Less Added Sugar, Health Outcome Measurements, More Utilization of Metabolic Surgery, and Diabetes Prevention Programs among Expectations for the Year Ahead
A Message from Dr. Christopher Still
Christopher Still, DO, FACN, FACP, Co-Clinical Editor, Bariatric Times; Medical Director for the Center for Nutrition and Weight Management, and Director for Geisinger Obesity Research Institute, Geisinger Medical Center, Danville, Pennsylvania.
First, I’d like to wish everyone a Happy New Year! 2016 was a wonderful year for our field. Among the highlights were an increase in the number physicians specializing in obesity medicine; consensus from diabetes organizations worldwide recognizing metabolic surgery as a standard treatment option for type 2 diabetes mellitus (T2DM); and completion of a nationally representative survey aimed to gauge public perception of obesity, its risks, and available treatment methods.
As we look toward a new year, many are evaluating the past and making predictions for the future. Recently, Ted Kyle, RPh, MBA, who is involved in the Obesity Society’s Advocacy Committee, STOP Obesity Alliance’s Steering Committee, and the Obesity Action Coalition Board of Directors, listed his 10 expectations for 2017 for obesity, food, and health. The article, titled “Pathway to the Future: Ten Expectations for 2017 in Obesity, Food, and Health,” was published on Mr. Kyle’s blog ConscienHealth, which offers other interesting, up-to-date postings on relevant news in the healthcare industry. This month, I’d like to share these expectations and also offer my own commentaries on the top five. Click here for the complete list.
1. More “Less Added Sugar.” Mr. Kyle states that we will see less added sugar in food products, and rightfully so as the food industry added sugar to foods, such as yogurt, years ago when removing the fat during the low-fat nutrition fashion. I think this is a huge expectation and one that I hope we see realized. There is a lot of sugar added to food and drink products, especially high fructose corn syrup. It’s important for the public’s health that they remove the sugars that were added to products as studies have shown that sugar overconsumption play a role in obesity and the metabolic syndrome, diabetes, kidney disease, and cardiovascular disease.[2–4]
2. Health Outcomes will be popping up in claims for obesity and diabetes treatments. Mr. Kyle said that the FDA has added one to the official empagliflozin indications for T2DM. Liraglutide and semaglutide also have data to show a benefit. A major cardiovascular outcomes study for lorcaserin is headed toward completion by 2018. I agree with this expectation and would add that we will be seeing not only health outcomes with regards to medications already approved, but also those in the pipeline. These medications have been shown in trials to be helpful in cardiovascular risk and also save lives. This is important because weight loss medications in the past, and even presently as the ASMBS/NORC survey revealed, have been looked upon with skepticism. The good news for 2017 and beyond is that not only are there more safe and effective medications, but they have also been shown to decrease mortality and improve health outcomes.
3. Metabolic Surgery for people with type 2 diabetes and obesity is due for growth next year. Around the globe, 45 professional organizations have called for expanded use to put diabetes into remission. This is exactly right and I would add the importance that these recommendations include bariatric surgery as an option for individuals with T2DM and BMI 30.0–34.9 kg/m2 who have failed to control their disease with medications. Additionally, the guidelines addressed consideration of patients ethnicity and research has shown that certain populations experience T2DM at lower BMIs.
4. Smarter Fitness Trackers will do a better job of engaging consumers for long-term use. Mr. Kyle predicts that fitness trackers will evolve to combine ease of use, engagement, and intelligence. I think that despite the study that came out questioning the effectiveness and accurateness of fitness trackers, they still have role in weight loss and health improvement because they help keep the user accountable. They also keep individuals mindful of their activity, regardless. Perhaps an evolved version of these devices will show a significant benefit to weight loss efforts in future studies.
5. Diabetes Prevention will take hold on a big way now that CMS is gearing up to cover the DPP everywhere through the YMCA and other low-cost providers. Private sector health plans are following quickly. This is another important and impactful expectation. If you look recent numbers of T2DM and pre-diabetes incidences, you can see that this is becoming a big health problem in the United States. The National Diabetes statistics report of 2014 reported that 29.1 million people or 9.3% of the U.S. population had diabetes. The Diabetes Prevention Program (DPP) and Look AHEAD (The Action for Health in Diabetes) trials have shown that modest weight loss of 5 to 7 percent can help prevent diabetes. Now, these prevention programs are popping up in areas other than the comprehensive weight management facility like YMCAs.
Thank you to Mr. Ted Kyle for providing such a thought-provoking list of expectations. I think 2017 is off to a good start so far. We don’t know exactly what the future holds, but we can be diligent in our everyday commitment to treat our patients and advance our field in hopes of a better tomorrow.
Christopher Still, DO, FACN, FACP
1. Kyle T. Ten Expectations for 2017 in Obesity, Food, and Health. ConscienHealth. January 1, 2017. http://conscienhealth.org/2017/01/ten-expectations-2017-obesity-health/. Accessed 1/1/17.
2. Velasquez-Melendez G, Molina MD, et al. Sweetened Soft Drinks Consumption Is Associated with Metabolic Syndrome: Cross-sectional Analysis from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). J Am Coll Nutr. 2016:1–9. [Epub ahead of print]
3. Lee AK, Chowdhury R, Welsh JA. Sugars and adiposity: the long-term effects of consuming added and naturally occurring sugars in foods and in beverages. Obes Sci Pract. 2015 Oct;1(1):41-49. Epub 2015 Oct 9.
4. Te Morenga L, Mallard S, Mann J. Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies. BMJ. 2012;346:e7492.
5. Rubino F, Nathan DM, Eckel RH, et al. Metabolic Surgery in the Treatment Algorithm for Type 2 Diabetes: A Joint Statement by International Diabetes Organizations. Diabetes Care. 2016 Jun;39(6):861-77. 6. Centers for Disease Control and Prevention. National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States, 2014. Atlanta, GA: U.S. Department of Health and Human Services; 2014.