Weight Loss or Bariatric Industry Strategy Blog

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Entelos, Inc. Develops a Simulation Process for Drug Treatment Analysis

2010-03-17T13:28:00.000-07:00

A while back, England's chief medical officer indicated that not having enough simulators for doctors to practice on could be harmful to patients. This opinion shows that using simulation has proven to be useful to some health care professionals. Further, Entelos, Inc., a California based company, is employing simulation to analyze drug treatment outcomes for diseases, including obesity and diabetes.

Simulation is often employed to improve skills. In the U.S. Space Program for example, simulation is used to train the astronauts. And a Yale University study showed that simulation can be used to increase a doctor's proficiency. In the study, student doctors were taught to successfully insert a catheter into a major vein of the body.

Modeling a drug treatment scenario and analyzing the outcome using simulation would be an effective way to determine appropriate treatment options for diseases. Entelos, Inc. has designed a biosimulation lab, called PhysioLab, that can simulate human disease, and disease treatments.

With the PhysioLab platform, a researcher can construct a virtual patient and carry out clinical trials for, say, an obesity drug, using computer modeling and simulation. In fact, the company was just given a U.S. patent entitled, “Apparatus and Methods for Assessing Metabolic Substrate Utilization."

For more information, interested organizations can contact Entelos, Inc. According to a statement on the company’s Website, “Access to Entelos expertise and technology is available through R&D partnerships, research agreements, licenses, and strategic alliances.”

We feel that simulation for obesity drug analysis would mean a great deal to the bariatric or weight loss industry. The weight loss industry has had a difficult time developing a safe and effective drug that can help a person lose weight. However, since the potential market for weight loss products, including obesity drugs, was estimated by some to be 59 billion dollars in 2009, a tool to improve the development of weight loss drugs would be a boon to the bariatric or weight loss industry.

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Wellness Programs Are Beneficial to Employers And Employees

2010-03-02T05:31:00.000-08:00

In an effort to improve the general health of their employees, employers have been offering wellness programs to employees. Among the programs’ most important components are help with diet and exercise. These programs aim to keep employees healthy and lower health care costs. Medical weight loss centers may be able to play an important role in these programs by joining with organizations that deliver wellness programs and with employers who purchase the programs.

More and more, experts believe that putting wellness programs in place may enable organizations to be more profitable by improving employee health. In fact, according to the organization, U.S. Preventive Medicine, an effective wellness Program can yield a $1.00 to $3.00 return on investment.

And according to Right Management, a subsidiary of Manpower Inc., an organization’s wellness program can improve the organization’s competitive edge by increasing employee productivity and performance.

Further, some insurance providers see the benefits of offering wellness programs. CIGNA has just purchased Kronos Optiman Health Company, a Phoenix-based health and wellness company. This acquisition will enable CIGNA to expand its wellness program offerings, including its online services.

To make a wellness program more effective, program leaders will often ask for a participant's medical history, and inquire about family illnesses. As an incentive to employees, some medical information obtained may be used in decisions to lower or raise health insurance premiums, or establish monetary employee awards.

But using medical information to give monetary awards or raise or lower health insurance premiums may conflict with the Genetic Information Nondiscrimination Act of 2008. This act provides "protections against discrimination based on an individual's genetic information in health insurance coverage and employment settings."

But still, effective wellness programs are proving to be beneficial to the employer and the employee. The employer gets a more engaged and productive employee. And the employee will likely pay less out-of-pocket for health care, and the employee will have a higher quality of life.

Because wellness programs are beneficial, medical weight loss centers may be able to work with employers and wellness program organizers to help find ways to use the medical information without discriminating against any group or anyone in the group. It's worth a shot, and this activity may give a weight loss center a competitive advantage.

Body Fat Percentage May Be a Significant Problem

2010-02-13T07:14:00.000-08:00

As some in the media have reported, obesity may be leveling off in most segments of the U.S. population. Although about a third of the U.S. population is obese, obesity appears to be holding constant. This might mean that some of the efforts to head off obesity are working. But still, there might be an unseen problem -- hidden fat that is not usually measured. And bariatric centers might want be at the forefront in the effort to tackle the problem.

According to the Mayo Clinic, a person can have a normal BMI (body mass index), but still be obese. The condition is called normal weight obesity. BMI takes only a person's height and weight into consideration, since BMI is computed by dividing a person's weight in kilograms by the person's height in meters, then squaring the result. Therefore, BMI does not measure the percentage of fat on the body.

Although BMI is sometimes controversial, it is probably the most used measurement of body weight. BMI categories have been established to indicate when a person is of normal weight (a BMI between 18 and 25), when a person is overweight (a BMI between 25 and 30), and when a person is obese (a BMI over 30).

Indeed, at most bariatric surgical centers, BMI is one of the key factors used to determine if a person should be considered for bariatric surgery. For example, at many centers, one must have a BMI of 40 or more before bariatric surgery is recommended. With a BMI less than 40, a person might be considered for bariatric surgery if the BMI is greater than 35, and the prospective patient suffers from comorbidities such as diabetes or high blood pressure.

However, the prospect of normal weight obesity may necessitate the inclusion of fat percentage measurements when assessing body weight. And this is where the expertise of bariatric centers could come into play. While there are home methods for calculating body fat percentage, at this time, the most accurate method is probably done in a facility equipped to make accurate body fat percentage measurements.

The relatively new finding by the Mayo Clinic that a person of normal weight could be obese identifies a problem that bariatric centers can equip themselves to handle. Centers should become knowledgeable about the current recommended fat percentages. The centers should also get involved in the ongoing research to nail down more accurate fat percentage classifications. At any rate, strategically inclined bariatric centers should prepare to play an important role in helping potential clients manage body fat percentage, as well as BMI.

Using the Pedometer and the Mandometer for Lifestyle Modification

2010-02-03T11:43:00.000-08:00

Lifestyle modification is a significant element in most weight loss or weight management programs. Lifestyle changes can lead to new habits that enable a person to lose and control weight. The use of two instruments -- one old and one, relatively new -- might be key instruments that can prompt an individual to modify the two most important weight loss and weight management activities. The two instruments are the pedometer and the mandometer. The activities are eating and exercise.

