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The long-term effects of alcohol (ethanol) consumption range from cardioprotective health benefits for low to moderate alcohol consumption in industrialized societies with higher rates of cardiovascular disease[1][2] to severe detrimental effects in cases of chronic alcohol abuse.[3]Health effects associated with alcohol intake in large amounts include an increased risk of alcoholism, malnutrition, chronic pancreatitis, alcoholic liver disease, and cancer. In addition, damage to the central nervous system and peripheral nervous system can occur from chronic alcohol abuse.[4][5] The long-term use of alcohol is capable of damaging nearly every organ and system in the body.[6] The developing adolescent brain is particularly vulnerable to the toxic effects of alcohol.[7] In addition, the developing fetal brain is also vulnerable, and fetal alcohol spectrum disorders (FASDs) may result if pregnant mothers consume alcohol.

The inverse relation in Western cultures between alcohol consumption and cardiovascular disease has been known for over 100 years.[8] Many physicians do not promote alcohol consumption, however, given the many health concerns associated with it, some suggest that alcohol should be regarded as a recreational drug, and promote exercise and good nutrition to combat cardiovascular disease.[9][10] Others have argued that the benefits of moderate alcohol consumption may be outweighed by other increased risks, including those of injuries, violence, fetal damage, liver disease, and certain forms of cancer.[11]

Withdrawal effects and dependence are also almost identical.[12] Alcohol at moderate levels has some positive and negative effects on health. The negative effects include increased risk of liver diseases, oropharyngeal cancer, esophageal cancer and pancreatitis. Conversely moderate intake of alcohol may have some beneficial effects on gastritis and cholelithiasis.[13] Of the total number of deaths and diseases caused by alcohol, most happen to the majority of the population who are moderate drinkers, rather than the heavy drinker minority.[14] Chronic alcohol misuse and abuse has serious effects on physical and mental health. Chronic excess alcohol intake, or alcohol dependence, can lead to a wide range of neuropsychiatric or neurological impairment, cardiovascular disease, liver disease, and malignant neoplasms. The psychiatric disorders which are associated with alcoholism include major depression, dysthymia, mania, hypomania, panic disorder, phobias, generalized anxiety disorder, personality disorders, schizophrenia, suicide, neurologic deficits (e.g. impairments of working memory, emotions, executive functions, visuospatial abilities and gait and balance) and brain damage. Alcohol dependence is associated with hypertension, coronary heart disease, and ischemic stroke, cancer of the respiratory system, and also cancers of the digestive system, liver, breast and ovaries. Heavy drinking is associated with liver disease, such as cirrhosis.[15] Excessive alcohol consumption can have a negative impact on aging.[16]

Recent studies have focused on understanding the mechanisms by which moderate alcohol consumption confers cardiovascular benefit.[17]

Different countries recommend different maximum quantities. For most countries, the maximum quantity for men is 140g210g per week. For women, the range is 84g140g per week.[citation needed] Most countries recommend total abstinence during pregnancy and lactation.

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Over-consumption of alcohol causes many deaths worldwide. The overall mortality from alcohol use was found to be similar to that of the effect of physical inactivity.[19] A review in 2009 found that "the net effect of alcohol consumption on health is detrimental, with an estimated 3.8% of all global deaths and 4.6% of global disability-adjusted life-years attributable to alcohol."[20]

Extensive research of Western cultures has consistently shown increased survival associated with light to moderate alcohol consumption.[21][22] A 23-year prospective study of 12,000 male British physicians aged 4878, found that overall mortality was significantly lower in current drinkers compared to non-drinkers even after correction for ex-drinkers. This benefit was strongest for ischemic heart disease, but was also noted for other vascular disease and respiratory disease. Death rate amongst current drinkers was higher for 'alcohol augmentable' disease such as liver disease and oral cancers, but these deaths were much less common than cardiovascular and respiratory deaths. The lowest mortality rate was found for consumption of 8 to 14 'units' per week. In the UK a unit is defined as 10ml or 8g of pure alcohol.[23] Higher consumption increased overall mortality rate, but not above that of non-drinkers.[24] Other studies have found age-dependent mortality risks of low-to-moderate alcohol use: an increased risk for individuals aged 1634 (due to increased risk of cancers, accidents, liver disease, and other factors), but a decreased risk for individuals ages 55+ (due to lower incidence of ischemic heart disease).[25]

