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Brain Reward Systems of Obese Women Different from those of Women with Anorexia

The brain reward systems of women with anorexia may work differently from those of women who are obese, a new study suggests.  Researchers found that women who are anorexic have sensitized brain reward circuits, while women who are obese have desensitized brain reward circuits.(University of Colorado School of Medicine 5/16/12)

Growth Hormone Treatment after Weight Loss Surgery Prevents Loss of Muscle Mass

For Release: January 30, 2009

Contact: Arlyn G. Riskind Director, Media Relations
Phone: (301) 941-0240
ariskind@endo-society.org

Contact: Aaron Lohr
Manager, Media Relations
Phone: (240) 482-1380
alohr@endo-society.org

 

Growth hormone treatment for six months after weight loss surgery reduces patients’ losses in lean body mass and skeletal muscle mass, according to a new study accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM).

Weight loss surgery techniques, such as gastric banding, have been shown to be effective in reducing body weight and obesity-related diseases, such as diabetes. Although the results of these procedures are widely beneficial, there are some complications. Following surgery, patients are at risk of losing needed lean body mass and skeletal muscle mass due to the serious complications associated with rapid and sustained weight loss. This new study investigated whether growth hormone treatment could prevent or reduce these losses.

“Besides its more commonly known effect on linear growth during childhood, growth hormone benefits body composition throughout life by increasing muscle mass and reducing fat mass,” said Dr. Silvia Savastano, M.D., Ph.D., researcher at University Federico II of Naples in Italy and lead author of the study. “The results of our study show that the use of short-term treatment with growth hormone during a standardized program of low calorie diet and physical exercise is effective in reducing the loss of muscle mass and increasing the loss of fat mass after bariatric surgery.”

In this study, Dr. Savastano and her colleagues evaluated women who underwent laparoscopic-adjustable silicone gastric banding surgery and were diagnosed with growth hormone deficiency after the procedure. These women were divided into two groups where both groups participated in a standardized diet and exercise program, but only one group also received growth hormone. After a follow-up period of six months, women receiving growth hormone experienced a significant decrease of fat mass and an increase in lean body and skeletal muscle mass.

“This evidence opens a new frontier for growth hormone therapy in the management of morbidly obese patients,” said Dr. Savastano. “However, growth hormone treatment can be costly and a careful cost-benefit analysis that also takes into account the cost of commonly used therapy for management of morbidly obese patients is needed.”

Other researchers working on the study include Carolina Di Somma, Francesco Orio, Gaetano Lombardi, and Annamaria Colao of University Federico II of Naples in Italy ; and Salvatore Longobardi of Merck-Serono Italia in Rome , Italy .

The article “Growth Hormone Treatment Prevents Loss of Lean Mass after Bariatric Surgery in Morbidly Obese Patients,” will appear in the March 2009 issue of JCEM.

Pediatric Obesity May Alter Thyroid Function and Structure

For Release: December 3, 2008

Contact: Aaron Lohr
Manager, Media Relations
Phone: (240) 482-1380
alohr@endo-society.org

In addition to its strong associations with hypertension, cardiovascular disease, and diabetes, pediatric obesity may induce alterations in thyroid function and structure, according to a new study accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM).

Thyroid hormones drive metabolism, however demonstration of a direct or strong correlation of obesity with deficient thyroid function has been controversial, and previous studies provide conflicting conclusions. While some studies have found that thyroid disorders may lead to obesity, this recent study shows that in some cases, it is the obesity that may cause the disorder.

“Our study shows that alterations in thyroid function and structure are common in obese children and we may have uncovered the link,” said Giorgio Radetti, M.D., of the Regional Hospital of Bolzano in Italy and lead author of the study. “We found an association between body mass index and thyroid hormone levels which suggests that fat excess may have a role in thyroid tissue modification.”

This study evaluated 186 overweight and obese children over a period of nearly three years. Researchers measured subjects’ thyroid hormone levels and thyroid antibodies and also performed a thyroid ultrasound.

The presence of thyroid antibodies would suggest a diagnosis of Hashimoto’s thyroiditis, an autoimmune disease of the thyroid where T-cells attack the cells of the thyroid. In this study, 73 children did not show these antibodies, yet their ultrasound pattern was still suggestive of Hashimoto’s thyroiditis.

“The ultrasound findings are a bit mysterious,” said Dr. Radetti. “However, the findings do suggest the existence of a low-grade inflammation state, which has been known to characterize obesity.”

Thyroid function has been shown to return to normal after weight loss, said Dr Radetti, raising the question of the potential reversibility of thyroid abnormalities shown on an ultrasound. However, researchers still do not know whether the persistence of thyroid abnormalities in obese children may also progress into chronic thyroid disease in early adulthood. Dr. Radetti says more studies are needed to answer these questions.