The pedometer is a tool that can be used by an individual to give the individual an accounting of the distance traveled based on the number of steps taken. The pedometer is said to have been around for well over two hundred years. Although older pedometers were mechanical, today's pedometers are usually electronic. The instrument is usually attached to the belt of a walker, jogger, or runner, giving step-count information to the wearer.

Since most people engage in walking, jogging, or running to lose or control weight, the pedometer can encourage a person to add steps to his or her daily activities.

The mandometer is a tool that can help a person change the way he or she eats. The mandometer was developed by two researchers at the Karolinska Institute in Stockholm, Sweden. The instrument is a portable electronic scale that is connected to a small computer. The scale weighs the food, in a plate for example, before any food is eaten, and continues to calculate the rate of change in the weight of the food as a person eats from the plate. The rate of change is correlated with eating rate. And the device shows a graph of eating rate, giving off an alarm when the rate is too high, indicating that a person is eating too fast.

This alarm is an attention-getter that encourages the patient, with a too-high eating rate, to lower his or her rate. Lowering the eating rate can be important in weight management and weight control. Changing the way we eat food is an important lifestyle modification. And using the mandometer to monitor eating rates appears to be an effective way to motivate better eating habits.

So the pedometer and the mandometer are possibly two important tools for lifestyle modification for weight loss and weight control. Indeed, these tools might enable a person to increase exercise activity and decrease eating rate.

Therefore, weight loss centers should view these tools as important weapons in the overweight and obesity fight. Along with their existing inhouse services, a center could recommend these tools as methods for weight loss and weight control.

(Please leave a comment by clicking on the "COMMENTS" link at the lower right part of this blog post. SUBSCRIBE to this blog by scrolling to the bottom of this page and entering your email address.)

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Using Telemedicine to Modify Lifestyle for Weight Loss

2010-01-24T16:17:00.000-08:00

In a November 25, 2009 blog post, we said that "telehealth has the potential to improve the treatment of obesity and obesity-related diseases such as diabetes." And we said that "telehealth devices may elevate the treatment of obesity by making it easier to modify lifestyle." Scientists at the University of Southern California lab are developing a wearable wireless monitoring device that may assist lifestyle modification for overweight and obese persons.

In the blog post mentioned above, we cited the Free Dictionary definition of telehealth as "the use of telecommunication technologies to provide health care services and access to medical and surgical information for training and educating health care professionals and consumers, to increase awareness and educate the public about health-related issues, and to facilitate medical research across distances." Well, telemedicine is a subset of telehealth. And the above-mentioned wearable device is a telemedicine device.

In the University of Southern California lab experiment, the monitoring device was used to detect what the teenagers ate and did while wearing the device. The device's output is sent via cell phone to the researchers. Because the information received by the researchers does not depend on self-reporting, the information is likely more accurate that self-reported information. Self-reported information is often inaccurate.

The wearable sensor sends the lab reports on such things as heart rate and physical activity. There are other devices that actually track calories burned. And, still, other devices are in development that may record video for further study. All these devices might allow weight loss and weight management counselors to have a better idea of what a client is doing. And this can enable a counselor to better personalize a weight loss or weight management program for a client, enabling the client to successfully modify a lifestyle.

The counselor can collect results, determine the appropriate weight program, or modify an existing program. The counselor can then determine what diet is most appropriate and what physical activity might be the most effective.

We think these telemedicine monitoring devices could be a important tool for weight loss and weight management. Bariatric or weight loss centers should keep abreast of these tools. Indeed, including some of these items in its arsenal may allow a bariatric or weight loss center to improve its weight loss services.

(Please leave a comment by clicking on the "COMMENTS" link at the lower right part of this blog post. SUBSCRIBE to this blog by scrolling to the bottom of this page and entering your email address.)

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Obesity Gives Rise to Disability

2010-01-13T13:46:00.000-08:00

Disability is on the rise among the elderly who don't reside in elder care facilities. According to a recent study, one of the reasons for this rise in disability is the rise in obesity. Indeed, there is a link between obesity and disability. But if more people adopt healthy living habits, this adoption could lower the levels of obesity, and thus lower the disability numbers.

The above-mentioned study was done by researchers from the University of Toronto, and the University of California at Berkeley. According to the study results, there has been a doubling of obesity over the past three decades. This doubling of obesity is associated with a rise in disability among those 65 and older. And many of these older persons are poor.

Of course, obesity-fighting treatments should be made available to all socioeconomic groups. This is especially true for the poor elderly. We believe that if this group is given access to obesity-fighting services, this group could make lifestyle changes that might lower obesity rates, and thus reduce disability levels. For this reason, we hope the current health care overall being debated will create a workable health care system.

A workable health care system would bring more of the poor elderly into the health care system. And these new entrants would increase the market for weight-loss tools, since losing weight is viewed as a way to address many health problems -- including disability.

The rise in obesity-related ailments is already an inducement to bariatric centers to refine their weight loss services. The rise in disability should be an additional motivator for these centers. Weight loss centers should emphasize the importance of a healthy weight in dealing with disability.

Weight loss centers should also prepare for the potential enactment of the health care overall. While there may be an assortment of problems with the reform under review, a workable health care system will widen the market for weight loss services. And this could benefit some weight loss centers, by giving the centers the opportunity to offer their weight loss services to more clients.

Gastric Bypass and Adjustable Lap Band May Be Cost Effective for Treating Type 2 Diabetes

2010-01-01T19:28:00.000-08:00

As we've all heard, today, more and more U.S. citizens are succumbing to diabetes. Furthermore, Type 2 diabetes among children is increasing. Some forms of bariatric surgery are being viewed as a viable treatment for Type 2 diabetes. Studies show that in more than two thirds of the study subjects with Type 2 diabetes, the disease was either gone or easier to control after weight loss surgery. And recent research indicates that gastric bypass surgery and the adjustable lap band are more cost effective in treating Type 2 diabetes than conventional diabetes treatment methods for persons with a BMI greater than or equal to 35.

