Treating obesity: One size does not fit all

Analyzing data from more than 2,400 obese patients who underwent bariatric weight-loss surgery, researchers identified at least four different patient subgroups that diverge significantly in eating behaviors and rate of diabetes, as well as weight loss in three years after surgery.

Read the source article here.

 

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Put The Phone Away

Published in the Journal of Social and Clinical Psychology, the most recent study linking poor mental health conditions to social media use has added even more evidence to back up the theory. The researchers from the University of Pennsylvania intentionally designed their experiment to be more comprehensive than previous studies on the topic. Rather than relying on short-term lab data or self-reported questionnaires, they recruited 143 undergraduate students to share screenshots of their Phone battery screens over a week to collect data on how much they were using social media apps including Facebook, Snapchat, and Instagram.

ZeroHedge article link.

Independent article link.

Earlier this year I felt it was important to Put The Phone Down….

With increasing scientific evidence you need to put the phone away.

Unless you want a self-imposed endless cycle of depression and misery.

There’s always Wellbutrin.

Coronary Artery Calcium Scan Embraced By New AHA/ACC Cholesterol Guidelines: Will Insurance Coverage Follow?

Thank you Dr. Pearson.

The Skeptical Cardiologist

The skeptical cardiologist has been utilizing coronary artery calcium (CAC) scans to help decide which patients are at high risk for heart attacks, and sudden cardiac death for the last decade. As I first described in 2014, (see here) those with higher than expected calcium scores warrant more aggressive treatment and those with lower scores less aggrressive treatment.

Although , as I have discussed previously, CAC is not the “mammography of the heart” it is incredibly helpful in sorting out personalized cardiovascular risk. We use standard risk factors like lipids, smoking, age, gender and diabetes to stratify individuals according to their 10 year risk of atherosclerotic cardiovascular disease (ASCVD) but many apparent low risk individuals (often due to inherited familial risk) drop dead from ASCVD and many apparent high risk individuals don’t need statin therapy.

Previously, major guidelines from organizations like the AHA and the ACC did not recommend…

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Daily Weighing may be Key to Losing Weight

Researchers identified several categories of self-weighing adults, from those that weighed themselves daily or almost daily to adults who never used at-home scales.

They found that people who never weighed themselves or only weighed once a week did not lose weight in the following year. Those that weighed themselves six to seven times a week had a significant weight loss (1.7 percent) in 12 months.

Link to source article.

184.4

Yes, I weigh myself almost every day.

Yes it’s been over 40 years since I lost 200 pounds.

Yes!

The Fine Print of the Keto Diet: Harms and Failures

Thanks Dr. Joshi for the research and study links.

afternoonrounds

shutterstock_730538119 (1)

The keto diet has been widely promulgated as an effective therapy for the treatment of diabetes and weight loss with minimal side effects. Many discussions regarding the diet present an unbalanced view, often omitting studies that show harm or lack of a benefit. To balance the narrative, I’ve written this post that I intend to keep maintained for foreseeable future. Below I present the links to references of important studies that are often excluded from the discussion of ketogenic, and by association, low-carbohydrate diets. I invite you to look through them. Personally, I did not expect to find as much as I did (and certainly not so many concerning side effects). If you have other studies or comments, please post them below in the reply section of this page. You can also share them with me on Twitter @sjoshiMD.

  1. Claim that the Ketogenic Diet is Beneficial for Diabetes
    1. I’ve…

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The Power of Positive Deviance

Positive deviance

Positive deviance is the observation that in most settings a few at risk individuals follow uncommon, beneficial practices and consequently experience better outcomes than their neighbours who share similar risks.14

 

Positive deviant behaviour is an uncommon practice that confers advantage to the people who practise it compared with the rest of the community. Such behaviours are likely to be affordable, acceptable, and sustainable because they are already practised by at risk people, they do not conflict with local culture, and they work.15 For example, in Egypt, contrary to custom, parents of poor but well nourished children were found to feed their children a diet that included eggs, beans, and green vegetables. Child nutrition programmes that provided opportunities to parents of malnourished children to follow this and other new behaviours, such as hand washing and hygienic food preparation, improved child growth.

Summary points

Even in the poorest communities, a few individuals or families achieve good health

Positive deviance is a quick, low cost method to identify the strategies used by these people and encourage the rest of the community to adopt them

The approach has been used successfully, mainly to improve child health

The potential for the approach to help communities to gain better health or other social benefits is vast and largely untapped

 

BMJ 2004; 329 doi: https://doi.org/10.1136/bmj.329.7475.1177 (Published 11 November 2004) Cite this as: BMJ 2004;329:1177

How One Colorado Town Is Tackling Suicide Prevention

Eight of the top ten states with the highest suicide rates in the nation are in the rural mountain West, including Colorado. The region has been labeled “the suicide belt.” Even scenic mountain resort towns like Aspen and Durango, Colo., have reported upticks in suicide. Suicide is a problem everywhere in rural America though. More than half of those surveyed in a poll conducted by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health said they knew someone personally affected by suicide.

HT Kaiser. 

Link to source article.