Other researchers working on the study include Wolfgang Kleon, Lucia Pappalardo, and Claudio Crivellaro of the Regional Hospital of Bolzano in Italy, Fabio Buzi of the University of Brescia in Italy, and Natascia di Iorgi and Mohamad Maghnie of the University of Genova in Italy.

The article “Thyroid Function and Structure are Affected in Childhood Obesity,” will appear in the December issue of JCEM.

Endocrine Society Releases Guideline on Metabolic Syndrome

For Release: November 7, 2008

Contact: Aaron Lohr
Manager, Media Relations
Phone: (240) 482-1380
alohr@endo-society.org

The Endocrine Society has released a new clinical practice guideline for the primary prevention of cardiovascular disease and type 2 diabetes in patients at metabolic risk. The guideline appears in the October issue of the Journal of Clinical Endocrinology & Metabolism (JCEM), a publication of The Endocrine Society.

There is growing evidence that many patients who develop cardiovascular disease or diabetes have a pre-existing metabolic risk. This risk includes conditions such as enlarged waist circumference, hypertension, and elevated plasma glucose levels. The presence of three of more such conditions should alert a clinician to a patient at metabolic risk, said Dr. James Rosenzweig, director of diabetes services in the Section of Endocrinology, Diabetes and Nutrition at Boston Medical Center, and chair of the task force that developed this guideline.

“The dramatic increase in the incidence of patients at risk for cardiovascular disease and diabetes throughout the developed and developing world requires physicians and other care providers to be aware of the risk factors for these conditions and identify patients at risk in order to initiate treatment,” said Dr. Rosenzweig. “This guideline was developed for just this purpose.”

The guideline recommends that:

•    Health care providers should incorporate into their practice concrete measures to reduce the risk of developing cardiovascular disease or diabetes. These include the regular screening and identification of patients at metabolic risk with measurement of blood pressure, waist circumference, fasting lipid profile, and fasting glucose.

•    Patients with pre-diabetes should be screened at 1- to 2-year intervals for the development of diabetes with either measurement of fasting plasma glucose or a 2-hour oral glucose tolerance test.

•    For the prevention of cardiovascular disease and diabetes, priority should be given to lifestyle management. This includes anti-atherogenic dietary modification, a program of increased physical activity, and weight reduction.

•    All patients having metabolic risk should undergo a 10-year global risk assessment for cardiovascular disease. This scoring will determine the targets for lipoprotein-lowering therapy. The level of intensity of lipoprotein-lowering therapy should be determined by risk reduction, safety, and cost-effectiveness.

Other members of the task force that developed this guideline included Ele Ferrannini of the University of Pisa School in Pisa, Italy.; Scott Grundy of University Texas Southwestern Medicine in Dallas, Tex.; Steven Haffner of the University of Texas Health Science Center in San Antonio, Tex.; Robert Heine of VU University Medical Center in Amsterdam, The Netherlands; Edward Horton of Joslin Diabetes Center in Boston, Mass.; and Ryuzo Kawamori of Juntendo University School or Medicine in Tokyo, Japan.

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Founded in 1916, The Endocrine Society is the world’s oldest, largest, and most active organization devoted to research on hormones, and the clinical practice of endocrinology.  Today, The Endocrine Society’s membership consists of over 14,000 scientists, physicians, educators, nurses and students in more than 80 countries. Together, these members represent all basic, applied, and clinical interests in endocrinology. The Endocrine Society is based in Chevy Chase, Maryland. To learn more about the Society, and the field of endocrinology, visit our web site at www.endo-society.org.

Endocrine Society Releases Guideline on Pediatric Obesity

For Release: October 1, 2008

Contact: Aaron Lohr
Manager, Media Relations
Phone: (240) 482-1380
alohr@endo-society.org
The Endocrine Society has released a new clinical practice guideline for the prevention and treatment of pediatric obesity. A rapid release version of the guideline has been published on-line and will appear in the December issue of the Journal of Clinical Endocrinology & Metabolism (JCEM). Occasionally

The prevalence of obesity in 6- to 11-year-old children increased almost four-fold between 1970 and 2000. Although rates vary among different ethnic groups, the overall prevalence of childhood obesity is 17.1 percent.

“The increased prevalence of childhood obesity is particularly important as it is predictive of adult obesity which is associated with cardiovascular disease, diabetes, metabolic syndrome, and hypertension,” said Dr. Gilbert August of the George Washington School of Medicine in Washington, D.C., and chair of the task force that developed this guideline. “This new guideline provides evidence-based recommendations to prevent and treat this growing epidemic.”