We've noted before that some experts feel that bariatric surgery can be used for more than just weight loss. Indeed, the American Society for Bariatric Surgery (ASBS) changed its name to the American Society for Metabolic and Bariatric Surgery (ASMBS) to recognize non-weight-loss applications of gastric bypass surgery.

And the New York-Presbyterian Hospital/Weill Cornell Medical Center has started treating Type 2 diabetes using a modified version of the gastric bypass surgery used for weight loss. In the modified version of the surgery, nothing is done to shrink the stomach; only the small intestine is rerouted.

Using bariatric surgery to treat diabetes, no doubt, will receive more attention. And if it turns out that the surgery is a good, cost effective treatment for diabetes, the surgical option will become an important surgical service that bariatric surgical centers can offer.

Another item that favors surgery as a reasonable option for treating diabetes is research showing that insulin treatment for Type 1 and Type 2 diabetes causes some patients to gain weight. Gaining weight can be a negative factor in cardiovascular disease.

So depending on how viable the utilization of bariatric surgery is for treating diabetes, compared to insulin use, it may be reasonable, in some cases, to consider bariatric surgery for the treatment of diabetes for economical reasons.

Bariatric or weight loss centers should stay abreast of activities associated with the use of bariatric surgery for the treatment of diabetes. It might turn out that offering this treatment could give a weight loss or bariatric center a competitive advantage and help to lower the health care costs associated with Type 2 diabetes.

The Importance of Gut Bacteria in Weight Control

2009-12-17T06:25:00.000-08:00

In a 2008 study at The Washington University St. Louis Medical School, researchers indicated that trillions of bacteria live in our gut. These bacteria perform specific activities, including the extraction of calories from food and the management of nutrients. And while the bacteria are common to all people, each individual has a unique set of the bacteria. A more recent study done at Washington University showed that the composition of the bacteria plays an important role in weight control.

Working with mice, the researchers found that obese persons had more of the bacteria called Firmicutes in their gut, and fewer of the bacteria called Bacteroidetes. Firmicutes are associated with obesity and Bacteroidetes are associated with leanness. Furthermore, diet played a significant role in the number of Firmicutes and Bacteroidetes in the mice gut. Those mice who were fed a low-fat diet had more Bacteroidetes and less Firmicutes than the mice who were fed the high-fat diet.

Since diet plays an important role in the composition of gut bacteria in mice, there is a high probability that diet plays a significant role in the human gut bacteria composition. Firmicutes and Bacteroidetes also populate the human gut. The above mentioned studies provide more evidence that diet is the significant factor in controlling weight.

Of course, more study will enable the researchers to determine exactly what diets best control these bacteria in humans. This determination could lead to the creation of of more effective diets.

Organizations that provide meal replacements should be especially interested in creating more effective diets. Therefore, these organizations should be interested in the above mentioned studies. Understanding gut bacteria that function in the body to influence obesity or leanness might enable meal replacement producers to manufacture better diet products. And bariatric or weight loss centers could offer these improved diet products as part of their weight loss services.

Governments Fight Obesity

2009-12-06T12:03:00.000-08:00

Some experts believe that the government must play a large role in the fight against obesity. For example, the government can put pressure on neighborhood designers to get them to create plans that provide for more walking and bike paths in neighborhoods. These plans could put grocery stores, and other frequented neighborhood sites within a reasonable walking distance of residential areas. The government could also emphasize the importance of fighting obesity. And, fortunately, governments are becoming more proactive in the fight against obesity.

The U.S. federal government has indicated that it will increase funding to fight obesity. Further, the government has indicated that one of the important elements in the overhaul of the current health care system would be an initiative to boost the consumption of more nutritious food.

In addition to the federal government's increased activity in the fight against obesity, state governments are joining the fight. The Virginia state government has completed legislation to change the name of the "Virginia Tobacco Settlement Foundation" to the "Virginia Foundation for Healthy Youth." With the name change, the organization broadens its mission to fight childhood obesity, in addition to smoking.

In Ohio, the state government is working on legislation for "healthy choices for healthy children." The legislation will promote increased physical activity, physical education, and enhance the nutritional value of the food children eat in school.

As we can see, attention is being given to childhood obesity by governments. Although the federal or a local government can take action to combat childhood obesity, the fight against childhood obesity must begin in the home. And parents have the greatest influence on a child during the child's childhood.

Since obesity can be an impediment to future success, parents should be interested in joining the obesity fight. Bariatric or weight loss centers could work with parents in the community to educate them on the best procedures to use to help children maintain a healthy weight. This collaboration could help the community, and enhance a weight loss center’s local reputation.

Indeed, collaboration between weight loss centers and governments -- federal, state and local -- might be one of the best ways to beat overweight and obesity during childhood and adulthood.

(Please leave a comment by clicking on the "COMMENTS" link at the lower right part of this blog post. SUBSCRIBE to this blog by scrolling to the bottom of this page and entering your email address.)
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environmental scanning, strategic management, competitive analysis, strategic planning

Telehealth in the Obesity Fight

2009-11-25T09:02:00.000-08:00

According to the Free Dictionary, telehealth may be defined as "the use of telecommunication technologies to provide health care services and access to medical and surgical information for training and educating health care professionals and consumers, to increase awareness and educate the public about health-related issues, and to facilitate medical research across distances." Telehealth has the potential to improve the treatment of obesity and obesity-related diseases such as diabetes.

A recent study was done in Ottawa Canada to determine the effectiveness of telehealth for home health care. In the study, literature was analyzed to compare the benefits of treating diabetes using telehealth versus treating diabetes using common diabetes treatment procedures. It was found that patients who received treatment via telehealth had a higher quality of life, and experienced less hospitalization than diabetes patients receiving the normal diabetes treatment.

Although the leaders of the Canadian study indicated that more research needs to be done, as stated above, telehealth improved quality-of life and reduced hospitalizations. The use of telehealth also improved glycemic control and patient satisfaction.

