because fattening foods had become a bargain.   This argument, for example, points out that thanks in part to their relative cheapness, sodas have become the most popular food in the American diet.  But if Americans switched to water, they would weigh 15 pounds less (Kolbert, 2009, July 2, p. 2). 

David A. Kessler in The End of Overeating: Taking Control of the Insatiable American Appetite (Rodale, Reprint 2010) argues that America’s taste buds have been conditioned, a term that Kessler labels “conditioned hypereating”, so American consumers crave certain foods. He then likens this addiction to sweet, fatty foods to an addiction to cocaine (Kolbert, 2009, July 2, p. 2). 

Greg Critser in Fat Land: How Americans Became the Fattest People in the World (Houghton Mifflin, 2003) credits “supersizing” of food portions with this gain in weight while Brian Wansink expands on this premise in Mindless Eating: Why We Eat More Than We Think (Bantam, 2006). He hypothesizes that individuals rely on external cues like portion size to tell them when to stop.

Thus, when portion sizes increase, so does the weight of the diners. Experimenting with smaller and larger portion sizes, Wansink found that those with super-sized popcorn tubs ate a much larger percentage of popcorn. This finding perhaps offers an important clue as to why Americans are fatter since every fast-food portion size served today is also likely to have more calories than were originally available.  For instance, a small order of McDonald’s French fries once contained 200 calories while today a small serving of fries contains 230 calories, and a large order of fries is equal to 500 calories. Sodas use to come in 8-ounce servings, but today a small-sized serving is 16- ounces, and a large is 32-ounces.  As the fast-food servings have grown in size, so have the recommended portion sizes suggested by products sold in grocery stores and in cookbooks (Kolbert, 2009, July 2, p. 3).

These classics  on the whys of obesity, however, need to be juxtaposed against books like The Fat Studies Reader, edited by Esther Rothblum and Sondra Solovay (New York University Press, 2009) that argues for “size acceptance”, “fat liberation” and “fat power”—a trend in academia that places the obese among the disenfranchised groups (Kolbert, 2009, July 2, p. 3).  

Meanwhile, Francis Delpeach and others in Globesity: A Planet Out of Control (Earthscan, 2009) recognizes that America has exported obesity to the rest of the world, for now Cyprus, the Czech Republic, Finland, Germany, Greece, Malta, and Slovakia have a higher proportion of overweight adults than the United States does.  Meanwhile, obesity is on the rise among those just over the poverty line in Asia, Africa, and South America (Kolbert, 2009, July 2, p. 4).  As for solutions to the world-view obesity epidemic, the World Health Organization has proposed a fat tax on caloric snacks, improving health education, regulating food and beverage advertising, limiting food available in public facilities, and more sidewalks and bike paths (Kolbert, 2009, July 2, p. 4).

In other words, when the consumer bundles a purchase of fries with a hamburger, he or she should choose the small-size portions only as well as leaving part of the burger and fries uneaten while drinking a glass of water with a dash of lemon.

What causes overweight and obesity. (2012, July 13).  National Neart, Lung, and Blood Institute.  National Institutes of Health.  Retrieved from http://www.nhlbi.nih.gov/health/health-topics/topics/obe/causes.html

Lack of energy balance:  Energy balance works like an algebraic equation where “Energy IN should equal energy OUT”.  Thus, the amount of calories consumed should equal the amount of energy the body expends to maintain a healthy weight (What causes overweight, 2012, para. 1-3).

Inactive lifestyle:  Watching television, relying on cars instead of walking, modern labor-saving devices, and cutting Physical Education from the curriculum leads to coronary heart disease, high blood pressure, diabetes, and cancer (What causes overweight, 2012, para. 6-8).

Environment: Other lifestyle factors that make a post-modern populace gain weight include the following:

• Lack of neighborhood sidewalks and safe places for recreation;
• Work schedules; for example working two jobs;
• Over-sized food portions;
• Lack of access to healthy foods (a problem that is particularly true in poorer neighborhood);
• Food advertising.

