In This Issue

Physicians and patients fail to respond to the obesity epidemic

More than two-thirds of adults in the United States are either overweight or obese, and physician involvement, which can help encourage weight loss, is often inconsistent. Erika Yates and her team used data from the National Health and Nutrition Examination surveys to assess trends in the diagnosis, treatment, and self-care of overweight Americans from 1994 to 2008. Despite the increase in obesity since 1994, there has been no change in the likelihood of being diagnosed by a physician as being overweight and it has become less likely for adults to self-diagnose as overweight. The perceived ideal normal weight has increased over time, and recent data from another survey indicate that less than 50% of overweight adults are actively attempting to lose weight. The authors call attention to the need to address this increasing deficiency in obesity care. See page 1909

Protein synthesis in muscle is not impaired by weight loss

Prescribing weight loss to older obese adults carries a risk of debilitating muscle loss due to the decrease in muscle mass associated with losing weight, combined with an obesity-related fast rate of decline in physical function, leading to frailty. To investigate the mechanisms responsible for the loss of muscle mass that accompanies the loss of fat mass during dietary calorie restriction, Dennis Villareal and colleagues measured the rate of muscle protein synthesis in eight obese individuals 65–80 years of age who were at various stages of weight loss. The results demonstrate that muscle protein synthesis is not impaired by weight loss, indicating that accelerated muscle protein breakdown is responsible for the observed muscle loss. The authors suggest that treatment strategies to counteract weight loss—induced changes in muscle mass should be focused on muscle proteolysis rather than synthesis. See page 1780

Calories consumed in beverage form promote weight gain

Recent research has yielded inconclusive evidence as to whether caloric beverages are involved in weight gain. To test whether the food form per se has an impact on weight gain, Jenny Houchins and colleagues provided fruits and vegetables in either solid or juice form as a dietary supplement to 34 adults with a range of BMIs. The meals were provided for two eight-week periods, with a three-week washout period between. The overweight or obese adults gained significantly more weight than their lean counterparts in the beverage intervention group, and they were the only group to gain weight from the solid food. These results indicate that beverages may be particularly problematic for overweight individuals and that, although fruits and vegetables should be recommended, total energy intake should be taken into account. See page 1844