Radiation therapy for very overweight and obese patients poses a difficult challenge for even the most veteran radiologist.  With difficulty and precision, they have to position the patient so the thinnest fat layer is closest to the image receptor.  The increased subcutaneous fat thickness always makes the treatments less accurate.  This is why, depending on location and grade of tumor, oftentimes more radiation will be administered than would be to a slim person, where accuracy is assured.

Diabetic retinopathy is a complication of diabetes that results from damage to the blood vessels at the back of the eye.  The longer someone has diabetes, the less controlled their blood sugar, the more likely they are to develop diabetic retinopathy, which is increasing alarmingly as obesity rises.  Now, 3 in 10 diabetics has diabetic retinopathy, and it is the leading cause of legal blindness among adults.  To reduce the impact of diabetes, controlling one's blood sugar and blood pressure is a must ... weight loss is a must.

Prostate cancer is the second leading cause of cancer deaths among American men, after lung cancer. Factors impacting prostate cancer risk range from family history to intake of animal fat to excessive supplementation with multivitamins (especially zinc) to obesity. Now new research may help shed light on why heavier men tend to suffer more aggressive prostate cancers. Simply put: Fatter men have bigger tumors.

In a recent study from the Henry Ford Hospital in Detroit, Michigan, researchers actually weighed the tumors removed from 3,327 prostate cancer patients, comparing that data to the men's Body Mass Index (BMI). The result: "As the patient's BMI increased, the tumor volume increased," observed lead researcher Dr. Nilesh Patil, concluding that bigger tumors "may be contributing to the aggressive nature of the disease" among overweight and obese men. Another recent study out of John Hopkins found that gaining merely five pounds near the time of prostate surgery doubles the risk of cancer recurrence.

... will come from the burgeoning epidemic of childhood obesity.  Chronic acid reflux has ramifications for the long-term health of obese children, incuding esophageal cancers.  Back in 2000, acid reflux was prevalent in only 3 to 5% of children.  Today, 28% of overweight and obese kids have symptoms consisten with reflux---nausea, vomiting, substernal burning or pain, and a sour taste in the mouth.  If you have an oveweight child, don't assume they'll tell you about any of these symptoms.    ASK them.

Many studies in the past have suggested that obesity in middle age increased the risk of dementia decades later.  That is now confirmed by a study of the National Institute on Aging and the American Heart Association.  Brain scans of 94 people in their 70s showed that those in the group who were obese had 8 percent less brain tissue than those in the group of normal-weight.  The brains of the obese seniors looked 16 years older, and they had lost brain tissue in the areas critical for planning and memory, attention and executive functions, and movement---putting them at a highly increased risk of Alzheimer's and other diseases that attack the brain.  Bottom line:  Get your weight under control now to enjoy your brain to its fullest potential for the rest of your life.

Medication adherence is critical to the management of chronic diseases, and pharmacists provide an effective and pivotal role in this regard.  They are uniquely trained to help patients understand why they need to take their medications, as well as to help them overcome barriers that prevent patients from taking meds appropriately.  A study done not too long ago by the Universities of Pennsylvania and Buffalo found that when patients met with a pharmacist to discuss medication adherence and diet and lifestyle change, disease outcomes improved, particularly for diabetes patients.

Men and women hoping to undergo elective cosmetic surgery--be it facial, body contouring, or reconstructive--are not the ideal patients for reputable plastic reconstructive surgeons if they are extremely overweight or obese.  Plastic surgeons, the 'artists' of the medical field, will encourage these patients to reach an optimal weight loss so the surgeon can have the ideal palette with which to work, assuring the most long-lasting, natural results.

Over the past 15 years, patients in the U.S. have been getting heavier and at the same time fewer have been smokers.  Obesity has become a greater contributor to the burden of disease than smoking.  Smoking has a bigger impact on mortality; smokers die at a much younger age.  An obese person, although at an increased risk to die, does so at an older age, but with higher medical bills for chronic medications and expensive treatments, greater dependence on caretakers for mobility and a lower quality of life.  If you are overweight, wny not make a commitment to NOT begin the new year the same way you began and ended the old one?

A recent Mayo Clinic's Womens Healthsource Newsletter reported some facts and figures as relates to cancer.  Did you know that the American Cancer Society estimates that a little over 1/3 of all women in the country, and nearly 1/2 of all men, will be diagnosed with cancer in their lifetimes?  Evidence suggests that 1/3 of the more than 560,000 annual cancer deaths that occur in the U.S. are related to diet and weight.  A cancer patient must eat correctly to lower internal inflammation, to leesen their blood sugar so as to starve a tumor, and to strengthen their immune system to fight the battle.  A cancer survivor must eat correctly to achieve and maintain a stronger immune system, giving them the best chance to prevent a recurrent. 

Did you know that bariatric surgery doubles the risk of bone fracture?  The Mayo Clinic released the findings of a study showing that of the many potentially serious consequences of bariatric surgery one is the rapid and sustained bone turnover that occurs a couple years following obesity procedures.  This is attributed to a substantially altered nutrient intake after bariatric surgeries.  Even with aggressive calcium and vitamin D supplementation after bariatric procedures, the study found it was insufficent to prevent the increased risk of fracture--with hands and feet bearing the brunt of the highest fracture risks.  Losing weight should mean gaining health.  Losing bone is NOT healthy.

