Currently browsing posts about: Obesity

I subscribe to Pet Food Industry and greatly admire the superb quality of its reporting.

Here’s an example:

Pet obesity 2023: owners oblivious, vets scared to talk: Pet owners may be largely unaware that there is a problem, especially with their own dogs and cats, despite years of warnings.

Several items in this article got my attention.

A.  It is based on a survey by The Association for Pet Obesity (APOP).  Pet obesity is such a widespread problem that it has induced formation of a society to address it.

B.  Pet owners do not recognize that their pets are overweight.

The survey found only 28% of cat owners and 17% of dog owners to say their pets were overweight.  Instead,  84% of dog owners and 70% of cat owners said their pets’ weights were healthy.

Veterinarians say 59% of dogs and 61% of cats are overweight or obese, and percentages are rising.

C.  Veterinarians are reluctant to discuss obesity with pet owners.

Although the survey found 84% of veterinarians to report encountering “pet owners who appeared embarrassed or angry when told their pet was overweight,” only 4% of owners thought their veterinarian would be uncomfortable discussing the issue.

Comment

None of this should be surprising, as I think about it.  Doctors avoid discussing obesity with human patients (embarrassment, stigma, and lack of time, empathy, or satisfactory treatment approaches).  Obesity has become the “O” word.

An astonishing 75% of U.S. adults are overweight or obese, and children are also getting there.

We, as a society, need to prevent this kind of weight gain for ourselves, our kids, and our pets.

How to do this requires policies, and lots of them, all at once.  Policies require politics.  Politics requires advocacy.

We need all of these, and right away.

Resources

Sunday’s New York Times has an entire section on pets.

Information about my book with Malden Nesheim on pet food issues, Feed Your Pet Right, is here.

As I keep saying, eating less is bad for business.

If you need proof, just look at how the food industry is scrambling to figure out what to do in response to the effects of GLP-1 drugs in decreasing appetite and food “noise.”

Here are a few examples.

The threat

Weight loss drugs may be melting US ice cream demand: Demand for frozen dairy products in the US has been declining for decades. Consumers’ growing interest in GLP-1 weight loss products is putting further pressure on demand…. Read more

Ozempic’s Effect on Food Innovation: Anti-obesity drugs have dropped on the food business in the last year like ChatGPT has dropped on the world. And according to experts assembled for a recent Mattson webinar on the topic, the effects of new appetite suppressants including Ozempic, Wegovy, and Zepbound have only begun to be felt among American consumers and the food industry that sells to them.

The promise

Nestlé introduces Vital Pursuit brand to support GLP-1 users in the US: Nestlé is introducing Vital Pursuit, a new line of foods intended to be a companion for GLP-1 weight loss medication users and consumers focused on weight management in the US. The products are high in protein, a good source of fiber, contain essential nutrients, and they are portion-aligned to a weight loss medication user’s appetite. The new line is also well-suited to support a balanced diet for anyone on a weight management journey. Vital Pursuit is the first food brand from Nestlé intended for GLP-1 users with the goal of complementing the eating habits of millions of Americans who are currently prescribed a weight loss medication or actively working to manage their weight.

Food Companies Want a Piece of the Ozempic Pie, Too: Last fall, word of a looming existential threat to the packaged food industry began to bubble up in earnings calls and among analysts. Drugs such as Ozempic, Wegovy and Mounjaro, experts feared, could be a little too effective at curtailing people’s cravings for snacks and sweets, and if too many people got on the drugs, their changing habits could eventually do the industry real harm. Could buyers begin to forsake Doritos and Oreos and Pizza Bagels?

Danone Targets Health, Nutrition as Food Industry Braces for Ozempic Era: The food company is targeting like-for-like sales growth of 3%-5% for the 2025 to 2028 period, with operating income rising at a faster pace than sales. Danone plans to double down on health and nutrition in the coming years as food companies seek to tackle the effects of Ozempic and other blockbuster weight-loss drugs on eating habits.

Supergut’s Marc Washington on ‘Ozempic era’ opportunity: The IPA World Congress + Probiota Americas 2024 in Salt Lake City highlighted many of the innovations happening in the prebiotics space, including how GLP-1s are impacting the category…. Watch now

There is much discussion these days of the complexity of causes and consequences of excessive gain body fat.  This review addresses the history of what is known—and not known—about obesity., by someone who has been studying it for decades.

Bray GA. Obesity: a 100 year perspective. Int J Obes (Lond). 2024 May 7. doi: 10.1038/s41366-024-01530-6.

