Obesity Spreads Among Friends And Family

A new American study shows that obesity spreads among friends and family with close social ties, even when they don’t live near each other. The research is the first to explore the impact of social networks on the spread of obesity, and will help to develop new clinical and public health initiatives.

The research was funded by the US National Institute on Aging (NIA), part of the National Institutes of Health (NIH) and is published in the current online edition of the New England Journal of Medicine (NEJM).

One third of adult Americans, that is 66 million men and women, are obese, which significantly increases their risk of developing serious health problems such as type 2 diabetes, heart disease and stroke.

“We need to learn as much as we can about contributing factors. This study describes social network influences that might be an important part of that equation,” said Richard J. Hodes, Director of the NIA.

The researchers who conducted the study were Drs Nicholas Christakis of the Harvard Medical School, and James Fowler of the University of California in San Diego. They said that a sedentary lifestyle and eating more high calorie food are important reasons why obesity has risen steeply, but they suggest that the attitudes, behaviours and acceptance of obesity among family and friends in a person’s social network also play a strong role.

For their research, Christakis and Fowler used data from the Framingham Heart Study (FHS). The FHS is administered by the National Heart, Lung and Blood Institute, (NHLBI), also part of the NIH, and comprises a large scale, long term project that is now taking data from grandchildren of the original cohort enrolled in the 1940s.

Christakis and Fowler examined weight, height and other data from over 5,000 FHS participants at seven dates between 1971 and 2003. At the start of the study their ages ranged between 21 and 70, with an average of 38. They called these key participants “egos”.

They also looked at the data relating to the parents, spouses, siblings, children and close friends of the key participants, to find out whether obesity spreads from person to person in social networks. These were called “alters”.

The total number of people they explored, egos and alters together, formed a large social network of over 12,000 individuals.

Christakis said that:

“We were able to reconstruct a large network of individuals who had been repeatedly weighed over time as part of the Framingham Heart Study, and we could see that as one person gained weight, those around him or her gained weight.”

“We didn’t find that people who were overweight simply flocked together. Rather, we found what seemed to be a spread of obesity and that the likelihood of a person becoming obese depended on the nature of the relationship,” explained Christakis.

The findings showed that:
The chance of a key participant becoming obese went up by 57 per cent if he or she had a close friend who became obese.
If he or she had a same sex friend who became obese, this figure went up to 71 per cent.
But no such increase in a person’s chance of becoming obese was found in opposite sex friendships.
Perception of friendship was also important: when both the key participant and his or her friend said their friendship was close, the key participant’s chance of becoming obese was 171 per cent if the friend became obese.
They were not likely to become obese however if only the friend claimed the friendship was close.
Among pairs of brothers and sisters, one becoming obese increased the chance of the other one becoming obese by 40 per cent.
This chance was higher among same sex siblings as opposed to opposite sex siblings.
Among married couples, the chance of a husband or wife becoming obese if the spouse became obese was increased by 37 per cent.
The spread of obesity in a social network was not dependent on geographic distance.
Social distance, the degree of separation between two people in the network, had greater influence than geographic distance.
A geographic neighbour becoming obese did not increase a key participant’s chance of becoming obese.
Smoking behaviour did not affect the spread of obesity from person to person.
Christakis said:

“We identified distinct clusters of obese people within social networks, and the clusters spread about three people deep.”

“People who were only one degree removed from each other socially, such as siblings or close friends, influenced one another twice as much as people who were two degrees removed from each other,” he added.

The study concluded that:

“Network phenomena appear to be relevant to the biologic and behavioral trait of obesity, and obesity appears to spread through social ties. These findings have implications for clinical and public health interventions.”

“The rising rate of obesity threatens to reverse the decline in disability in the older population, with major implications for the health care system,” said Dr Richard Suzman, Director of the NIA’s Behavioral and Social Research Program.

“This seminal study breaks important new ground in showing how social networks may amplify other factors and help account for the dramatic increase in obesity across the population,” he said.

Source : www.medicalnewstoday.com

Weight Loss Drug Accomplia Dangerous For People On Anti Depressants Says European Watchdog

The European Medicines Agency (EMEA) says the weight loss drug Accomplia, which has also been shown to help smokers quit, should not be used by patients who are severely depressed or taking anti-depressants as it heightens the risk of suicide among this group.