This is consistent with other research that found a J-curve dependency between alcohol consumption and total mortality among middle aged and older men. While the mortality rates of ex-drinkers and heavy drinkers are significantly elevated, the all-cause mortality rates may be 15-18% lower among moderate drinkers. Although the definition of a drink varies between studies and countries, this meta-analysis found that low levels of alcohol intake, defined as 1-2 drinks per day for women and 2-4 drinks per day for men, was associated with lower mortality than abstainers.[26] This claim was challenged by another study[27][28] that found that in certain low quality studies occasional drinkers or ex-drinkers were included as abstainers, resulting in the increased mortality in that group. However, the J-curve for total and CHD mortality was reconfirmed by studies that took the mentioned confounders into account.[29][30][31][32] There seems to be little discussion of what proportion of individuals classified as abstainers are those already at greater risk of mortality due to chronic conditions and do not or cannot consume alcohol for reasons of health or harmful interactions with medication.

The observed decrease in mortality of light-to-moderate drinkers compared to never drinkers might be partially explained by superior health and social status of the drinking group;[33] however, the protective effect of alcohol in light to moderate drinkers remains significant even after adjusting for these confounders.[30][32] Additionally, confounders such as underreporting of alcohol intake might lead to the underestimation of how much mortality is reduced in light-to-moderate drinkers.[29][34]

A 2010 study confirmed the beneficial effect of moderate alcohol consumption on mortality.[32] Subjects were grouped into abstainers, light, moderate, and heavy drinkers. The order of mortality rates from lowest to highest were moderate, light, heavy, and abstainers. The increased risk for abstainers was twice the mortality rate as for moderate drinkers. This study specifically sought to control for confounding factors including the problem of ex-drinkers considered as non-drinkers.[32] According to another study, drinkers with heavy drinking occasions (six or more drinks at a time) have a 57% higher all-cause mortality than drinkers without heavy drinking occasions.[35]

Mortality is lowest among young abstainers and highest among young heavy drinkers.[36]

In contrast to studies of Western cultures, research in other cultures has yielded some opposite findings. The landmark INTERHEART Study has revealed that alcohol consumption in South Asians was not protective against CAD in sharp contrast to other populations who benefit from it.[37] In fact Asian Indians who consume alcohol had a 60% higher risk of heart attack which was greater with local spirits (80%) than branded spirits (50%).[38] The harm was observed in alcohol users classified as occasional as well as regular light, moderate, and heavy consumers.[38]

Another large study of 4465 subjects in India also confirmed the possible harm of alcohol consumption on coronary risk in men. Compared to lifetime abstainers, alcohol users had higher blood sugar (2mg/dl), blood pressure (2mm Hg) levels, and the HDL-C levels (2mg/dl) and significantly higher tobacco use (63% vs. 21%).[38]

Many countries collect statistics on alcohol-related deaths. While some categories relate to short-term effects, such as accidents, many relate to long-term effects of alcohol.

One study claims that "excessive alcohol consumption in Russia, particularly by men, has in recent years caused more than half of all the deaths at ages 15-54 years."[39] However, there are some difficulties with this study. For instance the same study also found a protective effect of heavy drinking on breast cancer mortality. This contradicts the well established scientific view that alcohol increases breast cancer risk.[40] On this account in further correspondence it was advised that "careful interpretation of mortality statistics in relation to alcohol use is needed, taking into account other relevant risk factors, incidence, and survival."[41]

The authors replied that "whether or not the apparent shortfall in breast cancer mortality among heavy drinkers is real, it accounts for only about 01% of adult deaths in Russia. Careful interpretation of it is therefore of little relevance to the findings for alcohol and overall mortality".