A 2008 study was done in the United States to establish the effectiveness of telehealth in treating obesity. Three weight loss programs were compared. These programs were telehealth, traditional classes, and no program. The study looked at the amount of weight participants regained in each program. The study also assessed a participants' satisfaction with a given program, and the convenience of a program for the participants. Participants in the telehealth program lost slightly more weight than participants in the other two programs.

However, the difference in weight loss was not enormous. But the telehealth group found the telehealth program to be more convenient. And convenience is important in trying to modify a lifestyle. If one program is more convenient to follow than another, a person is more likely to follow the more convenient program.

Some companies are focusing on telehealth. One of these companies is Washington, D.C. based Telcare. Telcare is a medical devices company specializing in health information technology using cellular technology. In 2009, Tel care won the 'best in show' award for a telehealth device at the MoveTechFest Americas conference. The conference was held in Santa Clara, California.

Telcare's device works like a glucose meter. And the device wirelessly transmits diabetic information between the diabetic patient and medical professionals. The device is easy for the patient to use, it reduces complications, and the device may reduce the costs of diabetes by as much as 37%. There are plans to use the device to manage obesity, as well as other chronic diseases.

Therefore, this telehealth device, as well as other telehealth devices, may elevate the treatment of obesity by making it easier to modify lifestyle. Bariatric industry providers should pay close attention to telehealth methodology for fighting obesity.

(Please leave a comment by clicking on the "COMMENTS" link at the lower right part of this blog post. SUBSCRIBE to this blog by scrolling to the bottom of this page and entering your email address.)

Podcasts as a Tool to Aid in Weight Loss

2009-11-13T18:56:00.000-08:00

In order to lose weight and maintain the weight loss, one must almost, always modify his or her lifestyle to be successful long term. Lifestyle modification generally includes a change in diet, and engagement in regular exercise. Because achieving weight loss and maintaining weight loss present mental and physical challenges, counseling intervention can be a useful tool. And a study, discussed in an October 2009 American Journal of Preventive Medicine article, has shown that podcasts or pre-recorded audio (or video) files can be an effective counseling intervention tool.

To determine the effectiveness of using podcasts for weight loss, in 2008 a 12 week study was carried out in North Carolina. The study consisted of 24 participants that were randomly assigned to one of two groups. Both groups were subjected to 24 weight loss podcasts over the 12 week study period. However, one of the groups was exposed to an enhanced weight loss podcast, based on social cognitive theory (SCT).

This theory, by Albert Bandura, postulates that one can learn new behavior through observation without imitating the behavior. Further, a person is likely to adopt the new behavior, if the behavior leads to positive outcomes.

Therefore, offering podcasts on behavioral changes that lead to weight loss may motivate an individual to the adopt the changes, if the changes, indeed, lead to weight loss. In the above-mentioned study, the SCT podcast group lost up to three more pounds than the group not using the SCT podcast.

Hence, we think that podcasts might be a useful weight loss tool. The CDC (Centers for Disease Control and Prevention) appears to agree that podcasting for weight loss may be useful. The CDC Website presents a podcast to help women maintain a healthy weight.

We believe that if podcasts and other lifestyle modification techniques are combined, the appropriate combination may prove to be a powerful weight loss and weight management method. Weight loss or bariatric centers that make use of effective weight loss tools elevate the centers' competitive advantage. And podcasts may be such a tool.

(Please leave a comment by clicking on the "COMMENTS" link at the lower right part of this blog post. SUBSCRIBE to this blog by scrolling to the bottom of this page and entering your email address.)
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The Obesity Society Reports on Qnexa, Contrave and Lorcaserin

2009-11-04T10:27:00.000-08:00

Information Uncover was represented at last month’s TOS (The Obesity Society) annual meeting in Washington, D.C. And one of the most exciting bits of news coming out of the meeting was the prediction that three obesity drugs, we’ve talked about on this blog, will likely be on the market within two years. These drugs are Qnexa, Contrave and Lorcaserin.

Qnexa is manufactured by Mountain View, California based Vivus. Contrave is manufactured by La Jolla, CA based Orexigen. And Lorcaserin is manufactured by San Diego, California based Arena.

Qnexa is a combination of two drugs: Phentermine and Topiramate. Phentermine was used in the obesity drug combination Fen-phen, an obesity drug combining Fenfluramine and Phentermine. Fen-phen was taken off the market in the 90s because the drug caused severe side effects -- including serious cardiovascular issues.

However, Phentermine was the safer of the two drugs in the Fen-phen combination. Phentermine is often prescribed today for short term weight loss. Furthermore, while Phentermine is combined with Topiramate in Qnexa, the serious side effects associated with Fen-phen have not been observed in Qnexa. In addition, Qnexa surpasses the FDA obesity drug guidelines.

Orexigen’s Contrave is also the combination of two drugs. These drugs are Naltrexone and Bupropion. Naltrexone is FDA approved for the treatment of alcohol dependence. And Bupropion is FDA approved for the treatment of depression. Contrave appears to have no serious side effects, and the drug satisfies FDA obesity drug guidelines.

Finally, Lorcaserin, produced by Arena, does not produce the weight loss percentages achieved by Qnexa and Contrave. However, Lorcaserin appears to be well tolerated, while satisfying the FDA obesity drug guidelines.

With the weight loss industry in need of a safe and effective weight loss drug, weight loss service and product providers are closely monitoring Qnexa, Contrave, and Lorcaserin. We believe that if these three drugs do come on the market within two years, their presence will give a needed boost to the weight loss industry. And a number of speakers at The Obesity Society's annual meeting seemed to agree with this opinion.

(Please leave a comment by clicking on the "COMMENTS" link at the lower right part of this blog post. SUBSCRIBE to this blog by scrolling to the bottom of this page and entering your email address.)
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Learning How to Treat Obesity from a UK NHS Program

2009-10-22T13:06:00.000-07:00

In our October 14, 2009 blog post, we discussed the Chronic Care Model as a tool to treat obesity. The model was developed by the MacColl Institute for Healthcare Innovation. Since obesity is viewed as a chronic illness, the model might be used to fight obesity. In the model, the obese patient plays the central role in the model. Now, a UK program is confirming the importance of the role the patient must play in obesity treatment.

