Category Archives: Obesity

Feb 20 2014
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Public Health News Roundup: February 20

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CDC: H1N1 Flu Killing at Epidemic Levels
The H1N1 flu virus has been killing at epidemic levels since mid-January, according to new data from the U.S. Centers for Disease Control and Prevention (CDC). While flu is known to disproportionately affect the very young and very old, this strain—also known as the swine flu and the cause of the 2009 global pandemic that killed tens of thousands—has so far caused 243 deaths of residents younger than 65 this year in California alone, with an additional 41 unconfirmed cases. In the 2012-13 season there were 26 deaths at this point and in the 2011-12 season there were nine. According o the CDC the average age of someone diagnosed with flu this season is 28.5 years. “These severe flu outcomes are a reminder that flu can be a very serious disease for anyone, including young, previously healthy adults,” CDC spokesman Jason McDonald said to The Washington Post. Read more on influenza.

Teens Who Text About Condoms, Birth Control More Likely to Use Them
Teens who talk about condoms and other types of birth control over text message and other technology are more likely to use them, according to a new study in the Journal of Adolescent Health. Researchers studied 176 high school juniors and seniors, finding that half of the 64 who reported being sexually active also failed to use condoms consistently. According to the U.S. Centers of Disease Control and Prevention, close to 40 percent of the 47 percent of high school students who reported having sex did not use a condom the last time. However, the study found that students who texted or used other private electronic technology to discuss condoms or other forms of birth control were approximately four times more likely to use them. It also found that the odds of consistently using condoms doubled among students reporting discussions of pregnancy or sexual limits. "Although prior research and media attention has focused on the risks of technology use, like sexting, we found that adolescents might also use electronic tools to communicate about ways they might promote their sexual health," said study lead author Laura Widman, who studies adolescent sexuality at the University of North Carolina at Chapel Hill. "It's not all about risky behavior. It might be another way that teens can have these conversations that can be a little bit awkward.” Read more on sexual health.

Study: Average Obese Woman Gets Only One Hour of Vigorous Exercise Each Year
The average obese woman in the United States gets only one hour of vigorous exercise each year, and the average obese man gets only 3.6 hours, according to a new study in Mayo Clinic Proceedings. The study utilized the results of a 2005-2006 government survey of adults aged 20 to 74, which covered areas such as weight, diet and sleep patterns of the nearly 2,600 adults and use accelerometer devices to track their movements. The study defined "vigorous" exercise as fat-burning activities such as jogging and jumping rope. “They're living their lives from one chair to another," said Edward Archer, a research fellow with the Nutrition Obesity Research Center at the University of Alabama at Birmingham. "We didn't realize we were that sedentary. There are some people who are vigorously active, but it's offset by the huge number of individuals who are inactive." According to the U.S. Centers for Disease Control and Prevention (CDC), approximately one in three U.S. adults is obese, which increases the risk of cardiovascular problems such as heart disease and stroke, diabetes and some cancers. Read more on obesity.

Feb 19 2014
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Public Health News Roundup: February 19

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Labor Department Announces Grants to help Adults Transition from Prison to Workforce
The U.S. Department of Labor has announced  close to $30 million in grants to help men and women participating in state or local prison work-release programs get the job skills needed for “in demand” jobs. Grants will be awarded to implementing partners that provide qualifying services in areas with high-poverty and high-crime rates, including communities that have a large proportion of returning citizens that typically experience higher rates of recidivism. Read more on community health.

Combining Online Games, Betting and Social Interaction Can Help People Lose Weight
A study by researchers at the Miriam Hospital in Providence, Rhode Island finds that a web-based commercial weight loss program that pairs financial incentives with social influence resulted in significant weight loss for many of the study participants. The results were published in JMIR Serious Games.

Players joined a game to lose weight while betting money on themselves and had four weeks to lose four percent of their starting weight. At the end of week four, all players who lost at least four percent of their initial body weight were deemed winners and split the pool of money collected at the start of the game. The researchers studied nearly 40,000 players over seven months and found that winners lost an average of 4.9 percent of their initial body weight and won an average of $59 in four weeks. Factors associated with winning the game included betting more money, sharing on Facebook, completing more weigh-ins, and engaging in more social interactions with the other players. Read more on obesity.

