Obesity at 20-25 age increase risk for liver disease
By Robert Preidt, HealthDay Reporter
Older teen boys who are overweight or obese could be at increased risk for severe liver disease later in life, a new study suggests.
The research included nearly 45,000 Swedish males who entered military service in their late teens between 1969 and 1970. The investigators reviewed over 40 years of their health information. Nearly 400 of them were diagnosed with severe liver disease, the study authors said.
Men who were overweight or obese in their late teens were 64 percent more likely to develop severe liver disease compared with men who had a low normal weight in their late teens. The researchers said that worked out to a 5 percent increased risk for every one point increase in body mass index (BMI).
BMI is an estimate of body fat based on weight and height. Overweight is defined as a BMI above 25. Obesity is defined as a BMI above 30, according to the U.S. Centers for Disease Control and Prevention.
“It is difficult to identify individuals in the general population who have an increased risk for development of cirrhosis and severe liver disease later in life,” said lead investigator Dr. Hannes Hagstrom.
But Hagstrom, of the Center for Digestive Diseases at the Karolinska Institute in Stockholm, said it’s important to learn how to predict liver disease so that researchers can develop effective prevention programs. And one factor that has been linked to the worldwide increase in liver diseases is the increasing prevalence of overweight and obesity.
The study was published June 16 in the Journal of Hepatology.
The findings can’t prove a cause-and-effect link, but do suggest “that the increased risk of a high BMI for the development of severe liver disease later in life is already present from an early age,” Hagstrom said in a journal news release.
“It is possible that this increased risk is caused by a longer exposure to being overweight, compared to becoming overweight or obese later in life, and that individuals with a longer history of being overweight have an increased risk of severe liver disease,” he explained.
Researchers have tested mice to see if obesity can be passed down the bloodline
Two new studies out of Hamilton have found a link between obesity and the inability to delay gratification.
The study by Dr. Michael Amlung at St. Joseph’s Healthcare, looked at 30 studies from over 2 decades, which included over 10,000 people.
“Individuals who are obese or overweight are more likely to choose immediate rewards, in a case of obesity that could be eating high calorie fatty foods in the immediate time frame at the expense of the longterm benefits of weight loss or management.”
A second study by Dr. James Mackillop at McMaster University, found similar results in people with attention defecit hyperactivity disorder or ADHD.
“They’re quite different conditions, one being characterized by attentional issues and the other by over-consumption of food, but that underlying mechanism impulsivity is elevated in both these groups.”
It wasn’t just obesity and ADHD, there is an entire family of psychiatric and behavioral conditions that share the common theme, that includes alcohol use disorder, drug addiction and others. But that doesn’t mean if you’re overweight or have ADHD that you can’t change.
“With targeted intervention and hard work, those things can change and it may just be a matter of shifting someone’s framework how they think about different alternatives.”
Going forward, doctors can now use the results of the studies as a screening tool for future weight loss programs to have better results.
Medication can help in fight against obesity
Systematic review and meta-analysis involving 30,000 patients reveals success of weight loss agents
The review published in JAMA looked at five medications approved for management of obesity in the US: orlistat, liraglutide, phentermine-topiramate, lorcaserin, and naltrexone-bupropion.
Only orlistat (Xenical) and liraglutide (Saxenda) are approved in Australia.
Among overweight or obese adults, each of the medications was associated with achieving at least 5% weight loss at 52 weeks, compared with placebo.
Liraglutide, along with phentermine-topiramate, was one of the medications associated with the highest odds of achieving at least 5% weight loss.
According to the TGA, liraglutide is indicated as an adjunct to a reduced calorie diet and increased physical activity for weight management in overweight and obese patients.
The medication is administered subcutaneously, with pre-filled pens delivering doses of eight 0.6mg, 1.2mg, 1.8mg, 2.4mg and 3mg.
The TGA suggests that if a patient on the 3mg/day dose has not lost at least 5% of their initial body weight after 12 weeks, it should be discontinued, since long-term safety data is limited.
Orlistat (Xenical) is available over the counter in Australia, although the TGA reports it is commonly associated with gastrointestinal effects.
Recently registered in the US but not yet in Australia, phentermine-topiramate is shown to be effective for weight loss but also has a high chance of causing significant adverse effects.
A 2014 Australian study published in the MJA found it was “not well tolerated” by the majority of patients due to symptoms paraesthesia, cognitive effects, dry mouth and depression.
However, for the 30% of participants who continued on the drug over the two-year trial, mean weight decreased by 6.7kg and this loss was maintained.
“In those able to continue with pharmacotherapy, the combination was efficacious for both maintenance of weight loss and ongoing weight loss,” the researchers found.