Simulating the Fiscal Impact of Anti-Obesity Medications as an Obesity Reduction Strategy

While substantial public health investment in anti-smoking initiatives has had demonstrated benefits on health and fiscal outcomes, similar investment in reducing obesity has not been undertaken, despite the substantial burden obesity places on society. Anti-obesity medications (AOMs) are poorly prescribed despite evidence that weight loss is not sustained using other strategies alone. We used a simulation model to estimate the potential impact of 100% uptake of AOMs on Medicare and Medicaid spending, disability payments, and taxes collected relative to status quo with negligible AOM use. Relative to status quo, AOM use simulation would result in Medicare and Medicaid savings of $231.5 billion and $188.8 billion respectively over 75 years. Government tax revenues would increase by $452.8 billion. Overall, the net benefit would be $746.6 billion. Anti-smoking efforts have had substantial benefits for society. A similar investment in obesity reduction, including broad use of AOMs, should be considered.

Download Full-text

Reframing Fatness: Critiquing ‘Obesity’

10.3366/edinburgh/9781474400046.003.0012 ◽

2018 ◽

Author(s):

Bethan Evans ◽

Charlotte Cooper

Keyword(s):

Public Health ◽

Weight Loss ◽

Michel Foucault ◽

Overweight And Obesity ◽

Health Concern ◽

Public Health Concern ◽

Policy Language ◽

Religious Imagery ◽

Fat Bodies

Over the last twenty years or so, fatness, pathologised as overweight and obesity, has been a core public health concern around which has grown a lucrative international weight loss industry. Referred to as a ‘time bomb’ and ‘the terror within’, analogies of ‘war’ circulate around obesity, framing fatness as enemy.2 Religious imagery and cultural and moral ideologies inform medical, popular and policy language with the ‘sins’ of ‘gluttony’ and ‘sloth’, evoked to frame fat people as immoral at worst and unknowledgeable victims at best, and understandings of fatness intersect with gender, class, age, sexuality, disability and race to make some fat bodies more problematically fat than others. As Evans and Colls argue, drawing on Michel Foucault, a combination of medical and moral knowledges produces the powerful ‘obesity truths’ through which fatness is framed as universally abject and pathological. Dominant and medicalised discourses of fatness (as obesity) leave little room for alternative understandings.

Download Full-text

Non-stigmatising alternatives to anti-obesity public health messages: Consequences for health behaviour and well-being

Journal of Health Psychology ◽

10.1177/1359105321999705 ◽

2021 ◽

pp. 135910532199970

Author(s):

Joanne A Rathbone ◽

Tegan Cruwys ◽

Jolanda Jetten

Keyword(s):

Public Health ◽

Weight Loss ◽

Experimental Studies ◽

Health Behaviours ◽

Well Being ◽

Health Messages ◽

Total N ◽

Positive Effects ◽

Public Health Messages ◽

Size Acceptance

This project investigated how alternative non-stigmatising public health messages influence people’s health behaviours and well-being, relative to traditional stigmatising weight-loss messages. We conducted three experimental studies (total N = 1281) that compared traditional weight-loss messages to weight-neutral messages (Study 1), weight-inclusive messages (Study 2) and size acceptance messages (Study 3). Results revealed that public health messages have differential effects on health behaviours and well-being, depending on the audience’s BMI or perceived weight. However, campaigns that challenge weight stigma and promote body positivity have positive effects on some psychological indicators of health and well-being for people of all body sizes.