New SAMHSA Guide Provides Resources to Help Families Support Their LGBT Children
The Substance Abuse and Mental Health Services Administration (SAMHSA) has released a Resource Guide to help health care and social service practitioners provide guidance to families on how to support their children who are coming out or identifying themselves as lesbian, gay, bisexual and transgender (LGBT). According to SAMHSA, with greater access to more information about sexual orientation, gender identity and LGBT resources through the internet and other media, more young people have been coming out than ever before and at younger ages, and the family-oriented approach offered by the guide can provide useful information during a critical period. Read more on pediatrics.

Feb 6 2014
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How Do We Help People Who Drop Out of Obesity Clinical Trials?

A surprising piece of information at this week’s AcademyHealth National Health Policy Conference came during a session on what additional evidence is needed to move forward in the prevention and treatment of obesity. Linda Billheimer, PhD, deputy director of the health, retirement and long term analysis office at the Congressional Budget Office, said that one weakness of some obesity clinical trials is that they may not reflect the number of people who drop out during the trial. For example, while a study may show the success rate for 400 participants, it may not account for the number of people who left the trial and have not lost weight—or even gained weight—since their trial participation.

Billheimer noted that retaining patients can be difficult because people who plateau are often frustrated, which can combine with other reasons to lead them to leave.

Attempting to keep participants in the trial can be critical because the modality offered may be a strong opportunity for the participants to lose weight, since the trials often have novel approaches. There is also the support from the clinical trials team. Researchers at the session noted that trial funders might add criteria to the trial on follow up for participants who withdraw to possibly increase participation time among a larger group of patients.

Recent novel obesity trials listed by the U.S. National Institutes of Health on ClinicalTrials.gov include

  • A trial comparing low and high financial incentives for weight loss
  • Using virtual reality to help trial participants work on weight loss
  • Community based obesity prevention among black women
Feb 6 2014
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Public Health News Roundup: February 6

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PSA Campaigns Uses Pets to Remind Uninsured People of Deadline to Enroll Under the ACA
With research showing that more than 80 percent of Americans are unaware of the March 31 deadline to sign up for health coverage under the Affordable Care Act, Enroll America has partnered with the Ad Council on the launch of a new national campaign to raise awareness, educate and motivate people to enroll. The “Take Care, People” national multimedia public service advertising (PSA) campaign, which is focuses on women ages 18-34, took a somewhat unusual approach when it came to selecting spokespeople: pets. “We needed a familiar face that would stand out amidst all the noise to communicate to all Americans the benefits of enrolling for health insurance in a way that’s entertaining, relatable and easy to digest,” said Creative Director Rodrigo Butori of La Comunidad, which created the PSAs along with Razorfish. “We thought about pets. Why? Two thirds of American homes have pets. They have been the recipient of people’s love and care for ages. So it’s time for them to return the favor. It’s time for pets to take care of people for a change.” Read more on the Affordable Care Act.

PHLR Online Database Brings Together Experts and Peer-reviewed Publications
Public Health Law Research (PHLR), a program of the Robert Wood Johnson Foundation, has launched the new PHLR SciVal Expert Community to allow users to discover existing and emerging evidence on laws and legal practices that improve health, to identify experts in the area and to pursue new collaborations. The searchable database currently includes 240 expert public health law researchers and more than 16,000 of their peer-reviewed publications covering a range of topics, from alcohol, tobacco and other drugs to occupational safety and health, oral health and preparedness. Read more on research.

Study: Healthy Eating on Weekdays the Key to Losing Weight
The key to losing weight and keeping it off may be healthier eating on weekdays rather than weekends, according to a new study in the journal Obesity Facts. Knowing that most people tend to gradually lose weight during the week and then gain it back on the weekends, researchers tracked the eating habits of 80 people ages 25 to 62, having them weigh themselves before breakfast every day for anywhere from two weeks to nearly a year. The study found that everyone experienced weight fluctuations, but that the people who consistently lost weight tended to compensate more strictly during the week for their weekend weight gain, with their weight decreasing immediately on Monday and continuing downward until Friday. "The ones who are big winners are those who lose a little bit of weight from Monday to Tuesday to Wednesday to Thursday," said study co-author Brian Wansink, a professor of consumer behavior at Cornell University. Read more on obesity.

