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COVID 19 and Obesity #BDAObesity #obsmukTweetchat

   T he COVID-19 pandemic has had a devastating effect on morbidity and mortality 1 and affected everyone’s normal daily living. People with severe and complex obesity are at greater risk from the impact of COVID-19 on health 2 . Consequently, this group have been classed as being one of the more vulnerable groups and people have to take additional precautions. For some, this has included shielding. This has caused practical issues such as access to food and shopping, decreased activity, increased anxiety and also resulted to people being subjected to stigma and weight bias.   At a time, when there is a greater need for access and support from weight management services across the spectrum, including specialist weight management and bariatric surgery services, many of the services were also affected. Face to face consultations, whether one to one or group, and bariatric surgery services were stopped. Health care professionals were redeployed to other areas of work. Clinical consu
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Eating behaviors and the possibility of positive change By Dr Helen McCarthy

The British Psychological Society (BPS) recently published a report titled “ Psychological perspectives on obesity ” in which they call for professionals and policy makers to take an approach that is guided by psychology. The report argues that reversing the trend of increasing obesity rates requires an integrated evidence-based approach that recognises that behaviours are influenced by a combination of biological, psychological and social factors. Biological Factors The BPS report is clear that our genes play a significant role in how the appetite regulation system in our brain functions. So people’s differing interest in food, their ability to know when they are full and emotional eating all have some genetic basis. And then there are the biological effects of chronic stress, which creates changes in brain activity as well as altering the balance of appetite-regulating hormones. Psychological Factors Many psychological factors play a part in how and what each o
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Obesity Is Complicated, So Is Preventing It. The 28th August #obsmuk chat's blog by Gemma Bridge.

Obesity Is Complicated, So Is Preventing It   The number of people living with overweight and obesity has increased over the past 30 years , and so have associated conditions such as diabetes and dental carries . As a result, prevention is extremely important. But prevention is complex since obesity is the result of a multitude of interrelated forces which act at multiple levels and influence patterns of eating and physical activity .  There are at least four preventive strategies for obesity: Education, regulation, modification of the food supply (availability, reformulation of products) and price changes . Traditionally obesity prevention has focused on individual-level behavioural changes through education, campaigns and commercial weight loss programs . However, such approaches overlook the complicated interaction between societal, environmental and genetic factors inherent to obesity and thus have poor long-term success . Alternative, ‘whole-system’ approaches to pre
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Polycystic ovary syndrome and obesity by Maureen Busby- #obsmuk chat's blog 24th July

Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder affecting up to one in five women of reproductive age [1]. PCOS is diagnosed according to The Rotterdam diagnostic criteria and is based on two of three features: infrequent periods or lack of ovulation, hyperandrogenism features such as excess facial hair or acne, and polycystic ovaries visible on a scan [2].  Obesity is unlikely to be a cause of PCOS as demonstrated by the prevalence of lean women with the condition.  However, having obesity does exacerbate the condition and increase the risk of other serious health problems [3].  Obesity is a common finding in PCOS with estimates of between 40% to 80% of women with PCOS having overweight or obesity [4]. PCOS is associated with several metabolic complications including pre-diabetes, Type II Diabetes and obesity [5].  Having PCOS also increases the risk of Heart Disease, Fatty Liver Disease and Uterine (womb) Cancer [6–8].  The etiology of the disease is not fully und
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Communicating about weight – can we bring patients and healthcare professionals together in support? #obsmuk blog by Fiona Quigley

Communicating about weight – can we bring patients and healthcare professionals together in support? Obesity is a medical condition described as excess body weight in the form of fat. When accumulated, this fat can lead to severe health impairments. The prevalence of obesity across the world continues to rise, and this is now recognised as one of the most important public health problems facing the world today. Subsequently, conversations about obesity between patients affected by obesity and healthcare professionals is an important and necessary aspect of at least some of their encounters. However, it isn’t easy for healthcare professionals or for patients to talk about weight and we know there are many reasons for this. Research shows that healthcare professionals worry that talking about weight might upset patients, as if they are delivering bad news. In turn, patients of a higher weight can often feel shamed and blamed. More research is needed on how to raise
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Alcohol and other addictions after bariatric surgery. #obsmuk 's 22nd May chat blog by Dr Denise Ratcliffe

Alcohol and other addictions after bariatric surgery Bariatric surgery is the most effective treatment for obesity in regards to weight loss and treatment of obesity related conditions. Perhaps more importantly, it is safe with a low risk of complications and death. However, the evidence on longer-term outcomes following bariatric surgery has evolved and there is a growing awareness of the psychological difficulties that can arise following surgery, including addictive behaviours that are the topic of the forthcoming #obsmuk chat. The types of addictive behaviours that have been discussed following surgery include alcohol, shopping, gambling, sexual behaviour, exercise etc.  The concept of “addiction transfer” following surgery is a widely held lay belief. It is based on the premise that the individual’s presumed pre-operative addiction to food is transformed into an addiction to other substances or behaviours after surgery (Mitchell et al., 2015).  This is underp
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Fatty liver, NAFLD and Obesity - #obsmuk blog by Dr Dina Mansour

Non-alcoholic fatty liver disease (NAFLD) is accumulation of fat in the liver.   NAFLD is part of the metabolic syndrome, characterised by diabetes or pre-diabetes (insulin resistance), affected by   overweight or obesity, hypertension and hyperlipidaemia, and is more common in people with these other features.   There is a spectrum of disease ranging from just fat in the liver (steatosis) to a more progressive form of the disease, non-alcoholic steatohepatitis (NASH) – this is where the fat in the liver is associated with inflammation and liver damage.   Over time this can lead to fibrosis or scarring.   Progressive fibrosis leads to cirrhosis with all its associated complications -jaundice, ascites, encephalopathy (confusion), varices (mainly in the oesophagus/gullet) and hepatocellular carcinoma (liver cancer). NAFLD affects approximately 30% of the population, 70% of people affected by type 2 diabetes and over 90% of patients with a BMI of over 30.   Steatohepatitis (NASH) i
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