Whenever you consult a physician, you have the right to expect responsible, ethical care. Yet some MDs are playing fast and loose with patient safety, taking shortcuts and pushing procedures and treatments that may endanger lives. 

Who’s holding the knife?
Debbie Daniels knew she wasn’t in the greatest shape. At 39, she still carried extra pounds from being pregnant. She worked full-time as a respiratory therapist in a Paducah, Ky., hospital, and no longer had time for the softball games that had once kept her active. But it never occurred to Daniels that cosmetic surgery might be the solution—at least, not until her OB/GYN offered to make some cosmetic tweaks at the same time as a scheduled hysterectomy. 

“He said, ‘We’re going to be opening you up anyway, and we can do a little tummy tuck while we’re there,’?” Daniels recalls. “It sounded so simple.” The doctor had delivered Daniels’s last baby, and she knew him from the hospital where they both worked. “I thought he was a compassionate, caring doctor,” she says.

But Daniels’s OB/GYN was not a board-certified plastic surgeon. According to lawsuits Daniels later filed, he’d even been placed on provisional status at another hospital for performing “modified abdominoplasties” without informed consent. During the surgery, rather than making a standard horizontal cut, he split Daniels open lengthwise, and removed not only too much skin but also important connective tissue. After several days, Daniels’s wound burst open, revealing a seven-inch-deep hole in her gut. She underwent emergency surgery and spent two weeks in a medically induced coma. 

Eight years and four major surgeries later, Daniels still has a mass of hernias in her belly, leaving her in constant pain and unable to bend over without risking a dangerous bowel obstruction. “I trusted my doctor when he said he could do this for me,” says Daniels, who eventually settled a lawsuit against her doctor. “Now I know, too late, that he didn’t know what he was doing.”

While Debbie Daniels’s case is especially frightening, her experience is far from unique. Under the right circumstances, plastic surgery should be relatively safe; the American Society of Plastic Surgeons (ASPS) reports that death occurs in only about one in 50,000 operative procedures.

But the growing popularity of cosmetic nips and tucks has made the field a breeding ground for exploitation.

Not surprisingly, cash is a huge factor. Last year plastic surgeons performed more than 1.6 million cosmetic surgeries worth almost $6.6 billion, a 9% increase over the year before. Other docs—OB/GYNs, emergency physicians—are also expanding into cosmetic surgery. A study published last year found that nearly 40 percent of liposuction practitioners in southern California were not trained as plastic surgeons. 

It’s not surprising: An OB/GYN might earn $2,000 for a C-section, while plastic surgeons on average charge more than $5,000 for a tummy tuck—typically paid for in cash, without the hassle of insurance company paperwork. 

“Physicians are pressed harder to make their livings, and are looking for ways to augment their income,” says Dr. James Zins, chairman of the department of plastic surgery at Cleveland Clinic. “More and more, they’re turning to cosmetic surgery.”

Of course, the way to make money as a plastic surgeon is to do surgery. For some, that’s an opportunity to layer on multiple procedures, try out an unproven new fad such as a “stem cell” face-lift, or take safety shortcuts that can endanger their patients. “I hear all the time of tragedies that occur,” says Dr. Robin T.W. Yuan, a board-certified Beverly Hills plastic surgeon and author of Behind the Mask, Beneath the Glitter: The Deeper Truths about Safe, Smart Cosmetic Surgery. “There are doctors out there capitalizing on patients and doing procedures they shouldn’t. That’s how patients get hurt and die.”

Plastic surgery used to be the exclusive domain of the rich and (sometimes) famous. Now, it’s attainable for almost anyone, thanks in part to the explosion in lower-cost cosmetic practices helmed by doctors from other specialties. But just because women can get cosmetic surgery from their internist or OB doesn’t mean they should. 

“Anyone can call themselves a cosmetic surgeon, with very little training,” says Dr. Joseph Serletti, chief of plastic surgery at the University of Pennsylvania. “It doesn’t mean they have the qualifications to perform surgery safely.” 

