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Browsing by Author "Cummings, David E."
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Item Joint international consensus statement for ending stigma of obesity(Nature Research, 2020) Rubino, Francesco; Puhl, Rebecca M.; Cummings, David E.; Eckel, Robert H.; Ryan, Donna H.; Mechanick, Jeffrey I.; Nadglowski, Joe; Salas, Ximena Ramos; Schauer, Phillip R.; Twenefour, Douglas; Apovian, Caroline M.; Aronne, Louis J.; Batterham, Rachel L.; Berthoud, Hans-Rudolph; Boza, Camilo; Busetto, Luca; Dicker, Dror; de Groot, Mary; Eisenberg, Daniel; Flint, Stuart W.; Huang, Terry T.; Kaplan, Lee M.; Kirwan, John P.; Korner, Judith; Kyle, Ted K.; Laferrère, Blandine; le Roux, Carel W.; McIver, LaShawn; Mingrone, Geltrude; Nece, Patricia; Reid, Tirissa J.; Rogers, Ann M.; Rosenbaum, Michael; Seeley, Randy J.; Torres, Antonio J.; Dixon, John B.; Medicine, School of MedicinePeople with obesity commonly face a pervasive, resilient form of social stigma. They are often subject to discrimination in the workplace as well as in educational and healthcare settings. Research indicates that weight stigma can cause physical and psychological harm, and that affected individuals are less likely to receive adequate care. For these reasons, weight stigma damages health, undermines human and social rights, and is unacceptable in modern societies. To inform healthcare professionals, policymakers, and the public about this issue, a multidisciplinary group of international experts, including representatives of scientific organizations, reviewed available evidence on the causes and harms of weight stigma and, using a modified Delphi process, developed a joint consensus statement with recommendations to eliminate weight bias. Academic institutions, professional organizations, media, public-health authorities, and governments should encourage education about weight stigma to facilitate a new public narrative about obesity, coherent with modern scientific knowledge.Item A Large Animal Survival Model to Evaluate Bariatric Surgery Mechanisms(Scientific Research Publishing, 2015-08) Simianu, Vlad V.; Sham, Jonathan G.; Wright, Andrew S.; Stewart, Skye D.; Alloosh, Mouhamad; Sturek, Michael; Cummings, David E.; Flum, David R.; Department of Cellular & Integrative Physiology, IU School of MedicineBACKGROUND: The impact of Roux-en-Y gastric bypass (RYGB) on type 2 diabetes mellitus is thought to result from upper and/or lower gut hormone alterations. Evidence supporting these mechanisms is incomplete, in part because of limitations in relevant bariatric-surgery animal models, specifically the lack of naturally insulin-resistant large animals. With overfeeding, Ossabaw swine develop a robust metabolic syndrome, and may be suitable for studying post-surgical physiology. Whether bariatric surgery is feasible in these animals with acceptable survival is unknown. METHODS: Thirty-two Ossabaws were fed a high-fat, high-cholesterol diet to induce obesity and insulin resistance. These animals were assigned to RYGB (n = 8), RYGB with vagotomy (RYGB-V, n = 5), gastrojejunostomy (GJ, n = 10), GJ with duodenal exclusion (GJD, n = 7), or sham operation (n = 2) and were euthanized 60 days post-operatively. Post-operative changes in weight and food intake are reported. RESULTS: Survival to scheduled necropsy among surgical groups was 77%, living an average of 57 days post-operatively. Cardiac arrest under anesthesia occurred in 4 pigs. Greatest weight loss (18.0% ± 6%) and food intake decrease (57.0% ± 20%) occurred following RYGB while animals undergoing RYGB-V showed only 6.6% ± 3% weight loss despite 50.8% ± 25% food intake decrease. GJ (12.7% ± 4%) and GJD (1.2% ± 1%) pigs gained weight, but less than sham controls (13.4% ± 10%). CONCLUSIONS: A survival model of metabolic surgical procedures is feasible, leads to significant weight loss, and provides the opportunity to evaluate new interventions and subtle variations in surgical technique (e.g. vagus nerve sparing) that may provide new mechanistic insights.