His conclusion:

Obesity is both a public health issue and an individual challenge
As noted during the discussion of the Fogarty Center Conference in 1973, the public health community was already aware of the health-related risks associated with obesity even before the explosion in prevalence occurred after 1975. The ensuing pandemic of obesity with some people developing obesity, but not others, challenges modern medicine and public health. As Hippocrates said more than 2500 years ago: “Life is short, art long, opportunity fleeting, experience treacherous, judgment difficult.” The challenge for those of us working in the field of obesity is that there is more to uncover to fully understand and be able to effectively treat people with obesity.

The paper has 137 references.  If you want to learn what the debates are about, this is a great place to begin.

I was thrilled to be invited to be on Oprah last week to discuss the influence of the food environment on obesity.  Alas, I was disinvited when the topic switched to fat shaming.

While recovering from the disappointment, I ran across this article in FoodDive: The Ozempic effect is real: Study zeroes in on GLP-1 users’ food needs.

A study found people taking anti-obesity medications such as Ozempic, Wegovy and Zepbound to be looking for:

• Foods packed with protein
• Smaller portions
• Foods that help quell nausea
• Foods that help reduce gastrointestinal side effects

The potential size of this market is impressive:

Manufacturers looking to create products that cater to this growing market segment – which according to recent research from Goldman Sachs could be as much as 15 million people, or 13% of the U.S. population, by 2030 – should focus on creating products that meet their new needs.

The research group used “its proprietary AI to generate food concepts that it had panel participants evaluate and several were appealing including:

• Pre-portioned grilled chicken strips
• 2-ounce portions of Greek yogurt in pouches
• Electrolyte-enhanced fruit popsicles
• Mini meal cups

Hey—this is a win-win.  First the food industry makes products that people can’t resist eating and make them gain weight.  Then the industry creates products that help them take drugs more easily.

A marketing opportunity for all

At the insistence of Jerry Mande, I watched the meeting of the President’s Council of Advisors on Science and Technology (PCAST) to learn about the Federal Vision for Advancing Nutrition Science in the United States.

This Vision derives from last year’s White House Conference on Hunger, Nutrition, and Health and its pillar on enhancing nutrition research.

Cathie Woteki, who introduced the report, made a forceful case for the importance of chronic disease prevention.  Her committee was shocked  that the majority of Americans are overweight or obese, and at a cost of $500 billion annually.  She pointed out the lack of focus and coordination of 200 existing programs that ought to be addressing this issue.

The conclusion: not enough research on chronic disease and more funding needed.

No question about that.  Yes, we need more nutrition research and more funding for it.  A lot more.

But the White House request for the Office of Nutrition Research is only $1.3 million (see p. 26).  Surely this  is some kind of joke?  It’s hardly even a rounding error in federal terms.

As for the PCAST report’s efforts needed:  That’s all?

Yes we can use more data and research on personal eating habits and individual behavior, but what about the food environment?

Maybe PCAST is under political constrainsts but this sure does feel like a lost opportunity.

The report —as yet unpublished—appears to say nothing about:

• The effects of ultra-processed foods on individual food choices and weight. (the word “ultra-processed” was not mentioned)
• The need to change the food environment to make it easier and less expensive for individuals to make healthier food choices.
• Policies to requirie food companies to produce healthier foods and reduce serving sizes.
• Policies to stop the food industry from marketing ultra-processed foods to kids.
• Programs to achieve the existing 2030 health objectives to prevent obesity and chronic disease (these were not mentioned).

The committee said it consulted widely to produce this report.  Not widely enough, I’d say.

Compare this to what the UK House of Lords is doing in its hearings on  Food, Diet and Obesity.  Take a look at who they are listening to.

If the PCAST committee talked to any of these people, their comments are not showing up.

PCAST has a real opportunity here to push for a strong research and policy agenda to address obesity and its related chronic diseases.

What kind? Here are my suggestions.

Today I’m participating on a panel discussion on Ozempic at 12:30 EDT.  See announcement to the right; register for it here. 

I watched the Oprah special on the obesity drugs.

Its messages:

• Obesity is a disease, requiring treatment.
• These drugs offer treatment.
• The drugs are effective; side effects are minimal.
• Yes they are expensive and therefore, promote inequality; therefore, the government should pay for them.

The program was a one-hour, prime-time commercial for the drugs.

The physicians who testified on their behalf consult for the drug companies.

The program has already had an effect.  cause the FDA says semaglutide helps prevent heart attacks, strokes, and deaths in overweigth people, the government will now authorize payment through Medicare Part D.

Here’s what was not discussed.