(What causes overweight, 2013, para. 9-14)

Genes and family history:  Obesity often runs in families since genetics affect the amount of food stored in the body and where the body stores fat, although children also pattern their eating habits after their parents (What causes overweight, 2013, para. 15-17).

Health conditions:  An underactive thyroid, Cushing’s Syndrome, and PolyCystic Ovarian Syndrome (PCOS) may cause obesity (What causes overweight, 2013, para. 18-22).

Medicines: Corticosteroids, antidepressants, and seizure medicines slow the rate at which the body burns calories while they increase appetite and cause the body to retain water (What causes overweight, 2013, para. 23-24).

Emotion: The bored, angry, or stressed sometimes comfort themselves with food (What causes overweight, 2013, para. 25).

Smoking:  When smokers try to quit, they often put on weight because food often smells and tastes better, and since nicotine elevates the rate at which the body burns calories, non-smokers will burn fewer calories than smokers (What causes overweight, 2013, para. 26-27).

Age:  As people age, they lose muscle and become less active, which, in turn, slows down the rate at which the body burns calories.  Women may also gain five pounds during menopause (What causes overweight, 2013, para. 28-29).

Pregnancy:  After delivery, mothers may have a difficult time losing weight (What causes overweight, 2013, para. 30).

Lack of Sleep:  Those who are deprived of sleep prefer foods higher in calories and carbohydrates.  Getting enough sleep helps maintain a balance between the hormones that making them feel both hungry and full.  Sleep also affects how the body reacts to insulin (What causes overweight, 2013, para. 31-35).

Self-help, Support Groups, 

& Therapists

Ellis, Marie.  (2013, October 16).  Study: weight loss groups better than self-help approach.  Medical News Today.  Retrieved from http://www.medicalnewstoday.com/articles/267537.php

A randomized-control trial that covered six months of dieters trying to lose weight undertaken by the Baylor College of Medicine and published in the American Journal of Medicine proves that individals that try to lose weight as a group lose more weight than those who rely only on self-help methods (Ellis, 2013, October 16, para. 1-3).  The 147 dieters that relied on Weight Watchers to lose weight lost on average 10.1 pounds in six months while those volunteers who relied only on “self-help” methods to help them lose weight only lost 1.3 pounds.  Volunteers using the Weight Watchers plan also were eight times more like to achieve a five percent weight loss than those who relied on self-help (Ellis, 2013, October 16, para. 5-6). Moreover, Weight Watchers participants who attended meetings and took advantage of mobile apps and Online tools lost the most weight, averaging 19 pounds of weight. Meeting attendance proved to be the strongest link to weight loss (Ellis, 2013, October 16, para. 10-11).

This study should be helpful to readers since most people first try to lose weight entirely on their own without relying on a support group or a medically-supervised program (Ellis, 2013, October 16, para. 7). Weight Watchers funded the study, but that doesn’t negate the findings that an individual is more likely to lose weight if he or she does so with a buddy or buddies (Ellis, 2013, October 16, para. 19).  The real challenge comes when the dieter tries to maintain this weight loss, however (Ellis, 2013, October 16, para. 19).   

Graffagnino, C.L. (2006, February. Effect of a community-based weight management program on weight loss and cardiovascular disease risk factors. Obesity (Silver Spring), 14(2), 280-8. [Abstract]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/16571854

The researchers at the Riverside Methodist Hospital and the McConnell Heart Health Center in Columbus, Ohio, must have a gift for stating the obvious:  Losing weight requires the dieter to learn how to modify eating habits and to commit him or herself to regularly performing aerobic exercise. A study of 142 women and 56 men who completed a structured, community-based weight management program for overweight and obsessed adults found a “significant correlation” between the percentage weight loss and the number of weekly counseling sessions attended and the number of visits to the wellness center for exercise.  Men in the study averaged a weight loss of 7.3 percent while women averaged a 4.7 percent weight loss.  Fasting lipids and blood glucose levels improved for both genders, and BMI and lipids improved in women. However, only 47 percent of the participants who entered the program finished it.