Dr. Felmont Eaves, a plastic surgeon in Charlotte, N.C., and immediate past president of the American Society for Aesthetic Plastic Surgery (ASAPS), says, “Doctors who are not board-certified surgeons are one of the biggest dangers in this field.”

A board-certified plastic surgeon must undergo at least five years of specialized surgical training post–medical school. Doctors must then pass both oral and written exams and fulfill ongoing continuing-education requirements. “It should be the minimum of what you want from your surgeon,” Zins says.

Yet none of that training is required by law. In most states, anyone with a medical license can perform cosmetic surgery. The results can be catastrophic.  Serletti says he and colleagues have seen patients come in with improperly placed breast implants and damaged facial muscles after going to poorly trained doctors. And yes, people do die: A recent German study of liposuction deaths concluded that lack of surgical experience was a major contributing factor. In July, Arizona internist Dr. Peter Normann, was convicted of second-degree murder and manslaughter after three patients died in his care, two after liposuction and the third after a botched fat-shaping procedure.

________________________________________________________________________

More From Health.com:

• 5 Questions to Ask Before You Have Cosmetic Surgery 

• Diet Doctors Gone Wrong 

• How Safe Is That Salon Procedure? 

_________________________________________________________________________

A different path
Dr. Gregory Alouf is one physician who created his own route to cosmetic surgery. Alouf, a family practitioner in Salem, Va., opened an “aesthetics” practice in 2004, offering non-surgical procedures such as laser hair removal. In 2006 he began doing liposuction, followed by breast implants and other surgical procedures. According to a reprimand issued last February by the Virginia Board of Medicine, Dr. Alouf learned the techniques primarily at medical conferences, where there was minimal hands-on experience.

Two years after he started offering liposuction, Alouf performed lipo on an obese 29-year-old woman—someone the Virginia Board of Medicine stated “was not a suitable candidate for such surgery” due to her weight. Three other lipo patients experienced complications, resulting in hard and lumpy areas and “visible contour irregularities.” (Dr. Alouf claims that those are the only complications he has had in more than 500 liposuction procedures.) 

In 2009, during a seven-hour mini-face-lift, Dr. Alouf’s 52-year-old patient started bleeding uncontrollably from her incisions. The doctor had her sit up and applied pressure to the site while he called a plastic surgeon friend for advice. As a result of these cases, the Virginia Board of Medicine ordered Alouf to stop all “full incisional” surgical procedures, stating that he “lacks the requisite education, training, experience, knowledge, skill, expertise and competence to perform such surgery.”

Alouf says the issue is not competence, but competition.

“I have more liposuction training than a lot of cosmetic surgeons,” Alouf says, adding that he’s never had a patient die, and none has ever filed a malpractice suit against him. “It all comes back to a turf battle,” he says. “Plastic surgeons are defensive because there’s a lot of money involved, and they have very cleverly couched this as an issue of public safety to choke out the competition.”

Money over medicine
It’s true that even board-certified surgeons can pose a risk to patients. Health’s investigation revealed these ways in which both unqualified doctors and board-certified plastic surgeons can be dangerous:
• Inappropriate procedures 
Sometimes, Zins says, refusing to perform surgery is the best medicine—if a patient is going through a divorce, for instance, or is dealing with depression. Other patients are simply physically unfit for surgery. Ideal liposuction candidates, for example, are relatively healthy, close to their ideal weight, with specific areas that need shaping.

But some doctors will operate on anyone with a checkbook. “A lot of doctors never say, ‘No,’?” Yuan says. “You should also avoid a doctor who tries to talk you into more procedures than you came in for.” Generally the longer the surgery and the more areas being operated on, the greater the risk: One study found that combining a tummy tuck with liposuction increases the chance of death 14-fold compared to liposuction alone. 

“Unfortunately, to some doctors, doing more procedures is more important than patient safety,” Eaves says. He adds, “We have a moral responsibility to our patients. The almighty dollar shouldn’t rule the roost.”