A governmental report from Britain has found that "There were 8,724 alcohol-related deaths in 2007, lower than 2006, but more than double the 4,144 recorded in 1991. The alcohol-related death rate was 13.3 per 100,000 population in 2007, compared with 6.9 per 100,000 population in 1991."[42] In Scotland, the NHS estimate that in 2003 one in every 20 deaths could be attributed to alcohol.[43] A 2009 report noted that the death rate from alcohol-related disease was 9,000, a number three times that of 25 years previously.[44]

A UK report came to the result that the effects of low-to-moderate alcohol consumption on mortality are age-dependent. Low-to-moderate alcohol use increases the risk of death for individuals aged 1634 (due to increased risk of cancers, accidents, liver disease, and other factors), but decreases the risk of death for individuals ages 55+ (due to decreased risk of ischemic heart disease).[45]

A study in the United Kingdom found that alcohol causes about 4% of cancer cases in the UK (12,500 cases per year).[46]

The Centers for Disease Control and Prevention report, "From 20012005, there were approximately 79,000 deaths annually attributable to excessive alcohol use. In fact, excessive alcohol use is the 3rd leading lifestyle-related cause of death for people in the United States each year."[47] A 1993 study estimated US deaths through alcohol at 100,000.[48]

Another Centers for Disease Control report from 2001 estimated that medium and high consumption of alcohol led to 75,754 deaths in the United States in 2001. Low consumption of alcohol had some beneficial effects, so a net 59,180 deaths were attributed to alcohol.[49]

In a 2010 long-term study of an older population, the beneficial effects of moderate drinking were confirmed. Both abstainers and heavy drinkers showed an increased mortality of about 50% over moderate drinkers after adjustment for confounding factors.[50]

Some animal studies have found increased longevity with exposure to various alcohols. The roundworm Caenorhabditis elegans has been used as a model for aging and age-related diseases.[51] The lifespan of these worms has been shown to double when fed 0.005% ethanol, but does not markedly increase at higher concentrations. Supplementing starved cultures with n-propanol and n-butanol also extended lifespan.[52]

A meta-analysis of 34 studies found a reduced risk of mortality from coronary heart disease in men who drank 2 - 4 drinks per day and women who drank 1 - 2 drinks per day.[26] Alcohol has been found to have anticoagulant properties.[53][54]Thrombosis is lower among moderate drinkers than abstainers.[55] A meta-analysis of randomized trials found that alcohol consumption in moderation decreases serum levels of fibrinogen, a protein that promotes clot formation, while it increases levels of tissue type plasminogen activator, an enzyme that helps dissolve clots.[56] These changes were estimated to reduce coronary heart disease risk by about 24%. Another meta-analysis in 2011 found favorable changes in HDL cholesterol, adiponectin, and fibrinogen associated with moderate alcohol consumption.[57]

Also, serum levels of C-reactive protein (CRP), a marker of inflammation and predictor of CHD (coronary heart disease) risk, are lower in moderate drinkers than in those who abstain from alcohol, suggesting that alcohol consumption in moderation might have anti-inflammatory effects.[58][59][60]

Despite epidemiological evidence, many have cautioned against recommendations for the use of alcohol for health benefits. A physician from the World Health Organisation labeled such alcohol promotion as "ridiculous and dangerous".[61][62] One reviewer has noted, "Despite the wealth of observational data, it is not absolutely clear that alcohol reduces cardiovascular risk, because no randomized controlled trials have been performed. Alcohol should never be recommended to patients to reduce cardiovascular risk as a substitute for the well-proven alternatives of appropriate diet, exercise, and drugs."[63] It has been argued[who?] that the health benefits from alcohol are at best debatable and may have been exaggerated by the alcohol industry. Some investigators hold that alcohol should be regarded as a recreational drug with potentially serious adverse effects on health and should not be promoted for cardio-protection.[9]