The UK program is about one year old. The program is an “NHS [National Health Service] nurses led service” program. As the description indicates, nurses lead the program. The program emphasizes patient education as a way for the patient to establish a strategy for losing weight. Indeed, in the UK program, as in the Chronic Care Model, an educated patient with assistance from trained professionals can lead to weight loss.

As we mentioned before, the Chronic Care Model consists of six elements. These elements are: community resources and policies, the provider’s health care organization, case management, delivery system design, decision support, and self-management. And the self-management aspect of the Chronic Care Model is the most important element of the model.

It was pointed out in our Chronic Care Model blog post that some of the most important functions of the model are best carried out by trained non-physicians. And again, the UK program’s nurse leadership supports the belief that non-physician professionals can play a significant role in the treatment of a chronic illness such as obesity.

It appears that much is being learned about non-surgical, non-drug approaches to treating obesity. If research can continue to help improve these weight loss approaches, more obesity patients will be able to successfully deal with obesity on a long term basis. Of course, bariatric or weight loss centers should follow research in this area, and make use of applicable research results.

(Please leave a comment by clicking on the "COMMENTS" link at the lower right part of this blog post. SUBSCRIBE to this blog by scrolling to the bottom of this page and entering your email address.)

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Using the Chronic Care Model to Treat Obesity

2009-10-14T16:49:00.000-07:00

Obesity may be viewed as a chronic illness. Therefore, tools used to successfully treat chronic illnesses can be used to treat obesity. An effective tool for treating chronic illness is called the Chronic Care Model. The Chronic Care Model was developed by the MacColl Institute for Healthcare Innovation. The institute is based in Seattle, Washington. The institute developed the model to treat those illnesses that require an ongoing relationship between the ambulatory patient and the health care provider.

The model was developed more than a decade ago. In designing the model, the developers researched literature to uncover methods that could be used to improve the treatment of chronic illnesses. Over time, the model evolved to contain six key elements. These elements are: community resources and policies, the provider’s health care organization, case management, delivery system design, decision support, and self-management.

The first of the six elements is community resources and policies. This means that the health care provider should make use of existing community resources. Further, the provider should work to institutionalize policies that improve care. In making use of community resources, for example, a bariatric center could partner with a gym in the community to provide exercise to patients.

The next item on the list is the provider’s health care organization. Among other things, this item stipulates that the provider’s health care organization should actively support improvements in health care. And the provider’s organization should emphasize the use of quality measures in the application of health care.

Case management, the next list item, is meant to indicate that the provider should work with the patient to enhance the patient’s self-management. Self-management will be discussed below. Case management also entails follow-up to make sure the treatment is working. Case management also includes an effort to help guide the patient through the health care system.

The delivery system design is the next element on the list. It is essential, for example, that the delivery system be designed so that necessary resources be made available to the patient. In fact, implementing the delivery system so that both the provider and the patient have access to resources is important. In the system, evidence based treatment methods should be used. And many of these treatment methods ought to be delivered by non-physician members of the provider team. Because in some cases, it has been found that non-physician members can deliver certain services better than the physician.

Next, we have decision support. Evidence-based guidelines must be part of the health care provider's organization. Established education methods should be employed. And treatment guidelines and clinical information should be shared with the patient.

Last on the list is self-management. Indeed, it has been found that self-management is a necessary part of the Chronic Care Model -- more so than any other element. In self-management, the patient must be viewed as the central player in the ongoing treatment of the chronic illness. And as part of the process, the provider must be agree to relinquish some control to the patient.

Since the introduction of the Chronic Care Model, efforts have been made to determine if the model improves health outcomes and is cost effective. Although more work needs to be done to determine the cost effectiveness of the model, published reports appear to indicate that by using the Chronic Care Model, health care organizations can improve the treatment of chronic illness.

Since overweight and obesity may be viewed as a chronic illness, The Chronic Care Model is applicable in the treatment of the illness. It has been shown that for long-term success, a strong ongoing relationship between the individual attempting to lose or control weight and the organization providing the weight loss or weight management service is of utmost importance. And the Chronic Care Model emphasizes this relationship.

Indeed for obesity treatment, weight loss centers should review elements of the Chronic Care Model, and try to implement as many of the model's elements as possible, with an emphasis on self-management.

GENova Biotherapeutics Inc. and Bridge Bioresearch Plc. to Look for Obesity-Cancer Link

2009-10-05T05:07:00.000-07:00

We now know that obesity is highly correlated with a number of illnesses, including some cancers. Therefore, efforts that might shed more light on the relationship between cancer and obesity can be useful. New York based GENova Biotherapeutics Inc, which has a research focus on cancer, will collaborate with the UK based company Bridge Bioresearch Plc., which has a focus on obesity. The two companies will try to find links between cancer and obesity by sharing their research results.

Obesity has been found to play a role in a number of ailments. It is well accepted that these ailments include high blood pressure and high cholesterol. Moreover, the The Mayo clinic did a study and determined that obesity contributes to the need for hip replacement. And some experts indicate that there is a link between obesity and Alzheimer’s disease.

Further, researchers in the UK suggest that obesity is a bigger health risk, today, than smoking. In the UK, it is estimated that there might be as many as 19,000 British cases of cancers per year resulting from obesity. Finding links between obesity and cancer is almost as important as the link discovered between smoking and cancer, since obesity is associated with a number of cancers.

According to the National Cancer Institute (NCI), a U.S. government organization, obesity is related to a number of cancers. These include: "colon, breast (postmenopausal), endometrial, kidney, and cancer of the esophagus." According to the NCI, the link between cancer and obesity is not known. In fact, the NCI goes on to say, the link might be different for different cancers. And the NCI has ongoing studies to determine what these links are.

