Headlines from the Centers for Disease Control and Prevention have emphasized the rise of obesity around the nation, with more than one-third of all U.S. adults classified as obese. The World Health Organization states that obesity has almost doubled worldwide since 1980. The Trust for America’s Health and the Robert Wood Johnson Foundation also released a report that predicts more than 50 percent of residents in 39 states will be classified as obese by 2030.

The reason that many within the medical field are extremely concerned with the rise in obesity is due to the health risks associated with being overweight. The Mayo Clinic website explains that obesity is defined as having a body mass index (BMI) of 30 or higher. While BMI is used to measure body fat, there are times it may inaccurately predict obesity such as when muscular athletes have the weight of someone in the 30 or higher category.

Causes of Obesity

Some of the basic causes of obesity are due to inactivity – exercise and fitness can go a long way to helping people lose weight. Essentially, there is a lack of energy balance in which the amount of energy taken in does not equal the amount taken out through physical activity, according to the National Institutes of Health.

Taking in more calories than one uses leads people to become overweight while those who keep their energy balance steady tend to have their weight stay the same.

Sometimes the environment we live in does not promote healthy behaviors, such as a lack of sidewalks and places for recreation, as well as longer work hours and time spent commuting to and from the office. Additionally, healthier produce may be too expensive for some families, which also leads them to consume less nutritious foods.

Fast food, high-calories beverages, and large portions all lead to becoming overweight and obese. A diet of fruits and vegetables, however, will help improve one’s health. Genetics also play a role in obesity, as studies show that identical twins raised apart have an impact on the siblings’ overall weight.

Lack of sleep can also lead to a change in hormones that could increase appetite and weight. Animal models show that leptin is one of the best hormone markers for obesity and the mutation of the leptin receptor may be tied to the condition. Additionally, some medications like antidepressants can lead to obesity.

Health Risks Tied to Obesity

There are a variety of different medical conditions that are due to obesity. These include Type 2 diabetes, high blood pressure, heart disease, stroke, several types of cancers, osteoarthritis, nonalcoholic fatty liver disease, breathing problems, and gallbladder disease.

The CDC reports that healthcare costs associated with obesity in 2008 reached $147 billion and the condition led to regular absence from work and reduced worker productivity. More state programs and public health approaches may decrease the high rates over time.

According to the Sydney Morning Herald, one study found overweight children in Australia have higher rates of asthma due to obesity. Physicians have had children as young as three years old come to the emergency room suffering from obesity and respiratory issues.

Researchers from the University of Queensland Diamantina Institute used a novel genetic testing tool to find a causal link between asthma and obesity. Every growth in the BMI numbers was connected to a 55 percent rise in asthma risk.

The medical risks tied to obesity affect children and adults alike. One major health problem associated with excess weight is cardiovascular disease. The Health Site reports on one study that found women have longer hospital stays and are at higher risk of death than men after a heart attack. The study from the Yale School of Medicine found that men are more likely to have high cholesterol but women have higher rates of heart failure, hypertension, and diabetes.

Obesity Drug Development and the Regulatory Environment

The first prescription obesity drug approved in the United States was desoxyephedrine or methamphetamine in 1947. However, due to amphetamine drug abuse, the FDA limited the use of obesity drugs to short-term use in 1973. In 1995, the FDA convened a meeting with an advisory committee to create a guidance document for the development of obesity drugs. The committee decided on significant weight loss alone as sufficient for drug approval and supported one-year trials to analyze efficacy with some preferring two-year trials to determine safety.

Medical devices have also been used to treat obesity with the Lap-Band Gastric Banding System and the Realize Gastric Band as two FDA-approved devices on the market. The FDA is also proposing to change food labels in its efforts to combat obesity. Packaged foods would prominently show calorie counts and added sugars, which changes previous labeling as it showed natural sugars along with added sweeteners like syrups and concentrated juice. Serving sizes will also be changing to better reflect the amount of food consumed by the average shopper.

Over time, the work of the FDA and drug developers may lead to the decline of obesity rates and the promotion of healthier lifestyles.

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Categories: Oncology

Tags: obesity drug development