Nevertheless, a large prospective non-randomized study has shown that moderate alcohol intake in individuals already at low risk based on body mass index, physical activity, smoking, and diet, yields further improvement in cardiovascular risk.[64] Furthermore, a multicenter randomized diet study published in 2013 found that a Mediterranean-diet, which included an encouragement to daily wine consumption in habitual drinkers, led to a dramatic reduction in cardiovascular events.[65]

A prospective study published in 1997 found "moderate alcohol consumption appears to decrease the risk of PAD in apparently healthy men."[66] In a large population-based study, moderate alcohol consumption was inversely associated with peripheral arterial disease in women but not in men. But when confounding by smoking was considered, the benefit extended to men. The study concluded "an inverse association between alcohol consumption and peripheral arterial disease was found in nonsmoking men and women."[67][68]

A study found that moderate consumption of alcohol had a protective effect against intermittent claudication. The lowest risk was seen in men who drank 1 to 2 drinks per day and in women who drank half to 1 drink per day.[69]

Drinking in moderation has been found to help those who have suffered a heart attack survive it.[70][71][72] However, excessive alcohol consumption leads to an increased risk of heart failure.[73] A review of the literature found that half a drink of alcohol offered the best level of protection. However, they noted that at present there have been no randomised trials to confirm the evidence which suggests a protective role of low doses of alcohol against heart attacks.[74] However, moderate alcohol consumption is associated with hypertension.[11] There is an increased risk of hypertriglyceridemia, cardiomyopathy, hypertension, and stroke if 3 or more standard drinks of alcohol are taken per day.[75]

Large amount of alcohol over the long term can lead to alcoholic cardiomyopathy. Alcoholic cardiomyopathy presents in a manner clinically identical to idiopathic dilated cardiomyopathy, involving hypertrophy of the musculature of the heart that can lead to congestive heart failure.[76]

Alcoholics may have anemia from several causes;[77] they may also develop thrombocytopenia from direct toxic effect on megakaryocytes, or from hypersplenism.

Alcohol consumption increases the risk of atrial fibrillation, a type of abnormal heart rhythm. This remains true even at moderate levels of consumption.[78]

Chronic heavy alcohol consumption impairs brain development, causes alcohol dementia, brain shrinkage, physical dependence, alcoholic polyneuropathy (also known as 'alcohol leg'), increases neuropsychiatric and cognitive disorders and causes distortion of the brain chemistry. At present, due to poor study design and methodology, the literature is inconclusive on whether moderate alcohol consumption increases the risk of dementia or decreases it.[79] Evidence for a protective effect of low to moderate alcohol consumption on age-related cognitive decline and dementia has been suggested by some research; however, other research has not found a protective effect of low to moderate alcohol consumption.[80] Some evidence suggests that low to moderate alcohol consumption may speed up brain volume loss.[81] Chronic consumption of alcohol may result in increased plasma levels of the toxic amino acid homocysteine;[82][83] which may explain alcohol withdrawal seizures,[84] alcohol-induced brain atrophy[85] and alcohol-related cognitive disturbances.[86] Alcohol's impact on the nervous system can also include disruptions of memory and learning (see Effects of alcohol on memory), such as resulting in a blackout phenomenon.

Epidemiological studies of middle-aged populations generally find the relationship between alcohol intake and the risk of stroke to be either U- or J-shaped.[87][88][89][90] There may be very different effects of alcohol based on the type of stroke studied. The predominant form of stroke in Western cultures is ischemic, whereas non-western cultures have more hemorrhagic stroke. In contrast to the beneficial effect of alcohol on ischemic stroke, consumption of more than 2 drinks per day increases the risk of hemorrhagic stroke. The National Stroke Association estimates this higher amount of alcohol increases stroke risk by 50%.[91] "For stroke, the observed relationship between alcohol consumption and risk in a given population depends on the proportion of strokes that are hemorrhagic. Light-to-moderate alcohol intake is associated with a lower risk of ischemic stroke which is likely to be, in part, causal. Hemorrhagic stroke, on the other hand, displays a loglinear relationship with alcohol intake."[92]