The collaboration between GENova Biotherapeutics Inc. and Bridge Bioresearch Plc. may add to results coming out of the NCI studies and other studies investigating the link between cancer and obesity. In fact, health care organizations that offer both weight loss treatment and cancer treatment might also add to the obesity-cancer link knowledge base.

(Please leave a comment by clicking on the "COMMENTS" link at the lower right part of this blog post. SUBSCRIBE to this blog by scrolling to the bottom of this page and entering your email address.)

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Weight Loss Through Lifestyle Modification Could Be Enhanced with Nutrisystem D

2009-09-27T07:22:00.000-07:00

Lifestyle modification, as a way to lose weight, is the most popular weight-loss method. It’s the most popular method because it's usually the easiest, least expensive, and safest way to lose weight. The main components of lifestyle modification for weight-loss generally include a modified diet and an exercise program -- diet being more important than exercise. And Nutrisystem has introduced a new program, called Nutrisystem D, that greatly improves a person's weight-loss chances, according to a recent study done at the Temple University School of Medicine.

The Nutrisystem D program is directed at overweight people, who have type 2 diabetes. As part of the program, a person receives 150 pre-packaged meals. The meals are portioned controlled. And the meals are designed to cause low rises in blood sugar.

The Nutrisystem D study done at Temple was led by Dr. Gary Foster. The study participants following the Nutrisystem program lost more than twice the weight as did participants who followed a diet designed for diabetics.

Using prepackaged meals as meal replacements has already been shown to lead to weight loss. Meal replacements include shakes, entrees and bars. And along with Nutrisystem's meals, pre-packaged meals include meals made by Lean Cuisine and Healthy Choice. With pre-packaged meals, a dieter can simply pick up a meal without having to worry about the calorie or nutritional content. And this can be quite convenient. Further, a 2003 Pub Med report indicated that meal replacements can be employed safely to enable one to lose weight and maintain the weight loss.

Nonetheless, staying on a diet long term -- even on a well designed diet -- can prove to be difficult. But modifying a lifestyle to follow a specific diet, long term, can be aided with external reinforcement from weight-loss counselors. And counseling is a part of the Nutrisystem D program. Since the Nutrisystem D program appears to be a good one, bariatric centers should take note of the program. Some of the procedures employed in the Nutrisystem D program may be adaptable to bariatric center programs.

Vivus Is Planning to Apply for FDA Approval for Its Obesity Drug Qnexa

2009-09-17T11:44:00.000-07:00

A few obesity drugs in the drug pipeline are continuing to show promise. The companies, developing obesity drugs, that have recently received attention include the California based companies, Vivus, Arena and Orexigen. Vivus manufactures the drug Qnexa. Arena makes the drug lorcaserin, and Orexigen produces the drug contrave. But Vivus, with its drug Qnexa, is currently dominating the news.

Qnexa is a combination of two drugs: phentermine and topiramate. Phentermine was used in the obesity drug combination fen-phen. Fenfluramine and Phentermine were fen-phen. Fen-phen was taken off the market in the 90s, at the request of the FDA, because of severe side effects, including cardiovascular problems. But phentermine was the safer of the two drugs.

Qnexa motivates weight loss by suppressing the appetite, and by making the user feel full. So far, the main Qnexa side effects are “dry mouth, tingling, constipation, altered taste and insomnia.”
And persons participating in Qnexa drug trials experienced an approximate 15 percent weight loss. This weight loss percentage greatly exceeds FDA guidelines. Further, Qnexa has the potential to reduce some risks associated with diabetes.

The market for obesity drugs is potentially lucrative, if an obesity drug is found that is safe and effective. “JMP securities recently projected Qnexa's annual sales would hit $1.5 billion by 2015.”

Based on trials results, Vivus expects to apply for approval from the FDA to market the Qnexa by the end of this year. The company is then planning to start marketing the drug by the end of 2010. Also, the company will start looking for collaborative opportunities to sell the drug.

With the weight loss industry in need of a safe and effective weight loss drug, weight loss service and product providers should closely monitor Qnexa and if reasonable, the companies should take advantage of collaborative opportunities.

(Please leave a comment by clicking on the "COMMENTS" link at the lower right part of this blog post. SUBSCRIBE to this blog by scrolling to the bottom of this page and entering your email address.)

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An Update on the GI Dynamics Intestinal Liner

2009-09-12T18:15:00.000-07:00

Last year we wrote that the company, GI Dynamics of Lexington, Massachusetts, presented a report on the results of tests done using an intestinal liner that duplicates some of the functions of gastric bypass surgery. We went on to say that the liner, called the EndoBarrier, reduces the amount of calories that the body absorbs from food that is eaten.

Further, we indicated that the liner is inserted endoscopically through the mouth, and placed in the small intestine, covering about two feet of the intestine. Finally, we said that test results indicated that the liner could cause weight loss and produce beneficial effects for those with type 2 diabetes.

The intestinal liner mimics some of the malabsorptive characteristics of gastric bypass surgery. Gastric bypass surgery is a combination of two weight-loss surgical procedures that reduce calorie intake. In one of the procedures, called restriction, the surgeon creates a smaller stomach using a portion of the original stomach. This smaller stomach restricts the amount of food a person eats, thus reducing calorie intake. In the other procedure, called malabsorption, the surgeon reroutes the small intestine so that food bypasses a portion of the small intestine, reducing the amount of calories (and nutrients) absorbed by the body.

Persons participating in intestinal liner tests were able to lose an average of 30 pounds and there was a decrease in the blood sugar level in study subjects. Thus, there was a lessening of symptoms associated with type 2 diabetes.

Last month, GI Dynamics reported that they have improved the therapeutic effects of the Endobarrier Intestinal Liner by combining the liner with the company's Endobarrier Flow Restrictor. This device is used to delay the stomach's emptying of food into the small intestine. This is known as gastric emptying or GE. And this device appears to enhance the effects of the Endobarrier.

