Saturday, April 19, 2014

Weight Loss: 10 Recent Scientific Findings

Below is a summary of 10 of the most recent scientific findings on weight loss. The numbered references at the end correspond to the numbered sections below. Links to free versions of the full articles are provided when available if you are interested in reading more.

FEATURED BOOK: The DASH Diet Weight Loss Solution

1. Barriers and Help for Women: The two main barriers of weight loss include a) struggling with self such as poor self-control, insecurity, health problems, and difficulties changing food habits and b) problems implementing a diet. Self-determination (which was associated with having clear goals) and social support from friends and family helped achieve weight loss.

2. Telephone support: People who received 4 telephone wellness coaching calls and completed a weight loss program reported losing three pounds. This was more weight loss than people who were not targeted for wellness coaching and people who did not complete a weight loss program. Telephone support appeared to provide a small weight loss benefit but reliance on self-reported weight is a limitation of the study.

3. Predictors of Weight Loss Maintenance: Based on a survey of 450 people, the best weight loss maintenance predictors were weekly weighing, decreased evening snacking, decreased portion size, and being physically active each day.

4. Psychological Problems: In 138 obese women, 77% had symptoms of anxiety, 61% had moderate to major depression symptoms, and half had low assertiveness. The prevalence of these problems increased with the degree of eating disorders. Feelings of ineffectiveness were common among the women’s psychological profiles.

5. Zonisamide: A case study of an obese adolescent showed that when treated with Zonisamide, weight loss decreased from 279.5 pounds to 234 pounds, a 16.25% reduction. The authors discuss the possibility of using this medication, which is normally used to treat seizures, for weight loss in adolescents. Clinical trials are ongoing to study this medication for weight loss.

6. Effects on Offspring: Dietary interventions are important during pregnancy because maternal obesity has long-term consequences for the offspring’s ability to metabolize of lipids (fats) in the liver.

7. Benefits of Lap Bands: The first 10% weight loss from the lap band procedure, which involves partial clamping of part of the stomach to slow down food consumption, is associated with improved kidney function, metabolism, blood flow, and sympathetic nervous system functioning. The sympathetic nervous system is the part of the nervous system that generally excites the body by doing things such as increasing both the heart rate and blood pressure.

8. Urinary problems: Weight loss in obese women helps reduce episodes or urinary incontinence, urine leakage, and quality of life.

9. Benefits of a Revised Gastric Bypass Surgery: A revised gastric bypass surgery that is performed after the first failed or when converting stomach stapling to a gastric bypass surgery provides less weight loss and more health complications compared to if gastric bypass surgery was performed initially and was successful. However, the revised gastric bypass surgery provides an excellent opportunity to reduce other diseases related to obesity.

10. Low Intensity Weight Loss Programs: Even low intensity weight loss programs in the workplace can lead to clinically significant weight loss (5 or more % of body weight) in a significant number of participants. Weight tracking tools through a website were most predictive of weight loss. Other helpful weight loss predictors were eating more fruits and vegetables, increased physical activity, and reducing stress.

References

1. Hammarström A, Wiklund AF, Lindahl B, Larsson C, Ahlgren C. (2014). Experiences of barriers and facilitators to weight-loss in a diet intervention - a qualitative study of women in Northern Sweden. BMC Womens Health.14(1):59.

2. Tao M, Rangarajan K, Paustian ML, Wasilevich EA, El Reda DK. (2014). Dialing in: effect of telephonic wellness coaching on weight loss. Am J Manag Care. 20(2):e35-42.

3. Abildso CG, Schmid O, Byrd M, Zizzi S, Quartiroli A, Fitzpatrick SJ. (2014). Predictors of Weight Loss Maintenance following an Insurance-Sponsored Weight Management Program. J Obes. FREE article here.

4. Panchaud Cornut M, Szymanski J, Marques-Vidal P, Giusti V. (2014). Identification of psychological dysfunctions and eating disorders in obese women seeking weight loss: cross-sectional study. Int J Endocrinol. FREE article here.

5. Nguyen ML, Pirzada MH, Shapiro MA. (2013). Zonisamide for weight loss in adolescents. J Pediatr Pharmacol Ther. 2013 Oct;18(4):311-4. FREE article here.

6. Nicholas LM, Rattanatray L, Morrison JL, Kleemann DO, Walker SK, Zhang S, Maclaughlin S, McMillen IC. (2014). Maternal obesity or weight loss around conception impacts hepatic fatty acid metabolism in the offspring. Obesity (Silver Spring).

7. Lambert EA, Rice T, Eikelis N, Straznicky NE, Lambert GW, Head GA, Hensman C, Schlaich MP, Dixon JB. (2014). Sympathetic Activity and Markers of Cardiovascular Risk in Nondiabetic Severely Obese Patients: The Effect of the Initial 10% Weight Loss. Am J Hypertens. (epub ahead of print).