Alcohol abuse is associated with widespread and significant brain lesions. Alcohol related brain damage is not only due to the direct toxic effects of alcohol; alcohol withdrawal, nutritional deficiency, electrolyte disturbances, and liver damage are also believed to contribute to alcohol-related brain damage.[93]

Excessive alcohol intake is associated with impaired prospective memory. This impaired cognitive ability leads to increased failure to carry out an intended task at a later date, for example, forgetting to lock the door or to post a letter on time. The higher the volume of alcohol consumed and the longer consumed, the more severe the impairments.[94] One of the organs most sensitive to the toxic effects of chronic alcohol consumption is the brain. In the United States approximately 20% of admissions to mental health facilities are related to alcohol-related cognitive impairment, most notably alcohol-related dementia. Chronic excessive alcohol intake is also associated with serious cognitive decline and a range of neuropsychiatric complications. The elderly are the most sensitive to the toxic effects of alcohol on the brain.[95] There is some inconclusive evidence that small amounts of alcohol taken in earlier adult life is protective in later life against cognitive decline and dementia.[96] However, a study concluded, "Our findings suggest that, despite previous suggestions, moderate alcohol consumption does not protect older people from cognitive decline."[97]

There is tentative evidence that drinking a small amount of alcohol may decrease the risk of Alzheimer's disease latter in life.[98]

WernickeKorsakoff syndrome is a manifestation of thiamine deficiency, usually as a secondary effect of alcohol abuse.[99] The syndrome is a combined manifestation of two eponymous disorders, Korsakoff's Psychosis and Wernicke's encephalopathy, named after Drs. Sergei Korsakoff and Carl Wernicke. Wernicke's encephalopathy is the acute presentation of the syndrome and is characterised by a confusional state while Korsakoff's psychosis main symptoms are amnesia and executive dysfunction.[100]Banana bags, a bag of intravenous fluids containing vitamins and minerals, can be used to mitigate these outcomes.[101][102]

Essential tremorsor, in the case of essential tremors on a background of family history of essential tremors, familial tremorscan be temporarily relieved in up to two-thirds of patients by drinking small amounts of alcohol.[103]

Ethanol is known to activate aminobutyric acid type A (GABAA) and inhibit N-methyl-D-aspartate (NMDA) glutamate receptors, which are both implicated in essential tremor pathology[104] and could underlie the ameliorative effects.[105][106] Additionally, the effects of ethanol have been studied in different animal essential tremor models. (For more details on this topic, see Essential tremor.)

Chronic use of alcohol used to induce sleep can lead to insomnia: frequent moving between sleep stages occurs, with awakenings due to headaches and diaphoresis. Stopping chronic alcohol abuse can also lead to profound disturbances of sleep with vivid dreams. Chronic alcohol abuse is associated with NREM stage 3 and 4 sleep as well as suppression of REM sleep and REM sleep fragmentation. During withdrawal REM sleep is typically exaggerated as part of a rebound effect.[107]

High rates of major depressive disorder occur in heavy drinkers and those who abuse alcohol. Whether it is more true that major depressive disorder causes self-medicating alcohol abuse, or the increased incidence of the disorder in alcohol abusers is caused by the drinking, is not known though some evidence suggests drinking causes the disorder.[108] Alcohol misuse is associated with a number of mental health disorders and alcoholics have a very high suicide rate.[109] A study of people hospitalised for suicide attempts found that those who were alcoholics were 75 times more likely to go on to successfully commit suicide than non-alcoholic suicide attempters.[110] In the general alcoholic population the increased risk of suicide compared to the general public is 5-20 times greater. About 15 percent of alcoholics commit suicide. Abuse of other drugs is also associated with an increased risk of suicide. About 33 percent of suicides in the under 35s are due to alcohol or other substance misuse.[111]