Jan 30 2014
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Public Health News Roundup: January 30

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CDC Report Details Support of State, Local Health Responses
The U.S. Centers for Disease Control and Prevention (CDC) has released a new report detailing its support of state and local public health responses from 2012 to 2013, as well as assessments of all state and select local public health preparedness. The 2013-2014 National Snapshot of Public Health Preparedness is the sixth annual report from CDC’s Office of Public Health Preparedness and Response. “The lives protected by the public health response to Hurricane Sandy, the fungal meningitis outbreak, and the tornadoes in Joplin are just a few examples of how communities and CDC can work together to protect the public's health when its needed most,” said CDC Director Tom Frieden, MD, MPH.

Among the report’s highlights:

  • During outbreaks and emergencies, response time is essential. In 2012, lead state responders reported for immediate duty within 27 minutes of receiving notification of a potential public health emergency—9 minutes faster than the 2011 national average.
  • In 2012, across the 62 Public Health Emergency Preparedness (PHEP) cooperative agreement awardees, Emergence Management Program (EMP) activities included 185 engagements and 204 exercises. Internationally, EMP activities across 35 countries included 15 activations, 19 engagements, and 12 exercises.
  • The percentage of E. coli-positive tests analyzed and entered into the PulseNet database within four working days increased from 90 percent to 94 percent and timely testing and reporting of Listeria-positive results increased from 88 percent to 92 percent.

“The ability of our local and state health departments to be innovative and maintain a steady level of preparedness despite extensive budget cuts is reassuring,” said Ali Khan, M.D., M. P. H., director CDC’s Office of Public Health Preparedness and Response. “However, preventing an erosion of our nation’s health security will be difficult in the current fiscal environment.” Read more on preparedness.

Study: Overweight Kindergarteners Four Times as Likely to Be Overweight Teens
Children who are overweight at the age of five are four times as likely to be obese by the age of 14 than are children who start their school years at an average weight, according to a new study in the New England Journal of Medicine. Approximately 27 percent of the five-year-olds in the study were overweight. Using data on almost 8,000 children gathered by the Early Childhood Longitudinal Study conducted by the U.S. National Center for Education Statistics, researchers determined that:

  • Approximately 32 percent of kids who were overweight when they entered kindergarten had become obese by age 14, compared to 8 percent of normal-weight kindergarteners.
  • The obesity rate rose most rapidly between first and third grades—from 13 percent to almost 19 percent—but not significantly between fifth and eighth grades.
  • Between kindergarten and eighth grade, the prevalence of obesity rose by 65 percent among white children, 50 percent among Hispanic children and more than doubled among black children.

"If we're just focused on improving weight when kids are adolescents, it may not have as much of an impact as focusing on the preschool-age years," said lead researcher Solveig Cunningham of Emory University, adding that the study "doesn't tell us what to do about it, but it helps tell us when we need to think creatively about what to do." Read more on obesity.

Study: One-third of Americans, Two-Thirds of University Students Have Used Indoor Tanning
Despite clear and widespread data on their link to skin cancer risk, more than a third of Americans and nearly two-thirds of U.S. university students have used indoor tanning, according to a new study in the journal JAMA Dermatology. Approximately 19 percent of teens had also used the machines. Researchers at the University of California, San Francisco based their conclusions on an analysis of 88 surveys covering more than 406,000 people in the United States, Europe and Australia. "It is appalling how often exposure to indoor tanning takes place in presumably educated populations and particularly worrisome that we allow adolescents to be exposed to this carcinogen," said Mark Lebwohl, MD, chairman of the department of dermatology at Mount Sinai Hospital in New York City. "We must do a much better job at educating people of all ages about the risks of indoor tanning.” Read more on cancer.

Jan 28 2014
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Public Health News Roundup: January 28

