By Pierre Bourdieu (London: Routledge, 2010), xxx + 607 pp. £15.99 paper. A combination of social theory, statistical data, illustrations, and interviews, Distinction: A Social Critique of the Judg...

Distinction: A Social Critique of the Judgement of Taste

The prevalence of obesity has increased worldwide in the past ~50 years, reaching pandemic levels. Obesity represents a major health challenge because it substantially increases the risk of diseases such as type 2 diabetes mellitus, fatty liver disease, hypertension, myocardial infarction, stroke, dementia, osteoarthritis, obstructive sleep apnoea and several cancers, thereby contributing to a decline in both quality of life and life expectancy. Obesity is also associated with unemployment, social disadvantages and reduced socio-economic productivity, thus increasingly creating an economic burden. Thus far, obesity prevention and treatment strategies - both at the individual and population level - have not been successful in the long term. Lifestyle and behavioural interventions aimed at reducing calorie intake and increasing energy expenditure have limited effectiveness because complex and persistent hormonal, metabolic and neurochemical adaptations defend against weight loss and promote weight regain. Reducing the obesity burden requires approaches that combine individual interventions with changes in the environment and society. Therefore, a better understanding of the remarkable regional differences in obesity prevalence and trends might help to identify societal causes of obesity and provide guidance on which are the most promising intervention strategies.

Obesity: global epidemiology and pathogenesis.

Mini Mental State

Context Obesity is a risk factor for cardiovascular events. Weight loss might protect against cardiovascular events, but solid evidence is lacking. Objective To study the association between bariatric surgery, weight loss, and cardiovascular events. Design, Setting, and Participants The Swedish Obese Subjects (SOS) study is an ongoing, nonrandomized, prospective, controlled study conducted at 25 public surgical departments and 480 primary health care centers in Sweden of 2010 obese participants who underwent bariatric surgery and 2037 contemporaneously matched obese controls who received usual care. Patients were recruited between September 1, 1987, and January 31, 2001. Date of analysis was December 31, 2009, with median follow-up of 14.7 years (range, 0-20 years). Inclusion criteria were age 37 to 60 years and a body mass index of at least 34 in men and at least 38 in women. Exclusion criteria were identical in surgery and control patients. Surgery patients underwent gastric bypass (13.2%), banding (18.7%), or vertical banded gastroplasty (68.1%), and controls received usual care in the Swedish primary health care system. Physical and biochemical examinations and database cross-checks were undertaken at preplanned intervals. Main Outcome Measures The primary end point of the SOS study (total mortality) was published in 2007. Myocardial infarction and stroke were predefined secondary end points, considered separately and combined. Results Bariatric surgery was associated with a reduced number of cardiovascular deaths (28 events among 2010 patients in the surgery group vs 49 events among 2037 patients in the control group; adjusted hazard ratio [HR], 0.47; 95% CI, 0.29-0.76; P = .002). The number of total first time (fatal or nonfatal) cardiovascular events (myocardial infarction or stroke, whichever came first) was lower in the surgery group (199 events among 2010 patients) than in the control group (234 events among 2037 patients; adjusted HR, 0.67; 95% CI, 0.54-0.83; P  Conclusion Compared with usual care, bariatric surgery was associated with reduced number of cardiovascular deaths and lower incidence of cardiovascular events in obese adults.

Bariatric Surgery and Long-term Cardiovascular Events

Mental health issues often co-occur with other problems such as substance abuse, and they can take an enormous toll on individuals and impact a college or university in many ways. There are staff and departments both onand off-campus who are concerned about the well-being of students and the impact of mental health issues, so partnerships around mental health promotion and suicide prevention make good sense.

전자/제조업의 Collaboration 전략

Background: Body dissatisfaction has been identified as a psychological correlate of obesity that is related to disordered eating, poor self-esteem, and depressio

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Body Dissatisfaction in Individuals with Obesity Compared to Normal-Weight Individuals: A Systematic Review and Meta-Analysis.

SummaryBackground
Research on obesity has shown that stigma often accompanies obesity and impacts many life domains. No previous research has systematically reviewed published literature about the prevalence and the nature of perceived weight discrimination in individuals with obesity. This systematic review and meta-analysis aims to fill that gap.

Methods
A systematic literature search was conducted without time limits using the databases Medline, ISI Web of Knowledge and the Cochrane Library. Meta-analyses were performed using random effect models. Observational studies pertaining to (i) prevalence estimates and (ii) forms of perceived weight discrimination among individuals with obesity were included.