8. Gozukara YM, Akalan G, Tok EC, Aytan H, Ertunc D. (2014). The improvement in pelvic floor symptoms with weight loss in obese women does not correlate with the changes in pelvic anatomy. Int Urogynecol J. (epub ahead of print).

9. McKenna D, Selzer D, Burchett M, Choi J, Mattar SG. (2014). Revisional bariatric surgery is more effective for improving obesity-related co-morbidities than it is for reinducing major weight loss. Surg Obes Relat Dis. (epub ahead of print).

10. Carpenter KM, Lovejoy JC, Lange JM, Hapgood JE, Zbikowski SM. (2014). Outcomes and utilization of a low intensity workplace weight loss program. J Obes. FREE article here.

Friday, April 18, 2014

Mothers Who Kill: 10 Scientific Facts about Infanticide

On April 13, 2014, Megan Huntsman from Utah was arrested after admitting to killing 6 newborns, placing them in plastic bags, and storing them in boxes inside her garage.  This occurred over a 10-year period from 1996 to 2006. Her estranged husband made the discovery the day prior to her arrest after cleaning out the garage and noticing a strange package with a strong and foul odor. Police then discovered other dead infants that were allegedly strangled or suffocated. One infant, a seventh, was reportedly a stillborn.

FEATURED BOOK: Infanticide: Psychosocial and Legal Perspectives on Mothers Who Kill

The murder of infants (known as infanticide), neonatocide (killing an infant within 24 hours after birth), and/or filicide (a parent killing their own child) are some of the most reviled crimes in society. It naturally leads most people to ask how and why someone can do such a thing. In Hunstsman’s case, the answer could not be that she did not have a safe way to get rid of children she did not want because Utah has a Safe Haven law that allows infants that parents do not want to be dropped off anonymously at a hospital without any legal consequences.

The following is 10 facts about infanticide based on a recent scientific review of the literature (reference below).

1. STATISTICS: The killing of infants and newborns is one of the most common forms of murder by women. In industrialized countries, for every 100,000 infants, 2.4 to 7 are murdered. The true incidence is likely under-reported because the existence of some deceased babies is unknown until the bodies are discovered. Up to 10% of sudden infant death syndrome (SIDS) cases are actually undetected homicides. Most murdered infants and newborns are killed by the biological mother.

2. DIFFERENT CHARACTERISTICS: Women who murder newborns tend to be younger than age 25, single, live with their parents, unemployed or attending school, do not seek prenatal care, and are no longer involved with the child’s father. Women who murder infants older than one day of age tend to be older than 25, are often married, well-educated, and commit the crime as a form of retaliation (e.g., against an abusive spouse).

3. MENTAL ILLNESS: Many to most women who kill infants are not formally designated as mentally ill. Other factors associated with infanticide besides illness include less education (e.g., dropping out of school), anger, youth of the mother, and not wanting to invest personal time in child rearing. Personality styles and hormone levels have not been found to differ between women committing infanticide and those who did not vomit infanticide. Psychosis (detachment from reality) and clinical depression is rare in mothers who commit infanticide, although some mild emotional disruption may be present.

4. LANGUAGE: The perpetrators of infanticide often use language to deflect personal responsibility  (e.g., “when my baby died” instead of “when I killed my baby”.)

5. SYMBOLISM: The infant victim is typically viewed by the mother as an object rather than as an independent living person.

6. CAUSE OF DEATH: Most women use their hands in the murder (e.g., suffocation, drowning, strangulation) instead of using external weapons.

7. GENDER OF VICTIM: Most murdered infants are male in Western nations whereas in some Eastern countries (e.g., India, China) most murdered infants are female. The male preference in Western cultures may be because the male is more symbolic of the female’s reproductive partner. (In Eastern countries it may be because females are viewed as less desirable).

8. CONCEALMENT: As in the Huntsman case, most cases of infanticide involve the mother trying to conceal it in some way (e.g., placing in garbage cans, refuse sites). This is similar to the Hunstsman case, with the infants stored in boxes in a garage. In neonaticide cases, the mother typically tries to make the pregnancy and birth a secret.

9. RECIDIVISM: The rate of recidivism of infanticide is unknown but there have been other cases of repeated infanticide, as high as eight. In some of these cases, the deaths had previously been attributed to Sudden Infant Death Syndrome.

10. PRIOR ARRESTS: Most women who murder infants do not have a prior arrest record.

Reference: Porter and Gavin (2010). Infanticide and neonaticide: a review of 40 years of research literature on incidence and causes. Trauma Violence Abuse. 11(3):99-112.