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Obese Children More Susceptible to Air Pollution-Related Asthma
Obese children are more susceptible to air pollution-related asthma, according to a new study in the journal Environmental Research. Researchers followed the health of 311 children, ages 5 and 6, in predominantly Dominican and African-American neighborhoods of New York City, finding that high exposure to polycyclic aromatic hydrocarbons (PAH)—a family of air pollutants—was only associated with asthma among obese children The study determined that obese children exposed to the PAH chemicals 1-methylphenanthrene and 9- methylphenanthrene were two to three times more likely to have asthma. PAHs are emitted by vehicles, cigarette smoke, cooking, incense, burning candles and various other indoor sources. Two possible explanations for the disparity are that obese children tend to be less active, so are more likely to be exposed to indoors sources of PAH, and that they may breathe more rapidly than children of healthier weights Better understanding of the risk factors opens the door to more targeted interventions. “These findings suggest that we may be able to bring down childhood asthma rates by curbing indoor, as well as outdoor, air pollution and by implementing age-appropriate diet and exercise programs,” said senior author Rachel Miller, MD, professor of medicine (in pediatrics) and environmental health sciences, and co-deputy director of the Columbia Center for Children’s Environmental Health at the Mailman School of Public Health. Read more on pediatrics.

Report: Antibiotics Dangerous to Humans Still Used in Livestock
Despite knowing their risk to humans, the U.S. Food and Drug Administration (FDA) continues to allow the use of certain antibiotics as additives in animal feed and water, according to a new report from the Natural Resources Defense Council based on documents acquired under the Freedom of Information Act. In a review from 2001 to 2010 the FDA concluded that 30 such antibiotics posed a significant risk of exposing people to antibiotic- resistance bacteria. The drugs were approved for “non-therapeutic” use in farm animals, such as preventing disease or promoting growth of the animals, instead of treating specific illnesses. In December the FDA announced its intention to combat the spread of antibacterial resistance by prohibiting the use of medically important antimicrobials in food animals for food production purposes, while also adding veterinary oversight to therapeutic use of the drugs in animals. Read more on food safety.

Residents of Public Housing Developments, Rental Assistance Units See Significant Gap in Oral Health Care
People who live in public housing developments and rental assistance units are less likely to have routine preventive dental care and more likely to have suffered serious oral health issues related to tooth loss, according to a new study in The Journal of Urban Health. The study was conducted by the Partners in Health and Housing Prevention Research Center (PHH-PRC) at the Boston University School of Public Health. The researchers looked at four indicators for people living in Boston’s publicly supported housing: having had a dental visit in the last year, having had a dental cleaning in the last year, having had six or more teeth extracted, and having dental insurance. They found that people in public housing, despite being as likely to have had a dental visit in the past year, were significantly less likely to have had a cleaning. The gap in health care is especially serious for the seniors in this already vulnerable population: Compared to younger residents, seniors 65-75 years old were 30 times as likely to have had six or more teeth removed. Read more on prevention.

Jan 23 2014
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Public Health News Roundup: January 23

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HHS to Form Committee to Address Children’s Needs in Disasters
The U.S. Department of Health and Human Services (HHS) is forming a new advisory committee to help meet the particular needs of children before, during and after a disaster or other public health emergency. The committee will seek to bring together experts from the scientific, public health and medical fields. HHS’s Office of the Assistant Secretary for Preparedness and Response (ASPR) also created the Children’s HHS Interagency Leadership on Disasters (CHILD) working group in 2010, which has so far increased interagency coordination and recommendations to improve lifesaving care for children in disasters; developed ways to mitigate the behavioral and psychological needs of children in disasters; and identification of medications and vaccines for children in emergencies. The deadline for nominations for committee membership is Feb. 14. Read more on disasters.

Study: Cold Weather May Help People Lose Weight
There’s at least one benefit to the frigid air currently blanketing much of the country—regular exposure to mild cold may help people lose weight and sustain healthier weights, according to a new study in the journal Trends in Endocrinology & Metabolism. However, that also means that the during the winter, when most buildings keep their temperature warmer, our body is working less to stay warm, so using less energy. "Since most of us are exposed to indoor conditions 90 percent of the time, it is worth exploring health aspects of ambient temperatures," said first author of the article Wouter van Marken Lichtenbelt of Maastricht University Medical Center in The Netherlands. "What would it mean if we let our bodies work again to control body temperature? We hypothesize that the thermal environment affects human health and more specifically that frequent mild cold exposure can significantly affect our energy expenditure over sustained time periods." Read more on obesity.