The guideline recommends that:

  • Overweight be defined as having a body mass index (BMI) > 85th percentile by < 95th percentile, and obesity as BMI > 95th percentile.
  • Prescribing and supporting intensive lifestyle (dietary, physical activity, and behavioral) modification as the prerequisite for any treatment.
  • Evaluating for obesity-associated co-morbidities in children with BMI > 85th percentile.
  • Pharmacotherapy (in combination with lifestyle modification) be considered in 1) obese children only after failure of a formal program of intensive lifestyle modification and in 2) overweight children only if severe co-morbidities persist despite intensive lifestyle modification.
  • Pharmacotherapy should be provided only by clinicians who are experienced in the use of anti-obesity agents and aware of the potential for adverse reactions.
  • Bariatric surgery should be pursued for adolescents with BMI > 50, or > 40 with severe co-morbidities in whom lifestyle modification and/or pharmacotherapy have failed.
  • Clinicians should emphasize the prevention of obesity by recommending breast-feeding of infants for at least 6 months and advocating that schools provide for 60 minutes of moderate to vigorous daily exercise in all grades.

Other members of the task force that developed this guideline included Sonia Caprio of Yale University School of Medicine in New Haven, Conn.; Ilene Fennoy of Columbia University in New York, N.Y.; Michael Freemark of Duke University Medical Center in Durham, N.C.; Francine Kaufman of Children’s Hospital of Los Angeles in Calif.; Robert Lustig of University of California San Francisco in Calif.; Janet Silverstein of the University of Florida in Gainesville, Fla.; Phyllis Speiser of Scheider Children’s Hospital in New Hyde Park, N.Y.; Dennis Styne of University of California Davis Medical Center in Sacramento, Calif.; and Victor Montori of the Mayo Clinic in Rochester, Minn.

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Founded in 1916, The Endocrine Society is the world’s oldest, largest, and most active organization devoted to research on hormones, and the clinical practice of endocrinology.  Today, The Endocrine Society’s membership consists of over 14,000 scientists, physicians, educators, nurses and students in more than 80 countries. Together, these members represent all basic, applied, and clinical interests in endocrinology. The Endocrine Society is based in Chevy Chase, Maryland. To learn more about the Society, and the field of endocrinology, visit our web site at www.endo-society.org.

Weight Loss Surgery May Be Associated with Bone Loss

For Release: September 23, 2008

Contact: Aaron Lohr
Manager, Media Relations
Phone: (240) 482-1380
alohr@endo-society.org

Weight loss surgery may be linked to deficiencies in calcium and vitamin D and bone loss, according to a new study accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM).

With the growing epidemic of obesity, many people are opting for surgical procedures to help promote weight loss. While these procedures result in significant and sustained weight loss and reverse many of the complications of obesity, this new study shows there may be harmful effects on calcium and bone metabolism.

“Our research shows that deficiencies of calcium and vitamin D absorption occur following gastric bypass surgery,” said Dr. Shonni J. Silverberg, professor of medicine at Columbia University College of Physicians & Surgeons in New York, N.Y., and coauthor of the study. “When analyzing hip bone density, we found that those who lost the most weight also lost the most bone.”

In this study, researchers evaluated 23 morbidly obese men and women who underwent gastric bypass surgery. Dr. Silverberg and her colleagues measured serum calcium, vitamin D, and parathyroid hormone levels before surgery and at three, six, and twelve months after surgery. Researchers also measured bone mineral density before and after surgery using dual-energy x-ray absorptiometry (DXA). One year after weight loss surgery, patients had lost an average of 99 pounds and had significant declines in hip bone mineral density (both total hip and femoral neck measurements).

“The calcium and vitamin D deficiencies may be due to the alterations in the gastrointestinal tract that take place during these procedures,” said Dr. Silverberg. “These deficiencies may be restored if the amount of calcium and vitamin D supplementation is increased appropriately.”

The findings from this study highlight the importance of assessing calcium sufficiency and skeletal health in the increasing numbers of individuals undergoing these procedures, said Dr. Silverberg. She adds that further studies are needed to discover how these findings relate to bone quality and fracture risk.

Other researchers working on the study include J. Fleischer, E.M. Stein, M. Della Badia, D.J. McMahon, M. Bessler, N. Restuccia, and L. Olivero-Rivera of Columbia University College of Physicians in New York, N.Y.

The article “The Decline in Hip Bone Density Following Gastric Bypass Surgery is Associated with Extent of Weight Loss,” will appear in the October issue of JCEM.

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Founded in 1916, The Endocrine Society is the world’s oldest, largest, and most active organization devoted to research on hormones, and the clinical practice of endocrinology.  Today, The Endocrine Society’s membership consists of over 14,000 scientists, physicians, educators, nurses and students in more than 80 countries. Together, these members represent all basic, applied, and clinical interests in endocrinology. The Endocrine Society is based in Chevy Chase, Maryland. To learn more about the Society, and the field of endocrinology, visit our web site at www.endo-society.org.