Results
Of 4393 citations retrieved, nine citations retrieved, nine studies met inclusion criteria. Pooled prevalence was 19.2% (95% confidence interval (CI) 11.7 to 29.8%) for individuals with class I obesity (Body mass index [BMI] = 30–35 kg m−2) and 41.8% (95% CI 36.9 to 46.9%) for individuals with more extreme obesity (BMI > 35 kg m−2). Findings from nationally representative US samples revealed higher prevalence estimates in individuals with higher BMI values (BMI > 35 kg m−2) and in women.

Conclusions
The results provide evidence that perceptions of weight discrimination by individuals with obesity were common, and its negative consequences are highly relevant issues within society and need to be the focus of potential interventions. © 2015 World Obesity

Obesity and discrimination - a systematic review and meta-analysis of observational studies.

Orthorexia is described as a strict, health-oriented eating pattern with clinically significant impairment in everyday life. Its prevalence varied widely in previous studies due to heterogenous assessment procedures. Determinants for the eating pattern and its prevalence have not been investigated in larger representative studies. A population-based telephone survey in Germany was conducted in n = 1007 participants. The Dusseldorf Orthorexia Scale with a cut-off of 30 was used to assess orthorexic behavior. Determinants of orthorexia, including personal BMI, depressive symptoms Patient Health Questionnaire and socio-demographic variables were analyzed in multivariate regression. The prevalence of orthorexic behavior was 6.9%. A higher rate of orthorexic behavior was observed in heavier, less educated, vegetarian and more depressed participants; in multivariate analysis only associations to lower educational attainment, a vegetarian diet and depressive symptoms remained. No gender or age differences were observed. The study results show that orthorexic behavior may indeed by associated with significant strain and psychological distress. Current debates on the criteria of clinical significance of orthorexic behavior call for new instruments and further investigations, to elicit the prevalence of people with orthorexic behavior that classifies as a pathological eating disorder. Level V: descriptive study.

Is orthorexic behavior common in the general public? A large representative study in Germany.

Aim 
Negative attitudes towards people with obesity are common even in health care settings. So far, the attitudes and causal beliefs of dietitians and nutritionists have not been investigated systematically. The aim of this article was to review the current state of quantitative research on weight-related stigma by dietitians and nutritionists.


Method 
A systematic literature review was conducted in 2014 using PubMed, PsycINFO, Web of Science and Cochrane Library.


Results 
Eight studies were found that differ in regard to study characteristics, instruments and the origin of the sample. Six out of eight studies reported weight stigma expressed by dietitians and nutritionists. Their believed causes of obesity indicated a defined preference for internal factors rather than genetics or biology.


Discussion 
Results of studies were not homogenous. The degree of negative attitudes by dietitians and nutritionists towards people with obesity appeared to be slightly less pronounced compared to the general public and other health care professionals. Stigma and its consequences should be included into educational programs to optimally prepare dietitians and nutritionists.

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Dietitians and Nutritionists: Stigma in the Context of Obesity. A Systematic Review

Obesity is associated with physical and medical restrictions and comorbidities, but it also entails psychosocial effects such as social isolation and feelings of rejection The aim of this study was to investigate the link between loneliness and weight stigma in a large sample of obese individuals Results were derived from a large representative sample (n = 1,000) The survey included the 3-item version of the UCLA loneliness scale, the Patient Health Questionnaire (PHQ-9) as well as the Weight Bias Internalization scale (WBIS) The mean UCLA score was 1943 (SD = 0771) Respondents with higher levels of depression (B = 0176), higher internalized weight bias (B = 0435), and the experience of discrimination (B = 0286) reported higher levels of loneliness Future studies should investigate the mediation pathways between obesity, loneliness, and its determinants to provide a framework for successful interventions as part of obesity management programs

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Claudia Luck-Sikorski

Papers

Body Dissatisfaction in Individuals with Obesity Compared to Normal-Weight Individuals: A Systematic Review and Meta-Analysis.

Obesity and discrimination - a systematic review and meta-analysis of observational studies.

Is orthorexic behavior common in the general public? A large representative study in Germany.

Dietitians and Nutritionists: Stigma in the Context of Obesity. A Systematic Review

Overweight and Lonely? A Representative Study on Loneliness in Obese People and Its Determinants.