AHA, NFL App to Encourage Kids’ Physical Activity
The American Heart Association and the National Football League have released a new app, NFL Play 60, to encourage kids to get the full 60 minutes of daily recommended physical activity. In the interactive running experience, players dropped into a virtual world full of obstacles, and have to run, jump, pivot and turn in place to make their app character do the same and navigate the world.  “One-third of U.S. children and adolescents are overweight or obese and at a higher risk for heart disease and stroke. Engaging young people in physical activity is one of the best ways to decrease their risk for heart disease,” said Mariell Jessup, MD, President of the American Heart Association.  “We’re proud to partner with the NFL in developing an innovative way to reach adolescents, through their schools and now via their smartphones, in an effort to impact their lives earlier to make their lives longer.” The app is available for free download in the iTunes store starting today and will be available for Android on Feb. Read more on physical activity.

Jan 20 2014
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Public Health News Roundup: January 20

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Arab Countries at Risk of Halting Progress in Life Expectancy, Child Mortality
If left unaddressed, the increasing problems of chronic disease, diet-related risk factors and road injury deaths could hamper the progress that countries in the Arab world have made in life expectancy and child mortality over the past two decades, according to a new study in The Lancet. The Institute for Health Metrics and Evaluation (IHME)-led study analyzed data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), finding that all 22 nations of the Arab League saw life expectancy increase for women from 1990 to 2010, and all but one saw increases for men (Kuwait, which was already at 76.8 in 1990 and dipped to only 76.1). However, societal changes linked to income levels are also bringing with them new issues. For example, higher-income countries where food is more abundant are seeing poorer diets and decreased physical activity. “The Arab countries are in transition from places where infectious diseases are the main cause of concern to places where heart disease, cancer, and diabetes are the main worries,” said IHME Director Christopher Murray, MD. “Right now, in the low-income countries, they are suffering from a double burden of non-communicable and infectious diseases. And that causes an incredible strain on their health systems.” Read more on global health.

Study: Cutting Fast Food Not Enough—Education Nutrition Also Needed to Combat Childhood Obesity
Cutting back or even cutting out fast food alone is not enough to combat the childhood obesity epidemic, with increased focus on the rest of diet also necessary, including proper education on nutrition, according to a new study in the American Journal of Clinical Nutrition. The study was supported by the Robert Wood Johnson Foundation. Researchers analyzed data from the U.S. National Health and Nutrition Examination Survey, looking at information on nearly 4,500 U.S. kids ages 2 to 18 from 2007 to 2010. The study found that nearly 40 percent of kids consumed up to 30 percent of their total calories from fast food, with 10 percent consuming more than 30 percent. They also found that kids who ate more fast food also tended to make unhealthy eating choices outside of fast food restaurants. "The fact that fast-food diners—especially adolescents—tend to choose nutrient-poor foods outside of the fast-food meal demonstrates the need for better nutrition education and a focus on the whole diet to meet health needs," said Connie Diekman, director of university nutrition at Washington University in St. Louis. Read more on nutrition.

FDA Approves First Post-natal Test to Diagnose Development Delays, Intellectual Disabilities
The U.S. Food and Drug Administration (FDA) has granted approval for the marketing of a first-of-its-kind test to help diagnose developmental delays and intellectual disabilities in children. The post-natal blood test analyzes the entire genome in search of chromosomal variations of different types, sizes, and genome locations; disabilities such as Down syndrome and DiGeorge syndrome are linked to chromosomal variations. “This new tool may help in the identification of possible causes of a child’s developmental delay or intellectual disability, allowing health care providers and parents to intervene with appropriate care and support for the child,” said Alberto Gutierrez, PhD, director of the Office of In Vitro Diagnostics and Radiological Health in the FDA’s Center for Devices and Radiological Health. Read more on mental health.

Jan 14 2014
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New Institute of Medicine 'Obesity Solutions' Roundtable Begins Its Work

Earlier this week a new Roundtable on Obesity Solutions, established by the Institute of Medicine (IOM), convened its first meeting in Washington, D.C.

The goal of the Roundtable, which plans to meet over the next several years, is to engage leadership from multiple sectors to help solve the U.S. obesity crisis. According to the IOM, more than one third of adults and 17 percent of children and adolescents are obese, and some estimates tag the cost of obesity at almost 10 percent of the national health care budget. Obesity also increases rates of chronic disease and their associated costs. The Roundtable will convene meetings, public workshops, background papers and “innovation collaboratives” with a goal of “accelerating and sustaining progress in obesity prevention and care,” according chair Lynn Parker, formerly with the Food Research and Action Center in New York City.

