A peer-reviewed, evidence-based journal that promotes clinical development and metabolic insights in total bariatric patient care for the healthcare professional
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24 News and Trends Bariatric Times • October 2016 c linicians through the specifics of age- related health conditions can provide invaluable support for clinicians who treat infants, children, and adolescents with obesity." " Many of my colleagues have expressed concern they do not have the resources to provide the kind of support these kids need," she added. According to Dr. Wendy Scinta, co- a uthor of the Pediatric Obesity Algorithm and medical director of Medical Weight Loss of New York, this algorithm will give clinicians a clearer idea of current medical research and t reatment recommendations. "Because doctors don't have the resources to treat kids with obesity appropriately, they end up providing misguided advice or referring them to a nother provider," Scinta said. She believes these new guidelines provide reinforcement to clinicians who want to treat patients with obesity and guidance to clinicians about referring c hildren with obesity to specialists or pediatric weight-management centers with comprehensive teams. Practicing pediatricians and clinicians compiled the Pediatric Obesity Algorithm using scientific evidence, medical literature, and their own clinical experiences. With more than 100 studies referenced, the document covers a diverse and comprehensive section of medical literature. These guidelines do not replace clinical judgement, but provide an in- depth look at what therapies and approaches work best for infants, children, and adolescents. "Clinicians can compare their approaches to what the medical literature recommends for patients in each age group," Scinta said. The Pediatric Obesity Algorithm is available as a free online download at www.PediatricObesityAlgorithm.org. About the Obesity Medicine Association. The Obesity Medicine Association (OMA) is the largest organization of clinicians dedicated to preventing, treating, and reversing the disease of obesity. Members of OMA believe treating obesity requires an individualized approach comprised of nutrition, physical activity, behavior, and medication. When personalized, this comprehensive approach helps patients achieve their weight and health goals. Visit www.obesitymedicine.org to learn more. GLOBALLY, INCREASINGLY POOR DIETS NOW POSE A GREATER RISK TO HEALTH THAN UNSAFE SEX, ALCOHOL, DRUG AND TOBACCO USE COMBINED C linicians are missing critical opportunity to prevent diabetes with obesity treatments Rome, Italy—A new report by the Global Panel on Agriculture and Food S ystems for Nutrition finds that the burden of malnutrition is equivalent to that of experiencing a global financial crisis every year. An estimated 3 billion people across 193 countries have low- q uality diets which contribute to poor nutrition and health outcomes, while also slowing economic and development progress. Food Systems and Diets: Facing the Challenges of the 21st C entury outlines the toll that malnutrition takes on individuals, nations and economies today and forecasts the expanding costs and consequences if these trends continue. T he report, launched today at the Food and Agriculture Organization (FAO), provides a guide for governments and decision-makers to change course through action and investment to create food systems that promote health and deliver quality diets. "Nutrition is not about just feeding people, it is about powering life and the growth of individuals, communities and nations," said the H.E. John Kufuor, former President of Ghana and co-chair of the Global Panel. "If we do not reshape food systems to prioritize nutrition, we are missing an opportunity to create a stronger, healthier and more prosperous future." Food systems, which include how food is grown, raised, transported, processed and marketed, play a central role in delivering high-quality diets, but today's food systems are too focused on quantity and not enough on quality. Low-quality diets are a driving force in increasing rates of overweight, obesity and chronic conditions such as high blood pressure, while also fueling non- communicable diseases, such as diabetes and heart disease. Without immediate action, the situation is set to worsen dramatically over the next 20 years as powerful drivers of change such as population growth, climate change and urbanization converge on our food systems. Without significant changes in policies and investments by 2030, the number of overweight and obese people will have increased from 1.33 billion in 2005 to 3.28 billion, or one-third of the projected global population. This is a major concern as no country to date has successfully reversed growth in obesity once it has been allowed to develop. "Our food systems are failing us," said Lawrence Haddad, a report author and chair of the project's Lead Expert Group. "The foods that are produced, are affordable and are chosen have been changing fast and will continue to do so. Now is the time to take action to ensure that food systems and nutrition are h elping to