• Following the latest fad 
Heard about laser liposuction, the technique that promises a faster recovery and more precise fat removal? So has every plastic surgeon in the country—both from manufacturer marketing materials and from patients, who have seen the ads and ask for laser lipo by name. Plastic surgeons say there’s no peer-reviewed data showing it’s any better than the traditional form of liposuction that has been practiced for years. In fact, they say, laser lipo may cause scarring that can’t always be corrected.

Laser lipo isn’t the first fad to hit the plastic surgery field, nor will it be the last. “We see new devices and procedures all the time that have marginal benefits, or may even be harmful,” Dr. Eaves says, noting the buzz about “stem cell” face-lifts and breast augmentations; this technique, in which your own fat stem cells are injected into your face or breasts, gets a lot of hype but has little clinical data showing it’s either safe or effective. It can take years to prove that a plastic surgery innovation works—or doesn’t work—as advertised. In the meantime, “Many doctors feel they have to use these new techniques in order to get more business,” Eaves says. “That’s a public safety problem.”

A safer cut
You don’t have to shun the plastic surgeon’s office. But you do have to be extremely careful about who is operating on you. To guarantee at least a base of training, oversight, and experience, seek out a board- certified surgeon. Look for a doctor who is certified in plastic surgery; in some cases one certified in otolaryngology (for cosmetic surgery on the head and neck) or ophthalmology (for cosmetic procedures in and around the eyes) may be appropriate. (You can verify board certification at certificationmatters.org.) Check your state medical board’s website (find it at fsmb.org/directory_smb .html) to uncover whether the doctor has ever been reprimanded or had his license suspended for something related to his surgical practice.

Once you’ve established these basics, you’re ready to dig deeper. Don’t be tempted by a discount or payment plan—you should choose your doctor based on medical expertise, not price. The surgeon should lay out the risks and possible complications, and should be able to offer satisfied patients for referrals, not just show you before-and-after pictures. Considering a new procedure? Ask if there are clinical data on its safety and effectiveness.

Eaves points out that your surgeon should have a variety of techniques from which to choose to get your desired results—you don’t want someone who only does one procedure. He or she should outline the options and explain clearly why one might be better for you. Any good surgeon will also let you take your time making a decision, and even encourage you to get a second opinion.

 ”You don’t want a doctor who talks to you for 10 minutes and then passes you to someone else in their office to seal the deal,” says Yuan.

The bottom line is to make sure you understand exactly how the surgeon learned his craft, and what he is going to do to you. And if you’re not satisfied with what you learn, walk away. 

“I should have asked more questions, or simply said, ‘No, thank you,’?” Daniels says. “If I knew then what I know now about what he was doing, I never would have let that doctor cut me open.”

Article source: http://www.foxnews.com/health/2011/09/26/niptuck-nightmare-dangerous-new-world-cosmetic-surgery/

Yale University scientists who searched through medical studies on weight bias published between January 2000 and May 2008 found:

More than half of 620 doctors surveyed view obese patients as “awkward,” “unattractive,” “ugly” and “non-compliant.” A third went further, painting the obese as weak-willed, sloppy and lazy. detailing . Even dietitians, personal trainers and doctors who specialize in treating obesity exhibit fat phobia.

College students asked to rank pictures of hypothetical sexual partners that included an obese partner or partners with various disabilities – including missing an arm or described as having history of sexually transmitted diseases – ranked the obese person as the least desirable sexual partner compared to the others.

In one study of nearly 3,000 people, obese respondents were 37 times more likely than normal-weight to report employment discrimination – not being hired for a job, not getting promoted and wrongful termination. Obese employees are considered less conscientious, “less agreeable” and less emotionally stable than “normal weight” workers.

“People think sometimes that, because obesity rates continue to increase, we really shouldn’t have this problem with bias and prejudice, that attitudes should be getting better and more tolerant,” says Rebecca Puhl, co-author of the study published in the most recent issue of the journal Obesity and director of research at the Rudd Center for Food Policy and Obesity at Yale.