Social skills are significantly impaired in people suffering from alcoholism due to the neurotoxic effects of alcohol on the brain, especially the prefrontal cortex area of the brain. The social skills that are impaired by alcohol abuse include impairments in perceiving facial emotions, prosody perception problems and theory of mind deficits; the ability to understand humour is also impaired in alcohol abusers.[112]

Studies have shown that alcohol dependence relates directly to cravings and irritability.[113] Another study has shown that alcohol use is a significant predisposing factor towards antisocial behavior in children.[114] Depression, anxiety and panic disorder are disorders commonly reported by alcohol dependent people. Alcoholism is associated with dampened activation in brain networks responsible for emotional processing (e.g. the amygdala and hippocampus).[115] Evidence that the mental health disorders are often induced by alcohol misuse via distortion of brain neurochemistry is indicated by the improvement or disappearance of symptoms that occurs after prolonged abstinence, although problems may worsen in early withdrawal and recovery periods.[116][117][118] Psychosis is secondary to several alcohol-related conditions including acute intoxication and withdrawal after significant exposure.[119] Chronic alcohol misuse can cause psychotic type symptoms to develop, more so than with other drugs of abuse. Alcohol abuse has been shown to cause an 800% increased risk of psychotic disorders in men and a 300% increased risk of psychotic disorders in women which are not related to pre-existing psychiatric disorders. This is significantly higher than the increased risk of psychotic disorders seen from cannabis use making alcohol abuse a very significant cause of psychotic disorders.[120] Approximately 3 percent of people who are alcohol dependent experience psychosis during acute intoxication or withdrawal. Alcohol-related psychosis may manifest itself through a kindling mechanism. The mechanism of alcohol-related psychosis is due to distortions to neuronal membranes, gene expression, as well as thiamin deficiency. It is possible in some cases that alcohol abuse via a kindling mechanism can cause the development of a chronic substance-induced psychotic disorder, i.e. schizophrenia. The effects of an alcohol-related psychosis include an increased risk of depression and suicide as well as psychosocial impairments.[119] However, moderate wine drinking has been shown to lower the risk for depression.[121]

While alcohol initially helps social phobia or panic symptoms, with longer term alcohol misuse can often worsen social phobia symptoms and can cause panic disorder to develop or worsen, during alcohol intoxication and especially during the alcohol withdrawal syndrome. This effect is not unique to alcohol but can also occur with long-term use of drugs which have a similar mechanism of action to alcohol such as the benzodiazepines, which are sometimes prescribed as tranquillizers to people with alcohol problems.[122] Approximately half of patients attending mental health services for conditions including anxiety disorders such as panic disorder or social phobia suffer from alcohol or benzodiazepine dependence. It was noted that every individual has an individual sensitivity level to alcohol or sedative hypnotic drugs and what one person can tolerate without ill health another will suffer very ill health and that even moderate drinking can cause rebound anxiety syndromes and sleep disorders. A person who is suffering the toxic effects of alcohol will not benefit from other therapies or medications as they do not address the root cause of the symptoms.[123]

Addiction to alcohol, as with any drug of abuse tested so far, has been correlated with an enduring reduction in the expression of GLT1 (EAAT2) in the nucleus accumbens and is implicated in the drug-seeking behavior expressed nearly universally across all documented addiction syndromes. This long-term dysregulation of glutamate transmission is associated with an increase in vulnerability to both relapse-events after re-exposure to drug-use triggers as well as an overall increase in the likelihood of developing addiction to other reinforcing drugs. Drugs which help to re-stabilize the glutamate system such as N-acetylcysteine have been proposed for the treatment of addiction to cocaine, nicotine, and alcohol.[124]

The impact of alcohol on weight-gain is contentious: some studies find no effect,[125] others find decreased[126] or increased effect on weight gain.

Alcohol use increases the risk of chronic gastritis (stomach inflammation);[3][127] it is one cause of cirrhosis, hepatitis, and pancreatitis in both its chronic and acute forms.