power fuel development—not hold it back." Data from the report shows that while income growth can help to alleviate hunger, it does not guarantee a ccessibility to healthier, quality diets. While many people today have better diets than before, the intake of foods that undermine diet quality has increased even faster. For example, the s ale of ultra-processed food and beverages rose from one-third of those in high income countries in 2000 to more than half by 2015. "We must rethink how we look at n utrition and food systems. Nutrition is not just an health and social development issue, but an investment that can spur economic growth," said Dr. Akinwumi Adesina, President of the A frican Development Bank and member of the Global Panel. "Nutrition fuels gray matter infrastructure—the minds of the next generation that will drive progress and innovation. If we do not act, we will f ail to unleash the full potential of millions of people around the world." The report calls on governments, donors and global partners to put food systems at the center of global action, including the Sustainable Development Goals. While policy must be tailored to meet country needs, priority actions at the global and national levels include: • Prioritize improvements in women's diet quality; • Develop policies to regulate product formulation, labeling, advertising, promotion and taxes to incentivize production of high-quality foods and inform consumers; • Use public sector purchasing power to institutionalize high-quality diets; • Improve availability, affordability and safety of fruits, vegetables, pulses, nuts and seeds; and • Foster increased collaboration and data access across agriculture, health, social protection and commerce. "This Report makes clear the enormous challenge posed by malnutrition and poor diets generally to the detriment of many millions of individuals and indeed whole economies," said Sir John Beddington, former UK Chief Scientific Advisor and co-chair of the Global Panel on Agriculture and Food Systems for Nutrition. "The level of effort required to address this problem is not dissimilar to the sort of effort that has been used by the international community to address the issues of HIV/AIDS, malaria and other pandemic diseases." To support a coordinated effort, the report provides a simple decision- making tool to help policy makers identify which actions will help leverage food systems toward improved diet quality. This innovative, six-step tool will help policy makers prioritize realistic actions based on local contexts. The gains from applying this tool, the report argues, could be very substantial toward ensuring better nutrition for all. NEWS FROM THE OBESITY SOCIETY NEW THERAPEUTIC TREATMENT HELPS PEOPLE LOSE MORE WEIGHT AND KEEP IT OFF Study shows clear gains from weight- loss treatment aimed at setting goals based on personal life values SILVER SPRING, MD – A new a pproach to weight loss called Acceptance-Based Behavioral Treatment (ABT) helped people lose more weight and keep it off longer than those who received only S tandard Behavioral Treatment (SBT) – a typical treatment plan encouraging reduced caloric intake and increased physical activity – according to a new randomized c ontrolled clinical trial. Researchers studied the impact of the new ABT method, which ties the effort to a larger personal value beyond weight loss for its own sake, to help people a dhere to diet and physical activity goals. The October issue of Obesity, the scientific journal of The Obesity Society (TOS), published both the original article and an accompanying commentary. "Standard Behavioral Treatments (SBT), which emphasize the importance of decreased caloric intake and increased physical activity, can help individuals lose weight for a period of time, but the strategies taught in such a program are difficult to maintain long-term," said lead author Evan Forman, PhD, FTOS. "The Acceptance-Based Behavioral Treatment (ABT) method teaches highly specialized self-regulation skills so individuals trying to lose weight can continue making healthful choices long after the program ends. These skills include mindful decision making, identifying and committing to big-picture life values and a willingness to accept discomfort and reduced pleasure for the sake of those values." The study, part of the well regarded Mind Your Health trial, is one of the first of its kind. Results showed that participants who received ABT (which includes all behavioral skills taught in SBT) lost 13.3 percent of their initial weight at one year, compared to 9.8 percent weight loss at one year for participants who received SBT only. This difference represents a clinically significant 36 percent increase in weight lost for those in the ABT group. In addition, the likelihood of maintaining a 10 percent weight loss at 12 months was one-third greater for ABT with a rate of 64 percent versus 49 percent for ABT alone. As Thomas Wadden, PhD, FTOS, and Robert Berkowitz, MD, FTOS point out in their accompanying commentary, weight loss with ABT is among the largest ever reported in the behavioral treatment literature without use of an aggressive diet or