Accomplia is made by the French pharmaceutical giant sanofi-aventis; the generic name of the drug is rimonabant. It has been authorized in the European Union since June 2006, to be used in combination with diet and exercise to help obese and overweight patients lose weight. It was not approved as a smoking cessation agent. Clinical trials showed that it could help patients lose 10 per cent of their body weight.

A warning was issued when it was approved by the EMEA informing doctors not to prescribe it to patients on anti-depressants because of risk of psychiatric side effects, and depression in particular. Information accompanying the drug indicated that doctors should not prescribe it to patients with uncontrolled serious psychiatric conditions such as major depression.

This latest warning is an upgrade, issued by the EMEA’s Committee for Medicinal Products for Human Use (CHMP) following one year of monitoring the drug since its approval. The CHMP asked the manufacturer to submit all the information it had on the psychiatric side effects of the drug.

The CHMP panel met last week to review the information on Accomplia’s side effects and concluded that the benefits of the drug still outweighed the risks, but not in patients with ongoing major depression or who are taking anti-depressants. As well as updating the psychiatric side effect information, they also recommended that the warning be upgraded to say that Accomplia should be stopped if the patient develops depression.

A letter is being sent to all doctors telling them about the new warning and suggesting that patients and the people who care for them should be advised of the risk of depression from taking Accomplia.

Last month, the US Food and Drug Administration (FDA) Advisory Committee for Endocrine and Metabolic Drugs (EMDAC) said that sanofi-aventis had failed to show that Accomplia (rimonabant) was safe and voted against recommending the anti-obesity treatment for use in the United States. According to a report in Britain’s Daily Mail, two of the patients in a trial reviewed by the FDA committed suicide and one was suicidal. One of the patients in the trial had also tried to kill his daughter.

Sanofi-aventis withdrew their application for FDA approval of Accomplia and said it would submit a new one in due course.

The body that controls drugs in the UK, the Medicines and Healthcare products Regulatory Agency, up to the end of last month, has received 318 reports of patients being affected by side effects from taking Accomplia. The drug has been on sale in the UK since July 2006. Since then more than 40,000 Britons have used it.

The CHMP recommendation now goes to the European Commission for a final decision.

Accomplia is used by patients who are obese with a body mass index (BMI) greater than or equal to 30 kg per meter squared as part of a program that includes exercise and diet. It is also used by patients who are overweight (BMI of 27 or more) who have other risk factors such as type 2 diabetes or high levels of blood fat.

The active ingredient in Accomplia (rimonabant) is a cannabinoid receptor antagonist. This blocks the cannabinoid type 1 (CB1) receptor in the brain which helps to control food intake. Blocking the receptor makes it easier for patients to stop over-eating. CB1 receptors are also found in fat cells in the body

Source : www.medicalnewstoday.com

Medical marijuana

SAN FRANCISCO (Ivanhoe Broadcast News) — For more than 4,000 years, it was used medicinally. Then, in 1942, medical marijuana was banned in the United States. But that’s not the end of the story. Today, patients with illnesses like cancer, AIDS and multiple sclerosis say it relieves pain and reduces nausea from their meds — and is the only thing that gets them through.

Brian Klein takes three pills twice a day for HIV. He’s also recovering from hepatitis C.

“It was pretty devastating getting both at the same time,” Brian says.

Hepatitis C meds are known for their severe side effects like nausea. Brian tried lots of treatments to relieve it, but only one worked — marijuana.

“Within a few minutes I could go eat. Whereas, before using it, I couldn’t even keep down water. So it was an amazing, dramatic difference,” Brian says.

A study on hepatitis C patients showed smoking marijuana made them three-times more likely to get rid of the virus because it got them through treatment.

“If there’s a patient for whom that medicine doesn’t work, and they do get benefit from marijuana, then that could really be the difference between life and death,” says Donald Abrams, M.D., an oncologist and HIV researcher from the University of California, San Francisco. “When we talk about the side effects, if you will, of marijuana compared to many, many prescription drugs that doctors prescribe on a daily basis, it’s really quite safe.”

Although medical marijuana is allowed in 12 states, the federal government has declared it “is not medicine” and “not safe.” Opponents say much more research is needed and that it’s linked to a higher risk of cancer, heart attack and brain damage.

For Brian, it was a short-term fix. He’s free of the hepatitis-C virus and has the energy to do simple things like read and exercise.

“This was relieving my nausea, and it worked. And I didn’t need it for anything more or less,” he says.

Dr. Abrams says patients with heart conditions or those who become paranoid, hyper or anxious from marijuana may want to steer clear.

Source : www.ivanhoe.com