If ongoing tests of the Intestinal Liner plus Flow Restrictor prove successful, the combination might be a safe and effective method for weight loss and weight maintenance. And a weight loss or bariatric center may be able to employ the device and gain a competitive advantage.

Environmental Change: A Weapon to Fight Obesity

2009-08-30T13:36:00.000-07:00

Environmental change as an effective and low cost approach to weight loss appears to be gaining more attention. Environmental change can promote lifestyle modification, which is the leading method used in weight loss and weight maintenance. The two key elements of lifestyle modification are diet and exercise. And environmental change can enable a person to lose weight by causing the person to modify his diet and exercise.

Along with overweight and obesity comorbidities such as high blood pressure and high cholesterol, we are now learning that the brain shrinks with overweight and obesity. And as overweight and obesity increase in children, we will likely see more brain shrinkage as these children reach adulthood. So it is important to attack overweight problems in children as well as in adults. And lifestyle modification appears to be a good weapon.

It is now believed that heavy-handedness is not as effective in helping children fight overweight and obesity as a soft-touch approach. In essence, children should not be restricted from eating certain foods. They should be taught to regulate their food intake and eat healthy food. And parents can help their children by exposing them to healthy food in the home. Indeed, modifying the home environment to be conducive to healthy eating and exercise may lessen the amount of overweight and obese children.

Furthermore, changing the workplace environment may lessen the amount of overweight and obese adults. A study by Justin Trogdon, a consultant at RTI International, indicated that “environmental change interventions in work sites may be more likely to be cost saving than high-cost, individually targeted behavioral change interventions...” The interventions include nutritional programs, on-site gyms, and weight-loss competitions. The competitions include “contests that give overweight employees money if they succeed in shedding extra pounds ...”

So, environmental change may be an important component of lifestyle modification in the home, and a cost effective component of lifestyle modification in the workplace. Environmental change can be an aide in weight loss and weight maintenance which can reduce health care costs for employers.

So weight loss service and product providers should emphasize the importance of environmental change as an element in lifestyle modification. These providers should work with parents and employers to initiate environmental changes that motivate exercise and a healthy diet.

(Please leave a comment by clicking on the "COMMENTS" link at the lower right part of this blog post.)

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Lifestyle Modification with Medical Counseling Can Lead to Weight Loss

2009-08-21T05:50:00.000-07:00

Lifestyle modification — including diet and exercise changes — is known to be the most utilized weight loss method. However, lifestyle modification doesn’t lead to long term weight loss for many obese persons. But a recent study done at the University of Kentucky shows that lifestyle modification -- specifically diet change -- utilized with medical supervision can lead to quite respectable weight loss for obese persons. And there may be ways to maintain the weight loss long term.

The study-participants' diet was modified with the use of meal replacements. And medical supervision was combined with the meal replacements. This combination enabled obese-study participants to lose up to 16 percent of their initial body weight. The participants in the medically supervised program “lost an average 43.4 pounds in 19 weeks.” The meal replacements in the study were shakes, entrees, and bars.

Indeed, it has been shown before that the use of meal replacements can lead to weight loss. Among shakes, entrees and bars, specific examples of meal replacements include Lean Cuisine and Healthy Choice packaged meals. The packaged meals enable a dieter to simply pick up a meal without having to worry about the calorie or nutritional content. And this can be quite convenient. Moreover, a 2003 Pub Med report indicated that meal replacements can be employed safely to enable one to lose weight and maintain the weight loss.

Still, maintaining the weight loss -- even with meal replacements -- can prove to be difficult. But modifying a lifestyle so that appropriate meal replacements are selected and used for the long term can be aided with external reinforcement from medical weight loss counselors. Bariatric centers can provide ongoing counseling to help the obese person continue to make the best choices and stick with a diet program. And long term counseling can be an important offering for a weight loss or bariatric services provider.

(Please leave a comment by clicking on the "COMMENTS" link at the lower right part of this blog post.)

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An Anti-Obesity Chewing Gum

2009-08-10T07:43:00.000-07:00

In the past, we have discussed lifestyle modification tools that can aid in weight loss. Now, the Switzerland based company, Ventana Biotech Inc, is working on another tool. The company is working on a chewing gum that might be an aid in weight loss. Of course, this wouldn't be the first time that chewing gum was employed to improve health.

Chewing gum is used to help smokers quit smoking. Chewing gum can serve as a substitute for smoking a cigarette, enabling a smoker to replace the smoking habit with chewing gum. Indeed, nicorette gum also gives the smoker a small amount of nicotine to reduce the effects of nicotine withdrawal.

And chewing sugar-free gum can help fight tooth decay. According to the American Dental Association (ADA), chewing gum containing the sugar substitute, xylitol, can prevent tooth decay.

Further, suggestions that chewing gum can be an aid in weight loss are not new. Contestants on the TV reality show, "The Biggest Loser," are told by the trainers and the nutritionists on the show to chew sugar free gum to help lose weight. And a 2007 Scotland study demonstrated that chewing gum can be an aid in weight management. Chewing gum can help as an aid in weight management because chewing gum can reduce hunger.

While chewing gum can reduce hunger, most chewing gum is not produced with an appetite suppressant as a key active ingredient. Ventana's gum contains an extract from the hoodia gordonii plant, and active ingredients in the plant can suppress appetite. Moreover, the gum is patented as an anti-obesity gum. The gum is currently in trials. And if the gum proves to be save and effective, Ventana hopes to license the gum to large pharmaceutical companies.

Indeed, if Ventana's chewing gum proves successful, it will be a useful tool for weight control. And the gum will be another weapon in the weight loss service provider' s arsenal.

(Please leave a comment by clicking on the "COMMENTS" link at the lower right part of this blog post.)
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Bariatric Surgery: An Option That Might Reduce Health Care Costs

2009-08-02T14:18:00.000-07:00

Most likely you've heard the following media report: Obesity accounts for $147 or almost 10% of the health care cost in the U.S. each year. You’ve also probably heard that the obesity market has unrealized potential. The potential is unrealized because most weight loss methods are not successful at providing long-term weight loss. However, since reducing obesity in the U.S. can reduce health care cost, finding ways to treat obesity is of the utmost importance. Perhaps, bariatric surgery could play a larger role in this treatment.