Download Full-text

Effect of a weight loss program on serum adiponectin and insulin resistance among overweight and obese premenopausal females

Journal of Egyptian Public Health Association ◽

10.1186/s42506-020-00060-z ◽

2020 ◽

Vol 95 (1) ◽

Author(s):

Walaa H. Foula ◽

Rana H. Emara ◽

Mona K. Eldeeb ◽

Samiha A. Mokhtar ◽

Fikrat A. El-Sahn

Keyword(s):

Public Health ◽

Insulin Resistance ◽

Weight Loss ◽

Adiponectin Level ◽

Normal Weight ◽

Weight Loss Program ◽

Serum Adiponectin ◽

Health Clinic ◽

Serum Adiponectin Level ◽

Health Crisis

Abstract Background Obesity has emerged as a public health crisis in many populations including Egypt. Adipose tissue produces a number of adipokines, one of them is adiponectin which has attracted much attention because of its antidiabetic and antiatherogenic effects. Objective To determine the effect of a weight loss program on serum adiponectin level and insulin resistance among overweight and obese adult premenopausal females. Study design A pre-postintervention study was carried out among 95 premenopausal overweight and obese females (body mass index ≥ 25 kg/m2) aged 20 to 40 years at the integrated health clinic affiliated to the High Institute of Public Health, Alexandria, Egypt, from February 2016 to February 2017. All participants underwent a weight loss program based on a reduced calorie balanced diet and advised to increase their physical activity. Dietary instructions and follow-up were done weekly throughout 16 weeks. Blood samples were collected to investigate serum adiponectin level and insulin resistance at the beginning and the end of the intervention. Results After 16 weeks, a significant decrease in body weight by 9.7% was associated with a significant increase in serum adiponectin from 13.3 ± 4.9 μg/ml to 18.5 ± 5.6 μg/ml. Both fasting insulin and insulin resistance had decreased significantly by 13.6% and 13.7%, respectively. Conclusion A weight reduction program depending on a reduced calorie diet for 16 weeks was associated with a significant increase in total adiponectin level and reduction in insulin resistance. An emphasis on the importance of keeping normal weight through nutritional education and the promotion of healthy diets is recommended to reduce the risk of occurrence of insulin resistance, type 2 diabetes, and cardiovascular diseases.

Download Full-text

Weighing in on heart failure: the potential impact of bariatric surgery

Heart Failure Reviews ◽

10.1007/s10741-021-10078-w ◽

2021 ◽

Author(s):

Tanuka Datta ◽

Andrew J. Lee ◽

Rachel Cain ◽

Melissa McCarey ◽

David J. Whellan

Keyword(s):

Heart Failure ◽

Bariatric Surgery ◽

Weight Loss ◽

Cardiovascular System ◽

Economic Burden ◽

Treatment Strategies ◽

It Impacts ◽

Potential Impact ◽

The Individual ◽

Physiologic System

AbstractObesity is a growing worldwide epidemic with significant economic burden that carries with it impacts on every physiologic system including the cardiovascular system. Specifically, the risk of heart failure has been shown to increase dramatically in obese individuals. The purpose of this review is to provide background on the individual burdens of heart failure and obesity, followed by exploring proposed physiologic mechanisms that interconnect these conditions, and furthermore introduce treatment strategies for weight loss focusing on bariatric surgery. Review of the existing literature on patients with obesity and heart failure who have undergone bariatric surgery is presented, compared, and contrasted.

Download Full-text

Public health impact of low-dose aspirin on colorectal cancer, cardiovascular disease and safety in the UK – Results from micro-simulation model

IJC Heart & Vasculature ◽

10.1016/j.ijcha.2021.100851 ◽

2021 ◽

Vol 36 ◽

pp. 100851

Author(s):

Jorne Biccler ◽

Kaatje Bollaerts ◽

Pareen Vora ◽

Elodie Sole ◽

Luis Alberto Garcia Rodriguez ◽

...

Keyword(s):

Public Health ◽

Colorectal Cancer ◽

Cardiovascular Disease ◽

Simulation Model ◽

Low Dose ◽

Health Impact ◽

Dose Aspirin ◽

Low Dose Aspirin ◽

Micro Simulation ◽

The Uk

Download Full-text

MODELING ANTIBIOTIC RESISTANCE IN PREGNANT WOMAN AND FETUS

Journal of Biological System ◽

10.1142/s0218339011004093 ◽

2011 ◽

Vol 19 (03) ◽

pp. 505-520

Author(s):

HAI-FENG HUO ◽

JUN LI ◽

YU-NING LI

Keyword(s):

