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Genomics, Proteomics and Bioinformatics
by ruth on March 10, 2009
Scientists may have found a promising new treatment for obesity using gene therapy. They have discovered that a particular gene called BDNF, can result in improved insulin sensitivity, reduced fat mass and weight loss when active in the hypothalamus.
The findings have been published online in the journal Nature Medicine, and human trials are being planned.
According to first author Lei Cao, assistant professor in the department of molecular virology, immunology and medical genetics, the study involved injecting the BDNF gene in normal mice, diabetic mice and mice fed with a high fat diet, to determine how the gene transfer would affect their weight. "The gene was active in the overweight mice, but as they lost weight the gene expression was essentially 'dialed down,' using a novel RNA interference approach, thus stopping the weight from continuing to decrease and allowing a stable target weight to be reached," she says.
The findings have been published online in the journal Nature Medicine, and human trials are being planned.
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With excessive weight, obesity has been defined as when excess body fat accumulates in one to where their physical overgrowth makes the person unhealthy to varying degrees.
Obesity is different than being overweight, as others determine obesity to be of a more serious concern.
While obesity is not a disease, it is a serious health risk for one who has this risk.
As measured by one’s body mass index (BMI), one’s BMI of 25 to 30 kg/m is considered overweight.
If one's BMI is 30 to 35 kg/m, such a person is class I obese, 35 to 40 BMI would be class II obese, and any BMI above 40 is class III obesity.
Presently, with obesity affecting children progressively more, the issue of obesity has become a serious public health concern.
In the United States, greater than one third of all citizens are obese, and this number continues to progress.
Approximately half of all children under the age of 12 are either obese are overweight.
About twenty percent of children ages 2 to 5 years old are either obese are overweight.
The consequences of these stats on our children are very concerning, considering the health issues they may or likely experience as they get older.
Worldwide, nearly one and a half billion people are either obese or overweight. In the United States, about one third of adults are considered either obese or overweight.
Women of low socioeconomic status are likely to be possibly twice as obese compared with those who are not at this status.
It is now predicted that, for the first time in about 150 years, our life expectancy is suppose to decline because primarily of this obesity problem.
Morbid obesity is defined as one who has a body mass index of 30 kg/m or greater, and this surgery, along with the three other types of surgery for morbid obesity, should be considered a last resort after all other methods to reduce the patient’s weight have chronically failed.
Morbid obesity greatly affects the health of the patient in a very negative way. It has about 10 co-morbidities that can develop if the situation is not corrected.
Some if not most of these co-morbidities are life-threatening.
One solution beneficial in many cases of morbid obesity if one’s obesity is not eventually controlled or corrected is what is known as gastric bypass surgery.
This is a type of bariatric surgery that essentially reduces the volume of the human stomach in order to correct and treat morbid obesity by surgical re-construction of the stomach and small intestine.
Patients for such surgeries are those with a BMI of greater than 40, or a BMI greater than 35 if the patient has co-morbidities aside from obesity.
This surgery should be considered for the severely obese when other treatment options have failed.
The standard of care illustrating as to whether this surgery is reasonable and necessary should be clarified by the health care provider as well as the patient.
There are three surgical variations of gastric bypass surgery, and one is chosen by the surgeon based on their experience and success from the variation they will utilize.
Generally, these surgeries are procedures related to gastric restrictive operations or mal-absorptive operations.
Over 200,000 gastric bypass surgeries are performed each year, and this surgery being performed continues to progress as a suitable option for the morbidly obese.
There is evidence that this surgery is particularly beneficial for those obese patients that have non-insulin dependent Diabetes Mellitus as well.
It is believed that the results of this surgery to correct morbid obesity greatly limits or prevents such co-morbidities associated with those who are obese.
Yet about two percent of those who undergo this surgery die as a result from about a half a dozen complications that could occur.
However, the surgery reduces the overall mortality of the patient by 40 percent or so, yet this percentage is debatable due to conflicting clinical studies at times.
Age of the patient should be taken into consideration to determine if the risks of this type of surgery outweigh the potential benefits or not.
Such candidates may have co-morbidities that have already caused physiological damage to the patient.
Also what should be determined by the surgeon is the amount of safety, effectiveness, and rationale for a particular patient regarding those patients who are elderly, for example.
Many feel bariatric surgery such as this should be considered as a last resort when exercise and diet have failed for a great length of time. There are risks with this type of surgery, such as gastric rupture or ulceration.
Such issues should be discussed with one’s health care provider.
If a person or a doctor is considering this type of surgery, there is a website dedicated to bariatric surgery, which is:
www.asmbs.org,
Dan Abshear