“But what we see is that the weight bias is getting worse.”

In the past year alone in studies, obese people have been held partially responsible for rising fuel prices, global warming and causing weight gain in their friends, Puhl and co-author Chelsea Heuer write.

In television and in film, people in fat suits and obese characters are played for fat gags, and reality shows such as the Biggest Loser perpetuate the stigma. For nearly two-thirds of the American population alone, the only place on television where they see bodies similar to their own “is on shows where the entire cast is trying desperately to become thin,” Puhl and Heuer write.

Weight bias is a “very pervasive problem that continues to really paralyze people in many aspects of their daily life,” Puhl said in an interview.

“This a category of stigma that is not protected legally at all. Whereas we have protections in place for gender based, or racial or age based discrimination, there are no legal protections in place for people who are discriminated against because of their weight.

“That sends a message that it’s okay to do this.”

There has been some positive news for obese people in Canada. As of this year, thanks to a Canadian Transportation Agency ruling on disabled airline passengers, an obese person can be allocated two seats for the price of one.

The researchers found that obese people face stigma and discrimination at every stage of the employment process, from getting hired to getting fired. They’re more likely to get less pay for equal work and Puhl says that “striking” experimental studies show people “would rather hire an unqualified thin person than a qualified overweight person with better credentials.”

In surveys, medical students report “with nearly total agreement,” that severely obese patients are the most common target of derogatory humour by doctors, residents and students, most often in surgery or obstetrics-gynecology settings. Overweight and obese children are also targets of humour, they said.

Obese people report being stigmatized about their weight by their mothers, fathers, sisters, brothers, sons, daughters, friends and spouses.

They’re more likely to suffer depression, anxiety, low self-esteem and even suicidal behaviours as a result, Puhl says, and they cope with the stress and trauma by eating unhealthy and avoiding physical activity “because those are settings where they often are criticized and teased and stigmatized.”

Puhl says media portrayals of the obese need to be challenged, and legislation is needed to protect people from weight-based discrimination.

“I think we need to show examples of diverse body types. We need to show that a person can be successful, ambitious and happy and reach their life goals, even if they’re not a size 4.”

In 2004, nearly seven million Canadians were overweight, and another 4.5 million were obese.

Article source: http://www.canada.com/health/Bias+against+obese+people+increasing+study+says/1609133/story.html

Obesity is the leading cause of numerous diseases and medical conditions for people across the nation – and here in Nevada. Experts are calling it a multi-generational epidemic.

25 percent of adults and 15 percent of children in our state are considered obese, and statistics show they have grown by 90 percent in the past 15 years.

Experts say this generation is the first that runs the risk of dying before their parents. water heater repairs Philadelphia . The government estimates obesity costs 150-billion dollars a year.

The summit will be held from 9 to 5 on Thursday, September 29 at the Mandalay Bay.

Article source: http://www.msnbc.msn.com/id/44717833

LOS ANGELES Exercise relieved symptoms ofarthritis in obese mice, even though they lost no weight from theirefforts, a study finds.

Excessive weight has long been considered one of the culprits ofosteoarthritis, since it puts additional strain on joints. roofing company florida . Whileexercise has been shown in some studies to ease arthritis symptoms,others have found that for overweight and obese people, a fitnessregimen can exacerbate the condition.

The study, published online Tuesday in the journal Arthritis Rheumatism, found that although weight may heighten the riskof osteoarthritis, regular exercise could diminish joint problemsby slowing its progression.

Researchers from Duke University worked with 20, 8-week-old malemice, half of whom were fed a high-fat diet in which 60 percent ofcalories came from fat. The other half got their usual food, with13.5 percent of calories from fat.