One obesity-related disease that has added to the increase in health care cost is diabetes. According to a 2008 Lewin Group study, the 2007 U.S. price tag for diabetes treatment was approximately $115 billion. And even when a diabetes patient has insurance, out-of-pocket cost for the patient can be significant.

For those with diabetes, losing weight can lead to a reduction in associated symptoms. Indeed, for morbidly obese persons with diabetes, appreciable weight loss can stop the progression of the disease in many cases. Therefore, weight loss methods that are safe and effective may be vital to reducing diabetes and health care costs.

There are three weight loss approaches. They are lifestyle modification, obesity drugs, and bariatric or weight loss surgery. Although bariatric surgery is probably the most effective method for treating obesity, patients receiving the surgery have experienced serious complications.

However, significant progress toward decreasing the bariatric surgery-complication rate has been made. For example, according to a HealthGrades study, patients who have bariatric surgery at five-star rated centers (as determined by HealthGrades) have a 67% lower chance of experiencing complications. And a new risk management system "presented ... at the 26th Annual Meeting of the American Society for Metabolic & Bariatric Surgery (ASMBS)" can reduce post surgical complications by 65%.

Therefore, bariatric surgery might play a more prominent role in the treatment of obesity -- and thus a more important role in the treatment of diabetes. This, in turn, could put a dent in health care costs.

Bariatric surgical providers should take note of the above-mentioned HealthGrades study and the above-mentioned risk management system. Adopting practices followed by five-star rated bariatric centers and following procedures related to risk management could improve surgical services, and give a weight loss surgical provider a competitive advantage.

(Please leave a comment by clicking on the "COMMENTS" link at the lower right part of this blog post.)
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Laparoscopic Vertical Gastroplasty

2009-07-23T06:20:00.000-07:00

A 2003 study, published in the Archives of Surgery, indicated that ‘vertical gastroplasty can benefit most patients with morbid obesity and should be more frequently used.’ And recently, the company, Power Medical Interventions(r), Inc. (PMI), introduced a medical device that facilitates a laparoscopic version of the surgery.

In vertical gastroplasty, a part of the stomach is stapled in such a way as to create a smaller stomach pouch. Vertical gastroplasty is a type of restrictive bariatric surgery which means that the patient’s food intake is limited by the surgery. Vertical gastroplasty is similar to sleeve gastrectomy.

In sleeve gastrectomy, a smaller stomach is made by sealing off part of the stomach using staples, and the unused part of the stomach is removed from the body. While vertical gastroplasty also seals off part of the stomach, resulting in a smaller stomach pouch, no part of the stomach is taken from the body in the surgery.

The device that PMI introduced is called the i60 Mid Cut device. The device can enable a doctor to perform vertical gastroplasty, laparoscopically, in approximately 30 minutes. As we’ve said before, laparoscopic bariatric surgery exposes the patient to less trauma and lowers recovery time.

As indicated on its Website, PMI is working on instruments that may allow vertical gastroplasty to be performed using a natural body orifice, such as the mouth, anus or vagina. Surgery using a natural orifice is often called Natural Orifice Translumenal Endoscopic Surgery or NOTES.

Laparoscopic vertical gastroplasty -- even laparoscopic vertical gastroplasty performed using NOTES -- is more evolutionary than revolutionary. Still, laparoscopic vertical gastroplasty is an important step toward developing less invasive, effective forms of bariatric surgery.

Medical device providers, working on bariatric surgical instrumentation, may help increase bariatric surgical options. These device providers' efforts can increase the surgical options that bariatric surgical providers may offer, increasing the surgical choices for prospective bariatric patients. (Please leave a comment by clicking on the "COMMENTS" link at the lower right part of this blog post.)

Opportunities to Fight Obesity May Become More Accessible

2009-07-13T06:45:00.000-07:00

Today, we talk a lot about the causes of obesity and the methods that may be used to treat obesity. However, we might be missing some important opportunities to combat the disease during its early stages. Moreover, accessing those opportunities may become easier to do.

A study, entitled “Adult Obesity and Office-based Quality of Care in the United States,” discussed in a recent issue of the journal, Obesity, indicates that opportunities to treat obesity during patient visits to health care providers are commonly missed. For example, when an obese patient goes in for a physician visit, the patient is often not provided counseling on weight loss methods. And this absence of counseling leads to poor health and higher health care costs.

We think that patient visits provide an opportunity for physicians, especially primary care physicians, to improve the health of many patients. But in order for primary care physicians to take advantage of this opportunity, barriers that inhibit weight loss counseling must be broken down. And these barriers exist from both the patients' and the physicians' perspective.

For example, a 2007 report asserted that many health care providers feel that patients are obese because patients don’t effectively use self-control. And many patients believe that it’s up to them to control their weight. Thus many patients don’t talk with their health care provider about methods to combat obesity.

Although these and other barriers do exist, we believe that rising health care costs will cause more people to recognize the importance of maintaining a healthy weight. And this will cause more people to talk with their health care providers -- especially primary care physicians -- about weight management. Further, more people will talk with their providers about weight management, because their employers will urge them to do so.

Indeed, a July 2009 Wall Street Journal article entitled, “When All Else Fails: Forcing Workers Into Healthy Habits,” reported that some companies are now compelling their employees to live healthier lifestyles, because if employees live healthier lifestyles, this will lower a company's health care costs. A healthy lifestyle includes getting periodic physicals, sticking to a healthy diet, and maintaining a healthy weight.

We believe that there will be an increasing focus on living a healthier lifestyle, by primary care physicians and by patients. And this increasing focus offers an opportunity for all weight loss providers, especially medical weight loss providers. These weight loss experts can form strategic alliances with primary care physicians and others who work with persons needing to lose or maintain a healthy weight.

(Please leave a comment by clicking on the "COMMENTS" link at the lower right part of this blog post.)
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