Grilo C. M. & Masheb, R. M. (2005 November). A randomized controlled comparison of guided self-help cognitive behavioral therapy and behavioral weight loss for binge eating disorder. Behaviour Research and Therapy. 43(11):1509-25.  PMID: 16159592.  [Abstract]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/16159592

In a controlled, randomized trial, the Department of Psychiatry of the Yale School of Medicine tested Guided Self-Help treatments, Cognitive-Behavioral Therapy, and Behavioral Weight loss Treatment as well as a third-control treatment group for binge eating disorder during a 12-week period.  Cognitive Behavior Therapy (87 percent) and the Control Treatment group (87 percent) had significantly higher completion rates than the Guided Self Help Treatment group (67 percent).  Weight loss, however, was minimal across all groups.  The findings thus suggested that Control Behavior Therapy, administered by way of Guided-Self-Help works for Binge-Eating Disorder, but not for obesity.  Interpretation:  Dieters do better when someone monitors their progress, but losing weight takes a long time.

Is Guided Self-Help Effective in Treating Childhood Obesity? (2013, April 1).  Science News. Science Daily.  Retrieved from http://www.sciencedaily.com/releases/2013/04/130401074919.htm

A five-month study of 50 overweight children between the ages of 8 and 12 conducted by the University of California’s San Diego School of Medicine indicates that a self-help program guided by clinical experts might be an effective way for overweight children and their families to lose weight (Guided self-help, 2013, April 1, para. 1).  Researchers measured the child’s BMI before beginning treatment and six months later.  During the course of the program, medical professionals promoted healthy eating behavior and physical activity for all family members (Guided self-help, 2013, April 1, para.  2).  This intervention resulted in a significant loss in BMI that the children maintained six months later in a program designed to fit into a family’s busy schedule (Guided self-help, 2013, April 1, para. 2-3).

This guided self-help program provided a structure that helped participants comply with the program.  Every other week the families came to a San Diego School of Medicine clinic to discuss their personalized weight-loss program as opposed to traditional children’s weight control programs that required families to attend an hour-and-a-half support group (Guided self-help, 2013, April 1, para. 5).

Latner, Janet D. (2007, March/April).  Self-help from obesity and binge eating. Nutrition Today, 42(2), 81-85).  Retrieved from http://www2.hawaii.edu/~jlatner/downloads/pubs/NT-article-self-help.pdf

The life style changes that accompany weight loss mean that the health risks associated with being overweight drop to zero after six months upon reaching an individual’s ideal weight.  However, very few dieters sustain this weight loss because they must remain physically active, continue to restrict their calorie intake, keep only healthy foods on hand, monitor their weight, and periodically refresh their memory by reading nutrition and exercise guides.  Because keeping the weight off requires constant vigilance, medical professionals consider obesity a chronic condition similar to alcoholism or drug addiction (Latner, 2007, p. 81).

Self-help is a cost-effective way of treating obesity over a long period of time while it also gives dieters some major psychological benefits as they take responsibility for their own shortcomings and benefit from the encouragement of other dieters when they participate in support groups (Latner, 2007, p. 82).

The first level of self-help involves no professional guidance while a dieter turns to computer Websites relies a little less on self-help.  Group self-help programs, whether community based or commercial programs like Weight Watchers, can also help dieters reach and maintain long-term goals (Latner, 2007, p. 82-83).

Bulimia nervosa and binge eaters only make up one to three percent of the population.  While they can benefit from specialist or generalist computer Websites that advocate self-help and interventions on the parts of friends and family, these psychological disorders necessitate medical supervision (Latner, 2007, p. 84).