As expected, the mice on the high fat diet got pretty chubby;after 12 weeks they had a 55 percent increase in body mass andtheir body fat percentage rose more than three-fold. Researchersfound evidence of osteoarthritis in the mice’s knees, such asmarkers for inflammation. Denver Bankruptcy Attorney . They also found elevated glucose levels(an indication of prediabetes).

When the obese mice started running regularly on a wheel,changes started happening, despite the fact that they were still onthe high-fat diet and losing no weight: the inflammation responsewas disrupted and glucose tolerance improved.

“I don’t want to say exercise is turning off that inflammatorysignal, it just impairs it,” lead author Timothy Griffin said in anews release. “This shows that if you are obese, it’s better toexercise. Sometimes pain can be a barrier to starting exercise, butif you overcome it, in the long term, it’s better.”

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Article source: http://www.stltoday.com/lifestyles/health-med-fit/fitness/article_538723db-87ec-5e4b-9f6b-89d4da729598.html

CAMBRIDGE, Mass.–(EON: Enhanced Online News)–Zafgen,
Inc., a pharmaceutical company pioneering novel obesity therapeutics
to help the body regain and sustain a lean, healthy state by targeting
imbalances in fat metabolism, today announced that the company will be
presenting at Obesity
2011, The Obesity Society’s 29^th Annual Scientific
Meeting, being held Oct. 1-5, 2011 at the Orlando World Center Marriott
in Orlando, Fla. Zafgen will present a clinical update on beloranib and
Phase 1b study highlights, as well as a poster for fumagillin, a
prototype methionine aminopeptidase 2 (MetAP2) inhibitor.

“Beloranib, a Methionine
Aminopeptidase 2 Inhibitor, Reduces Body Weight, Plasma Lipids, and
Inflammatory State in Obese Women”

“We have made significant progress this year in the development of our
MetAP2 inhibitor, which is being studied for its potential to be the
first drug to produce weight loss approaching that of bariatric
surgery,” said Thomas Hughes, Ph.D., president and chief executive
officer, Zafgen, Inc. “We are excited to present additional data from
preclinical studies and our Phase 1b clinical trial of beloranib at
Obesity 2011 as we prepare to initiate Phase 2 clinical trials early
next year.”

The schedule of oral presentations is as follows:

• On Oct. 1, Dr. Hughes will present an update and highlights from
  Zafgen’s Phase 1b study of beloranib from 1:00 to 3:30 p.m. in the
  Sago Conference Room. The session, titled “Beloranib, a Methionine
  Aminopeptidase 2 Inhibitor, Reduces Body Weight, Plasma Lipids, and
  Inflammatory State in Obese Women,” will be held as part of the
  “Pharmacology Update” pre-conference session.
• On Oct. 3, Dr. Hughes will present a poster titled “MetAP2 inhibitor
  treatment acutely reduces ERK phosphorylation and modulates expression
  of ERK-responsive hepatic lipid metabolism genes in obese C57BL/6
  mice,” from 12:30 to 1:30 p.m. in the Cypress Ballroom. Dr. Hughes
  will highlight additional preclinical findings, including the role of
  the ERK pathway in inhibiting MetAP2 and improving fat metabolism. In
  his presentation, Dr. Hughes will discuss results from the preclinical
  study, which evaluated short-term treatment with fumagillin in obese
  mice on ERK phosphorylation and key downstream effector genes relevant
  to the control of fat metabolism.

About MetAP2 Inhibition and Beloranib

MetAP2 inhibitor treatment has emerged as a new peripheral mechanism
driving rapid and substantial weight loss and improvements in cardio
metabolic risk factors. MetAP2 inhibitors have the potential to be the
first new class of obesity therapeutics to provide the severe obese
population with significant weight loss efficacy. Zafgen’s lead molecule
is being developed as a twice-weekly subcutaneous injection for severe
obesity. The company expects to enter Phase 2 trials in obese patients
and obese diabetic patients in early 2012. Zafgen is also developing new
compounds suitable for oral administration for use in broader
indications as part of its second generation program. Beloranib
hemioxalate was initially developed by CKD Pharmaceuticals. The molecule
was originally profiled for efficacy in the treatment of solid tumors.