• The fortunes the drug companies spent on getting doctors, health professionals, and influencers to promote the drugs and minimize their side effects.  See Reuters for US doctors and The Guardian for European influencers.
• The sharp rise in obesity prevalence between 1980 and 2000 and the environmental and commercial reasons for it.
• Anything about prevention. and changing that food environment.
• Anything serious about the down side of taking the drugs (lifetime treatment, cost, side effects, loss of joy in eating).

An editorial in The Lancet says:

A simple pill or injection will undoubtedly help some patients, but it cannot be the sole basis for addressing the complexities of obesity. Obesity is a product of not only an individual’s circumstances and behaviour, but also society at large, shaped by global food markets and trade agreements. Multidimensional approaches are needed to curb the effects of the obesogenic environment, particularly against an international industry that promotes overproduction of cheap food and drinks. Physical activity needs to increase; walking and cycling for journeys to work or school should be normalised and made easier and safer. Sugar taxes and curbs on marketing of high-energy, high-fat, ultra-processed foods need to be implemented. Prevention must be the foundation upon which everything else follows.

Other comments

• The New York Times account focuses on stigma.
• USA Today says people are suing the drug companies over side effects.

Much to be said about all this.  Stay tuned.

On Thursdays I like posting things I want everyone to enjoy.

This one, I stole from Tamar Haspel, who writes about food for the Washington Post.

I follow her on X (the site formerly known as Twitter), where she recently posted:

This could be my all-time favorite BMI correlation!

In China and post-Soviet states, BMI correlates with corruption. The fatter, the crookeder.

The correlation she cites is from an article in the Economist, Are Overweight Politicians Less Trustworthy?

I agree.  This is a fabulous example of how correlation does NOT mean causation—a basic tenet of epidemiology often forgotten.

But here’s my personal favorite example.  I laugh every time I see it.

No, the Dietary Guidelines did not cause the prevalence of obesity to rise.

This is correlation, NOT causation.

For causes, please consider food overproduction, pressures on food companies to sell food when there is so much of it, and the shareholder value movement, which demands not only profits, but  continual growth in profits.  All of these forced food companies to find new ways to get everyone to eat more food (by creating an “eat more” food environment.  I discuss all this in Food Politics and my other books).

Correlation is lots of fun but causation requires much deeper analyses.

Sorry about that.

Thanks Tamar.

Jerry Mande, a co-founder of Nourish Science wrote me to urge support for a national action plan to reduce obesity—and the chronic diseases for which it raises risks. (Note: he also has an op-ed in The Hill on NIH research and leadership needs).

Here is what we should do. It’s time for a new federal nutrition goal. For decades it’s been some variation of “access to healthier options and nutrition information.” Jim Jones [the new head of food and nutrition at FDA] used that last week in his vision for the new human foods program. It’s in USDA FNS’s mission too. The WaPo reporting on life expectancy, fatty liver disease, & Lunchables in school meals reveals that goal has failed and needs to be replaced.

The goal should be updated to: ensuring that every child reaches age 18 at a healthy weight and in good metabolic health. Cory Booker proposed making it the U.S. goal in his attached letter to Susan Rice on the WHC [White House Conference]. It’s part of the Nourish Science vision.

It’s doable.  USDA has the necessary power, reach, and resources. Over half of infants are on WIC, 1/3 of children in CACFP [Child and Adult Care Feeding Program], virtually all in school meals, and almost ½ of SNAP recipients are under 18. If we leveraged those programs to achieve the new goal and with FDA’s & CDC’s help, we could make substantial progress. For example, USDA was able to raise school meal HEI [Healthy Eating Index] scores from failing U.S. average of 58 to an acceptable 82 in just three years.

We have a successful blueprint in FDA regulation of tobacco. When we began our FDA investigation in 1993 1/3 of adults and ¼ of kids smoked cigarettes. Today we have a $700M FDA tobacco center and 11% of adults and only 2% of high school students smoke cigarettes.

We should set the new goal in the upcoming Farm Bill. We should change USDA’s name to the U.S. Department of Food and Agriculture and state the new goal.

The only needed ingredient to make this happen is an effective federal nutrition champion. That’s how tobacco happened.

I’m optimistic. We can do this.

I like the vision.  I’m glad he’s optimistic.  Plenty of work to do to get this on the agenda.

Some background

• The CDC on how nearly 70% of American adults are overweight or have obesity.
• My report on the White House Conference, a year ago
• Politico (Helena Bottemiller Evich, now at Food Fix)  on how diet- and obesity-related diseases are a huge public health problem, especially for COVID-19, but no government program exists to prevent them.
• Politico (Catherine Boudreau and Helena Bottemiller Evich) on how federal research on prevention of diet- and obesity-related diseases hardly exists.