Public Health ◽

Pregnant Woman ◽

Transmission Dynamics ◽

Resistant Bacteria ◽

Uniform Persistence ◽

Antibiotic Residues ◽

Global Public Health ◽

Antibiotic Resistant ◽

Gestational Period ◽

Potential Impact

Infection caused by antibiotic-resistant pathogens is one of global public health problems. Many factors contribute to the emergence and spread of these pathogens. A model which describes the transmission dynamics of susceptible and resistant bacteria in a pregnant woman and the fetus is presented. Detailed qualitative analysis about positivity, boundedness, global stability and uniform persistence of the model is carried out. Numerical simulation and sensitivity analysis show that antibiotic input has potential impact for neonatal drug resistance. Our results show that the resistant bacteria in baby mainly come from antibiotics which are wrongly-used during gestational period, or foods containing antibiotic residues.

Download Full-text

Climate-related migration and population health: social science-oriented dynamic simulation model

BMC Public Health ◽

10.1186/s12889-020-10120-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Rafael Reuveny

Keyword(s):

Public Health ◽

Social Science ◽

Simulation Model ◽

Environmental Health ◽

Dynamic Simulation ◽

Health Problems ◽

Ecological Impacts ◽

Sensitivity Analyses ◽

Pilot Model ◽

Dynamic Simulation Model

Abstract Background Social science models find the ecological impacts of climate change (EICC) contribute to internal migration in developing countries and, less so, international migration. Projections expect massive climate-related migration in this century. Nascent research calls to study health, migration, population, and armed conflict potential together, accounting for EICC and other factors. System science offers a way: develop a dynamic simulation model (DSM). We aim to validate the feasibility and usefulness of a pilot DSM intended to serve as a proof-of-concept and a basis for identifying model extensions to make it less simplified and more realistic. Methods Studies have separately examined essential parts. Our DSM integrates their results and computes composites of health problems (HP), health care (HC), non-EICC environmental health problems (EP), and environmental health services (ES) by origin site and by immigrants and natives in a destination site, and conflict risk and intensity per area. The exogenous variables include composites of EICC, sociopolitical, economic, and other factors. We simulate the model for synthetic input values and conduct sensitivity analyses. Results The simulation results refer to generic origin and destination sites anywhere on Earth. The effects’ sizes are likely inaccurate from a real-world view, as our input values are synthetic. Their signs and dynamics are plausible, internally consistent, and, like the sizes, respond logically in sensitivity analyses. Climate migration may harm public health in a host area even with perfect HC/ES qualities and full access; and no HP spillovers across groups, conflict, EICC, and EP. Deviations from these conditions may worsen everyone’s health. We consider adaptation options. Conclusions This work shows we can start developing DSMs to understand climate migration and public health by examining each case with its own inputs. Validation of our pilot model suggests we can use it as intended. We lay a path to making it more realistic for policy analysis.

Download Full-text

Public health impact of a US ban on menthol in cigarettes and cigars: a simulation study

Tobacco Control ◽

10.1136/tobaccocontrol-2021-056604 ◽

2021 ◽

pp. tobaccocontrol-2021-056604

Author(s):

David T Levy ◽

Rafael Meza ◽

Zhe Yuan ◽

Yameng Li ◽

Christopher Cadham ◽

...

Keyword(s):