The overarching themes of the Roundtable will include:

  • Viewing the problem of obesity from a systems perspective
  • Achieving health equity through focused action and research
  • Developing and using effective communication strategies
  • Identifying innovative financing mechanisms
  • Evaluating progress

The opening speaker at this week’s meeting was Bill Dietz, a former Director of the Division of Nutrition and Physical Activity at the U.S. Centers for Disease Control and Prevention, and now a consultant to the Institute of Medicine. Dietz pointed to reports last year that found signs of progress in efforts to reverse the obesity epidemic, with decreases in obesity among preschoolers from low-income families in 18 states.

“Change is beginning and change in a positive direction is taking place,” said Dietz. “The challenge is how we, working together, manage to accelerate this progress. How do we make the decline of obesity the norm and the mainstream of the future?”

file From 2008 to 2011, there were widespread decreases in obesity rates among preschool children from low-income families.

Dietz said that research shows that obesity among women has plateaued, which could indicate gains to come if compared with the history of smoking reduction, which showed plateaus in rates of smoking just before major policy changes. Dietz said subsequent initiatives were successful because the public was already aware of the dangers.

Presenters were asked to suggest innovative ideas for preventing obesity and reducing rates overall. Among them were:

  • Making physical activity a core component of the school day
  • Engaging parents
  • Tailoring interventions to culture and audience
  • Sustainable approaches, including businesses working on obesity prevention and sharing what works best for them

Several speakers mentioned the need to account for different community needs when addressing obesity.

“Each community faces different challenges so the multifaceted approach will look different in each community,” said speaker Jeff Levi, PhD, executive director of advocacy group Trust for America’s Health.

“We’ll make change by making the healthy choice the easier choice and a health in all policies approach,” said Howard Koh, MD, MPH, assistant secretary for health at the U.S. Department of Health and Human Services.

Jan 6 2014
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Public Health News Roundup: January 6

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HHS Moves to Strengthen Federal Background Checks for Gun Ownership
The U.S. Department of Health and Human Services (HHS) is taking steps to strengthen the federal background check system for the purchase of firearms by removing legal barriers under the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule that could stop states from reporting information to the National Instant Criminal Background Check System (NICS). The NICS is designed to ensure that felons, people convicted of domestic violence and people involuntarily committed to a mental institution cannot purchase firearms. A 2012 Government Accountability Office report found that 17 states had submitted fewer than 10 records of people prohibited from owning a firearm for mental health reasons. “There is a strong public safety need for this information to be accessible to the NICS, and some states are currently under-reporting or not reporting certain information to the NICS at all,” said HHS Secretary Kathleen Sebelius.  “This proposed rulemaking is carefully balanced to protect and preserve individuals’ privacy interests, the patient-provider relationship, and the public’s health and safety.” Read more on mental health.

CDC: ‘Widespread’ Flu Activity in Almost Half of the Country
Half of the 50 U.S. states are already reporting influenza cases this season, according to the U.S. Centers for Disease Control and Prevention (CDC). The majority of the cases have been attributed to the H1N1 virus, which killed an estimated 284,000 people across 74 countries in 2009-2010. Almost half of the country has also classified flu activity as “widespread” this season. Texas, which on December 20 issued an “influenza health alert,” has already seen 25 deaths, according to health officials. "We are seeing a big uptick in disease in the past couple of weeks. The virus is all around the United States right now," said Joe Bresee, MD, chief of Epidemiology and Prevention in the CDC's Influenza Division, adding, "There is still a lot of season to come. If folks haven't been vaccinated, we recommend they do it now.” Read more on influenza.

Slower Eating Leads to Fewer Calories
Normal-weight individuals looking for methods to maintain their healthy weight should consider simply eating slower, according to a new study in the Journal of the Academy of Nutrition and Dietetics. Researchers found that both normal-weight and obese or overweight people who ate at relaxed, slow-speed conditions reported feeling less hungry afterward than they did after eating fast-paced meals. However, only the normal-weight study participants consumed “significantly” fewer calories during the slower meals, according to the researchers: 88 fewer calories, compared to 58 fewer calories for obese or overweight participants. Study author Meena Shah, a professor in the department of kinesiology at Texas Christian University, in Fort Worth, said one explanation for the findings could be that “slower eating allows people to better sense their feelings of hunger and fullness.” Read more on obesity.