About Obesity

Obesity continues to be one of the world’s most costly and underserved
growing medical conditions. It is a complex condition with numerous
causes, many of which are largely beyond an individual’s control¹.
There exists a tremendous unmet medical need for effective drug
therapies to treat this serious disease, which has reached epidemic
proportions and is increasing at an alarming rate. Obesity leads to many
serious health consequences. As BMI increases, so does one’s risk for
chronic diseases such as cardiovascular disease, diabetes,
musculoskeletal disorders and some cancers². Currently
available weight loss treatments function by blocking fat absorption or
signalling feelings of fullness or diminished appetite in the brain.
These drugs are often associated with undesirable side effects and
limited efficacy that fails to provide sustainable weight loss in many
patients.

According to a recent Gallup poll, Americans are making no progress in
the fight against obesity, with a slight increase in obesity rates
across all key demographic groups between January 1, 2008 through April
30, 2010. The study found that adult obesity rates did not decrease
between 2009 and 2010, with the rate of obesity remaining stable at 26.7
percent in the first quarter of 2010, compared to 26.2 percent in the
last quarter of 2009, and that fewer Americans are maintaining a
“normal” weight as measured by BMI³.

About Zafgen, Inc.

Zafgen is pioneering novel obesity therapeutics that directly target fat
metabolism to help the body regain and sustain a lean, healthy state.
The company’s approach focuses on restoring control of key metabolic
processes, releasing stored fat which then is used by the body as fuel.
Zafgen’s first generation product, beloranib, is being studied for use
as a pharmacological alternative to bariatric surgery in the treatment
of severe obesity. Zafgen’s leadership and scientific advisors include
leading experts in obesity, metabolic disorders and medicinal chemistry.
Founded in 2005, the company is located in Cambridge, Mass. For more
information, visit www.zafgen.com.

¹OBESITY, Volume 16, Number 6, June, 2008;http://www.obesity.org/images/pdf/Publications/TOS%20OBY_disease_05_19_08.pdf

²World Health Organization, http://www.who.int/mediacentre/factsheets/fs311/en/index.html

³Gallup, http://www.gallup.com/poll/127610/americans-making-no-progress-obesity.aspx

Article source: http://eon.businesswire.com/news/eon/20110928005747/en

iStock

Cancer cells.

Misconceptions about what causes cancer and how it spreads still hold sway, a new British study shows. Researchers also found a widespread lack of awareness about the roles that poor diet, lack of exercise and obesity play in the development of the disease.

“It is clear that there is a continual need for education into the causes of cancer,” study researcher Paul Symonds, of the University of Leicester’s department for cancer studies and molecular medicine, said in a statement.

Between September 2007 and January 2010, researchers at that university surveyed 279 patients who had been diagnosed with cancer at the Leicestershire Cancer Centre. The researchers aimed to compare the cancer beliefs of British South Asian cancer patients with those of Caucasian cancer patients.

The findings showed that both groups overemphasize pollution, stress and injury as causes of cancer, while displaying a general lack of awareness about the potential correlation between an unhealthy diet, lack of exercise and obesity and the development of cancer.

“We clearly have more work to do in educating the public on the effect of diet and obesity,” Symonds said.

Myths about cancer’s spread

Reflecting the public’s common misconceptions about cancer, almost one-quarter of the participants asserted that they believed cancer was caused by injury. And 20 percent of people in both groups wrongly believed that cancer treatments — surgery in particular — could cause cancer to spread.

Almost 30 percent of the participants believed that alternative treatments, which include acupuncture and herbal supplements, could be as effective as surgery, radiotherapy or chemotherapy. This cancer myth was held by almost twice as many of the South Asian patients as Caucasian patients, the study said.

“Myths such as the belief that surgery causes cancer to spread and that alternative treatment is as effective as conventional treatments should be challenged,” study researcher Karen Lord said in a statement. “It is vital that those diagnosed with cancer have accurate information about treatment options so that they can make informed decisions about their care.”