Compared with women of normal weight at the beginning stages of pregnancy, overweight women have an 18% increased risk of giving birth to a child with heart defects; the severely obese have a 30% increased risk.  If these women develop gestational diabetes, they are at an even higher increased risk to give birth to a child with heart defects.  The head of the CDC's National Center on Birth Defects and Developmental Disabilities stated so aptly, "This doesn't mean that women should start dieting during pregnancy; these defects occur very early in pregnancy. Therefore, they should be at a healthy weight before that."  Exactly!

Temple University in Philadelphia initiated a study with 264 obese patients, average age 61 years old, all with a ‘moderate’ apnea index—meaning they experience 15 to 29 apnea events per hour. Those who had no weight loss over a year had a significant average increase of four apnea events per hour, moving them into a ‘severe’ apnea index). It confirms that obese apnea patients have a rapid progression of episodes as they age, and this progression leads to hypertension, stroke and oftentimes death from cardiovascular causes—risks that are already elevated because of their obesity.

I passed the local golf course early morning recently and saw a few couples, seniors definitely, playing golf.  It brought a smaile to my face and I thought ... geez, these guys are probably 10 to 15 years older than me, and they're walking the course, not riding; they were all slim, obviously healthy ... THAT's the way to grow old.    Please never stop telling the overweight seniors in your life that aging gracefully, energetically and in good health is called living.  Any other way of getting old is simply existing.

Brown University Medical School released results of an extensive study on childhood obesity.  The one statistic that stood out for me was that mothers, by 72%, increase control over food chooices when girls---NOT boys---gained excess weight from ages 4 to 7.  This shocked, and disappointed, me yet validates many of my experiences.   I can tell you from personal conversations with overweight young boys that, like girls, they DO care how they look, they DO want to wear the latest fashions from Abercrombie, and they DO hurt inside.   If there's a young boy in your circle of family or friends, please think of a way to initiate a discussion that might result in getting them to us.

You've heard of the relationship between stress and weight gain---not necessarily because someone eats more or less when stressed; but because stress wreaks havoc with hormones, and the erratic imbalance is what affects the metabolism.  Did you know that for women, perceived constraints in life and strain in family relationships are associated with the greatest weight gain? ... and for men, it's the various stresses in the work place, including lack of confidence in their skills and abilities.

Did you know that Gastroparesis is a disorder where the movement of food is slowed or stopped, and the stomach takes too long to empty.  It interfers with digestion, causes nausea, vomiting and dehydration, and plays havoc with blood sugar.  There is no cure.  However, you can feel better; you can learn how to eat correctly, you can lose weight in a healthy manner.  Pureed proteins, vegetables and fruits; broths; very lowe fiber foods, even baby foods ... all with proper pacing and portion control ... will do the trick.

PCOS is a major cause of infertility in women.  Unfortunately, many young women aren't diagnosed until they're trying to conceive and could be well into their 20's or later.  At that time, many of the symptoms are out of the bag:  head hair loss, acne on face, chest and back; facial hair at the sideburns and chin ... and lots and lots of weight gain.  If you are a young woman (moms--think of your daughters) who is having erratic menstrual cycles, or not having cycles at all, don't think it's normal.  It's not, even if you're slim and otherwise fit.  Bypass the gynecologist.  Get to the endocrinologist. (In NJ, I highly recommend Dr. Allen Morgan, who has written and spoken extensively on this subject.)  If you're diagnosed with PCOS, no one helps with weight loss in this area better than we do.

Recently the Urology Department Chairwoman of Johns Hopkins Medical Institution in Baltimore reported on the findings of a six-year study at John Hopkins, the first of its kind in the medical community, on the relationship between obesity and urinary tract and kidney infections.  Obese women had more than double the number of UTIs than normal weight women, and obese men had more than five times the number of kidney infections.  This data provides yet another reason to encourage dietary change and weight loss for obese people.

Did you know that (a) depression is a disease predominantly of women, that the ratio of women to men is 2:1? ... and (b) obese women are 5 times more likely to be depressed than normal weight women?  These are the findings of the American Psychiatric Association, presented a few months ago in California.  Many of the women, of all ages, who come to our offices are on antidepressants when they start, but it's amazing (and wonderful) to see how they are weaned off as they become slimmer----and happier, and more confident, more in control.  If you are depressed about the way you look, we can help you to learn how to get slim, and in turn become more confident, empowered and happy.

Did you know that 1 pound of excess weight feels like 4 pounds to your knees?  Think about that ... 10 to 15 pounds overweight doesn't seem like too much of a big deal, but to your knees that's 40 to 60 pounds of stress every day.  Aching knees can make it hard to feel anything but tense and irritated. Your posture will be thrown out of line, and the more out of line your body is the greater the stress and fatigue.  When you are slumped over, your digestive tract won't function well. You are likely to develop lower back problems and knee problems.  Your knee structure is very complex region and joint of the body. With each step you take, the whole ensemble must shift and flex properly to carry your weight. There is a lot that can go wrong … and does.  These days, more and more ‘overweight’ people are actually in the ‘obese’ category so it's no wonder the high percentage of knee replacement surgeries.  Even so, without weight loss, surgery does NOT provide 100% relief, and post-surgical physical therapy does NOT provide long-term benefits.  If you have had knee (or hip or back) surgery and are overweight, if you are doing physical therapy right now, do your therapist a favor ... take your weight off and they'll be able to help you even more.