Public Health ◽

Smoking Initiation ◽

Health Impact ◽

Status Quo ◽

Expert Elicitation ◽

Sensitivity Analyses ◽

Public Health Impact ◽

Menthol Cigarette ◽

Life Years ◽

Life Years Lost

IntroductionThe US Food and Drug Administration most recently announced its intention to ban menthol cigarettes and cigars nationwide in April 2021. Implementation of the ban will require evidence that it would improve public health. This paper simulates the potential public health impact of a ban on menthol in cigarettes and cigars through its impacts on smoking initiation, smoking cessation and switching to nicotine vaping products (NVPs).MethodsAfter calibrating an established US simulation model to reflect recent use trends in cigarette and NVP use, we extended the model to incorporate menthol and non-menthol cigarette use under a status quo scenario. Applying estimates from a recent expert elicitation on the behavioural impacts of a menthol ban, we developed a menthol ban scenario with the ban starting in 2021. We estimated the public health impact as the difference between smoking and vaping-attributable deaths and life-years lost in the status quo scenario and the menthol ban scenario from 2021 to 2060.ResultsAs a result of the ban, overall smoking was estimated to decline by 15% as early as 2026 due to menthol smokers quitting both NVP and combustible use or switching to NVPs. These transitions are projected to reduce cumulative smoking and vaping-attributable deaths from 2021 to 2060 by 5% (650 000 in total) and reduce life-years lost by 8.8% (11.3 million). Sensitivity analyses showed appreciable public health benefits across different parameter specifications.Conclusions and relevanceOur findings strongly support the implementation of a ban on menthol in cigarettes and cigars.

Download Full-text

Aging clinical problems: a difficult balance between age and frailty

Monaldi Archives for Chest Disease ◽

10.4081/monaldi.2015.727 ◽

2016 ◽

Vol 84 (1-2) ◽

Author(s):

Renzo Rozzini

Keyword(s):

Public Health ◽

Older Adults ◽

Weight Loss ◽

Elevated Risk ◽

Geriatric Syndrome ◽

Central Focus ◽

Health Practitioners ◽

And Function ◽

Public Health Practitioners ◽

Clinical Problems

Frailty is a common geriatric syndrome that embodies an elevated risk of catastrophic declines in health and function among older adults. Frailty is a condition associated with ageing with associated weakness, slowing, decreased energy, lower activity, and, when severe, unintended weight loss. As a population ages, a central focus of geriatricians and public health practitioners is to understand, and then beneficially intervene on, the factors and processes that put elders at such risk, especially the increased vulnerability to stressors (e.g. extremes of heat and cold, infection, injury, or even changes in medication) that characterizes many older adults. The syndrome of geriatric frailty is hypothesized to reflect impairments in the regulation of multiple physiologic systems, embodying a lack of resilience to physiologic challenges and thus elevated risk for a range of deleterious endpoints. The empirical assessment of geriatric frailty in individuals seeks to capture this or related features.RiassuntoFragilità è la predisposizione alla rottura, al danno. L’etimologia della parola fragilità da "frango", rompere, rimanda alla nozione di qualche cosa che se sottoposto a una pressione, a un impatto, rischia di danneggiarsi facilmente. E’ dunque una nozione ampia e intuitiva che può avere ambiti di precisazione più diversi a seconda che se ne parli in fisica (dove esistono dei coefficienti esatti) piuttosto che nei campi della morale o del sentimento, dove la valutazione sarà sempre più "poetica" e affidata alla sensibilità individuale.

Download Full-text

Receiving the mantle: perspectives from third generation researchers in Gurupá

Boletim do Museu Paraense Emílio Goeldi Ciências Humanas ◽

10.1590/1981-81222014000300011 ◽

2014 ◽

Vol 9 (3) ◽

pp. 707-712

Author(s):

Monte Talley ◽

Cynthia Pace ◽

Lucy Miller ◽

Simon Hurst-Dodd

Keyword(s):

Public Health ◽

Child Labor ◽

Original Research ◽

Third Generation ◽

Health Work ◽

The Third ◽

Ethnographic Studies ◽

Potential Impact ◽

Conducting Research ◽

Belo Monte

Ever since Charles Wagley's initial public health work in Gurupá in the 1940s, followed by his and Eduardo Galvão's pioneering ethnographic studies, there has been a steady stream of anthropologists conducting research in the community. As a result of this activity, to date there are books, dissertations, theses, articles, and reports from at least 17 different authors/organizations (mostly anthropologists) and approximately 15 years of collective on-site research. In this article we examine how our current research as the third generation following in Wagley's footsteps builds upon and expands his original research in areas ranging from public health, child labor, the influence of media, and the potential impact of the Belo Monte Dam.

Download Full-text