Waging War on Weight and Diabetes
YOU-Turn program team members
Friday, September 17, 2010
Roughly a million people in the United States develop diabetes each year. The overwhelming majority of these cases have type 2 diabetes, and the main culprit driving the growth of the disease is excess body weight.
Today about two-thirds of U.S. adults are overweight and a third are obese, noted Osama Hamdy, M.D., director of Joslin’s Obesity Clinical Program, speaking at this week’s Joslin Roundtable in Boston.
Slightly under 30% of people suffering from obesity end up with type 2 diabetes. Given the key role of excess weight, treating these people only with diabetes medications is like treating a bacterial infection with painkillers rather than antibiotics, he remarked.
Dr. Hamdy has been a leader in research demonstrating that obese patients with type 2 diabetes can see dramatic improvements in their diabetes control and their overall health by losing 7% of their body weight.
That’s a goal for Joslin’s Why WAIT (Weight Achievement and Intensive Treatment) program, which has been very successful with this population. Participants in the innovative weight-and-lifestyle-management program lose an average of 24 pounds during the 12-week program. Moreover, follow-up studies have shown that while they are likely to regain weight over time, they still average 17 pounds below their beginning weight after three years, said Dr. Hamdy.
Studies of Why WAIT alumni have reconfirmed that the weight loss comes hand-in-hand with improved diabetes control, reduced spending on diabetes medication and overall diabetes care cost, better cholesterol and blood pressure levels, heightened physical fitness and other benefits.
Joslin’s YOU-Turn, a week-long intensive clinical weight management program following the Why WAIT approach, also has produced very positive results for its participants.
Dr. Hamdy emphasized that many oral medicines for type 2 diabetes tend to produce weight gain, and suggested that pharmaceutical companies look toward creating drugs that avoid this problem.
Also at the Roundtable, Joslin researcher Aaron Cypess, M.D., highlighted recent studies of an energy-burning form of fat called brown fat. A small amount of active brown fat may burn hundreds of calories a day, by early estimates. Joslin led research demonstrating last year that this kind of fat is present and active in many adults.
Among current work at Joslin, Dr. Cypess is examining brown fat activity in various groups of people and environmental conditions. (For instance, brown fat may become more active in the cold.)
Additionally, Joslin investigator Yu-Hua Tseng, Ph.D., is examining the biological mechanisms behind brown fat development, including the role of a key protein called BMP-7. A clinical trial is underway in which researchers are giving BMP-7 to patients undergoing a certain form of spinal surgery, and seeing if that enhances brown fat activity in those patients.
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