Early screening

On a positive note, the study showed that 93 percent of the participants understood the advantages of early cancer screenings. The vast majority of the patients also believed that cancer is curable, with only 10.6 percent of the South Asian group and 2.7 percent of the Caucasian group reporting they think it’s incurable.

“The good news is that the majority of the sample believed that cancer was curable and screening effective, while 84 percent appreciated that smoking could cause cancer,” Symonds said.

The study, funded by the Leicestershire-based charity Hope Against Cancer, was recently published in the journal Clinical Oncology.

Pass it on: Although misconceptions about what causes cancer and how it can be treated are common, a majority of British cancer patients believe that cancer can be cured and recognize the importance of early cancer screenings.

• 10 Medical Myths That Just Won’t Go Away
• 11 Big Fat Pregnancy Myths
• 5 Dangerous Vaccine Myths

Article source: http://www.foxnews.com/health/2011/09/28/cancer-myths-persist-survey-shows/

Mayor Nutter’s proposed soda tax didn’t end up going anywhere, but it did contribute to an unfortunate myth: the notion that any class of food or beverage is particularly fattening.

That was the stated motivation for Nutter’s proposal. A ranking city health official declared that “there’s good evidence for sugary drinks’ being a major culprit in the increase in obesity.” And public-health activists claimed that soft drinks contribute disproportionately to the government’s obesity-related costs.

However, a new study I conducted with Lehigh University’s Shin-Yi Chou suggests that the dynamics of obesity are far more complex than the soda critics suggest.

Using government body mass index data spanning a 27-year period, we analyzed multiple potential factors in the recent rise in American obesity, including food prices, physical activity at work, restaurant prevalence, urbanization, employment, and cigarette smoking.

Based on the current conventional wisdom, you might guess that food prices or restaurant prevalence would affect obesity most. But among the variables we studied, the most significant factor in BMI increases was the decline in smoking. This makes sense: Cigarettes are an appetite inhibitor.

This single greatest factor, however, still accounted for a very small share of the rise in obesity, about 2 percent.

Obesity is also linked to urban sprawl, not surprisingly: More driving means less walking. Occupational fitness is another factor: More time sitting at a desk means fewer calories burned.

Neither of these plays a large role either, though. Urban sprawl accounted for only 0.7 percent of the rise in BMI, occupational fitness 0.5 percent. And fast-food prices, grocery prices, and restaurant prevalence were all statistically insignificant.

In other words, there’s no one or two central causes of rising obesity.

Philadelphia officials aren’t wrong to be concerned about obesity. The obesity rate citywide is 40 percent, and 17 percent among high school students, according to Temple University.

But our results indicate that antiobesity public policies are generally of limited utility. Besides soda, activists have accused corner stores and fast food of contributing to a “toxic food environment.” Yet fast-food prices, grocery prices, and restaurant prevalence all registered statistically insignificant effects in our study.

Policies seeking to reconstruct the urban landscape by banning new fast-food restaurants (as has been done in south Los Angeles) or giving tax breaks to supermarkets therefore may not have much of an effect on weight gain.

Governments can of course plow forward with taxes, zoning, and other often untested ways of battling obesity. But public policy is an instrument that’s too blunt for this task. There are simply too many factors and individual choices; after all, any food or drink with calories can fatten people if consumed in excess.

Instilling personal responsibility and expanding nutrition and fitness education are more likely to have an effect. People gain weight when they consume more calories than they burn. And many different lifestyle decisions can lead to weight gain, just as there are many different approaches to weight loss. Some people may have to eat less; others may have to run up and down the steps of the Art Museum.

No public-policy regimen can effectively target obesity unless it literally punishes people for being fat. And who wants to weigh in at the nearest post office?

Article source: http://www.philly.com/philly/opinion/20110929_Why_beverage_taxes_won_t_reduce_obesity.html