Videos on Obesity

8 best obesity videos of 2013. (2013). Diet & Weight Loss.  Healthline.  Retrieved from http://www.healthline.com/health-slideshow/best-videos-obesity

Generation XXl: A 12-year-old’s struggle with morbid obesity.  (2013, January 29).  America with Lisa Ling.  OWN.  Retrieved from http://www.oprah.com/own-our-america-lisa-ling/Generation-XXL-A-12-Year-Olds-Struggle-with-Morbid-Obesity-Video

Should obesity be a disease? (2013).  DNews.  YouTube. (3:03 minutes).  Retrieved from http://www.youtube.com/watch?v=kBLDNhyMAKE

The Skinny on obesity: An epidemic for everybody:

The Skinny on obesity: An epidemic for everybody. (2013).  Episode 1. UCTV Prime. YouTube. (12:16 minutes).  Retrieved from http://www.youtube.com/watch?v=h0zD1gj0pXk

The Skinny on obesity: Sickenly sweet. (2013). Episode 2. UCTV Prime. YouTube. (9:03 minutes).  Retrieved from http://www.youtube.com/watch?v=0ndTEu_qDGA

The Skinny on obesity: Hunger and Hormones: A vicious cycle. (2013). Episode 3. UCTV Prime.  YouTube.  (8:04 minutes). Retrieved from http://www.youtube.com/watch?v=Yo3TRbkIrow&list=PL39F782316B425249&index=3

The Skinny on obesity: Sugar: A sweet addiction. (2013).  Episode 4.  UCTV Prime.  YouTube. (7:14 minutes).  Retrieved from http://www.youtube.com/watch?v=Xn1cI8FNU6M&list=PL39F782316B425249

The Skinny on obesity: Generation XL. (2013).  Episode 5.  UCTV Prime. YouTube. (6:58 minutes).  Retrieved from http://www.youtube.com/watch?v=Of-qvDprr0w&list=PL39F782316B425249&index=5

The Skinny on obesity: A fast-paced fast food life.  (2013). Episode 6.  UCTV Prime.  You Tube.  (7:22  minutes).  Retrieved from http://www.youtube.com/watch?v=BAqcbQByeec&list=PL39F782316B425249&index=6

The Skinny on obesity: Drugs: Cigarettes, alcohol . . . and sugar. (2013).  Episode 7. UCTV Prime. YouTube. (8:36 minutes).  Retrieved from http://www.youtube.com/watch?v=CWnbMnnLo5w&list=PL39F782316B425249&index=8

The Skinny on obesity: The Skinny on Obesity (Extra): Diet and Lifestyle Tips from UCSF Experts. (2013).  Extra/UCTV Prime. YouTube. Retrieved from http://www.youtube.com/watch?v=wKkBs_pBRwA&list=PL39F782316B425249&index=9

Peter Attia: Is the obesity crisis hiding a bigger problem. (2013). TED Partner Series. YouTube. (15:58 minutes). Retrieved from
http://www.ted.com/talks/peter_attia_what_if_we_re_wrong_about_diabetes.html

Obesity: three times more deadly than thought previously. (2013). NBC Nightly News.  (3:26 minutes. Retrieved from http://www.nbcnews.com/video/nightly-news/52768611/#52768611

1 in 5 Americans dies from obesity, new study finds.  (2013). Today.  MSNBC.  (3:10 minutes). Retrieved from http://www.today.com/video/today/52771279/#52771279

Too fat for 15: 500 pounds and counting. (2011).  YouTube. (45:43 minutes).  Retrieved from http://www.youtube.com/watch?v=DVVjPND6Amk

Never, ever give up, Arthur’s inspiration transformation. (2012). Diamond Dallas Page. YouTube. (4:55 minutes). Retrieved from http://www.youtube.com/watch?v=qX9FSZJu448

Snyder, Evan Y, (2011, October 27).  Tackling diabetes and obesity from a different angle. Medscape.  Multispecialty. (14.10 minutes).  Retrieved from http://www.medscape.com/viewarticle/749623

Summary: Most diets are equally effective, although hormonal systems fight diet and exercise.  It’s also extremely difficult to create effective and safe “obesity therapy” drugs. Reducing body weight, however, will control or prevent co-morbid conditions like diabetes.  The interview’s script appears below the video.

The medical links furnished on this Web page represent the opinions of their authors, so they complement—not substitute—for a physician’s advice.