How best to curb obesity?

Here is a recent post in the New England Journal about the recent soda ban in New York City Ruling. A wonderful view that I personally share. 100% freedom has failed in this circumstance. If we let everyone eat whatever they want, you get the obesity rates that we currently see. We live in the greatest country in the world and we can do better!

http://www.nejm.org/doi/full/10.1056/NEJMp1303706?query=endocrinology 

Microbes and Obesity ?!

A truly facininating side to the obesity story is the relationship of gut flora to potential weight gain. Many believe that having an abnormal balance of gut bacteria can contribute to obesity through a multitude of mechanisms. One of the simplest explanations is that gut bacteria allow for more substrates (e.g. glucose or fatty acids) to be absorbed. Here is a summary of a recent study that came out in the JCEM: http://www.medscape.com/viewarticle/781943. The question that I always have is, are we looking at the chicken or the egg? Or does being obese eventually change your gut microbes? What we need is a study that can track people closely both before, during, and after developing obesity. Maybe then we can see a significant change in flora that precedes the obesity.

Just my thoughts...

New Era

The new era of this blog has begun! Since I am training to become a physician that specializes in childhood obesity, I will try and share new an exciting news on that front whenever I can. I will kick things off with a bit of good news. Apparently, some rates of childhood obesity are starting to fall, but I don't think that it is time to let our guard down. The fact of the matter is that we have only begin to scrape the surface of the obesity problem from the policy side and sadly there are few option on the "drug side." So, I guess that leaves diet and exercise right?

Concussions and Head Trauma

Sorry for the absence from the blog world! Clearly, residency has been making it tough to write! Anyway, I have been working in the outpatient world lately and I saw a teenager after being released from the ER after sustaining a head injury. It was a head to head collision in which the child started slurring his words and had neurological signs! No imagining was done and he was sent home after being watched for about 6 hours.  I think this management is debatable and could be talked about below.

I think we have all noticed an increase in the amount of press coverage of head trauma over the past few years. I thought about writing this article after seeing the following story: College Athlete Died of Head Trauma, Father SaysWe as pediatricians are much more careful about return to play now and in fact all patients should return to play in a step-wise fashion after first taking a full week off. It is sad to see another person die because of possible mismanagement and/or under appreciation of the severity of head trauma.

Happy New Year!

Happy New Year to all Followers! I know I have had very little activity lately, but as the year goes on, I should have more time as I have been through the meat of my schedule. We have seen a very interesting year in the medical field, especially with the H1N1 affair. It seems that we have been spared/done a wonderful job with the vaccination program. In fact, there is a wonderful Times article on this very subject:Swine Flu.  I urge anyone out there that would like me to cover any specific subject to drop me a line. Happy New Year again to you all!!

Cash and Money

You sometimes I just wonder about people and what has happened to healthcare. I saw a nice family this week who's child had an allergic rash. When I came back to the room to talk about our plan and told her that she was going to need to get some over the counter steroid cream she responded.."wait, wait, I am going to have to pay for something?!?!" I honestly didn't know what to say and we are certainly not talking about an expensive item that is likely going to take the rash away. Is that how the public thinks healthcare should work? All the care should be free and all the medications free? Let's see what healthcare reform has in store for us.

90%?

While this post is not about the rumored Apple tablet PC, I do find it pretty cool and maybe it would even have possible benefits to the healthcare industry. Today in the ER, I asked one of the financial experts and she claimed that 90%, yes 90% of the ER visits to our Pediatric ER get paid for! I was shocked by this number...could it actually be this high? I do think that it is good that the hospital is actually getting paid when kids come in with nothing, there needs to be a line drawn. Maybe you should be charged for ER visits that could be seen at your community MD. I still am amazed by how many people actually have primary doctors and yet they do not actually go to them! They only go for well child visits. I don't know, once again it all seems wrong to me.