A study concluded, "Mild to moderate alcohol consumption is associated with a lower prevalence of the metabolic syndrome, with a favorable influence on lipids, waist circumference, and fasting insulin. This association was strongest among whites and among beer and wine drinkers."[128] This is also true for Asians. A J-curve association between alcohol intake and metabolic syndrome was found: "The results of the present study suggest that the metabolic syndrome is negatively associated with light alcohol consumption (115 g alcohol/d) in Korean adults". However, "odds ratios for the metabolic syndrome and its components tended to increase with increasing alcohol consumption."[129]

Research has found that drinking reduces the risk of developing gallstones. Compared with alcohol abstainers, the relative risk of gallstone disease, controlling for age, sex, education, smoking, and body mass index, is 0.83 for occasional and regular moderate drinkers (< 25 ml of ethanol per day), 0.67 for intermediate drinkers (25-50 ml per day), and 0.58 for heavy drinkers. This inverse association was consistent across strata of age, sex, and body mass index."[130] Frequency of drinking also appears to be a factor. "An increase in frequency of alcohol consumption also was related to decreased risk. Combining the reports of quantity and frequency of alcohol intake, a consumption pattern that reflected frequent intake (5-7 days/week) of any given amount of alcohol was associated with a decreased risk, as compared with nondrinkers. In contrast, infrequent alcohol intake (1-2 days/week) showed no significant association with risk."[131]

A large self-reported study published in 1998 found no correlation between gallbladder disease and multiple factors including smoking, alcohol consumption, hypertension, and coffee consumption.[132] A retrospective study from 1997 found vitamin C (ascorbic acid) supplement use in drinkers was associated with a lower prevalence of gallbladder disease, but this association was not seen in non-drinkers.[133]

Alcoholic liver disease is a major public health problem. For example, in the United States up to two million people have alcohol-related liver disorders.[134] Chronic alcohol abuse can cause fatty liver, cirrhosis and alcoholic hepatitis. Treatment options are limited and consist of most importantly discontinuing alcohol consumption. In cases of severe liver disease, the only treatment option may be a liver transplant from alcohol abstinent donors. Research is being conducted into the effectiveness of anti-TNFs. Certain complementary medications, e.g., milk thistle and silymarin, appear to offer some benefit.[134][135] Alcohol is a leading cause of liver cancer in the Western world, accounting for 32-45% of hepatic cancers. Up to half a million people in the United States develop alcohol-related liver cancer.[136][137] Moderate alcohol consumption also increases the risk of liver disease.[11]

Alcohol abuse is a leading cause of both acute pancreatitis and chronic pancreatitis.[138][139] Alcoholic pancreatitis can result in severe abdominal pain and may progress to pancreatic cancer.[140] Chronic pancreatitis often results in intestinal malabsorption, and can result in diabetes.[141]

Chronic alcohol ingestion can impair multiple critical cellular functions in the lung.[citation needed] These cellular impairments can lead to increased susceptibility to serious complications from lung disease. Recent research cites alcoholic lung disease as comparable to liver disease in alcohol-related mortality.[citation needed] Alcoholics have a higher risk of developing acute respiratory distress syndrome (ARDS) and experience higher rates of mortality from ARDS when compared to non-alcoholics.[citation needed] Despite these effects, a large prospective study has shown a protective effect of moderate alcohol consumption on respiratory mortality.[24]

Research indicates that drinking alcohol is associated with a lower risk of developing kidney stones. One study concludes, "Since beer seemed to be protective against kidney stones, the physiologic effects of other substances besides ethanol, especially those of hops, should also be examined."[142] "...consumption of coffee, alcohol, and vitamin C supplements were negatively associated with stones."[143] "After mutually adjusting for the intake of other beverages, the risk of stone formation decreased by the following amount for each 240-ml (8-oz) serving consumed daily: caffeinated coffee, 10%; decaffeinated coffee, 10%; tea, 14%; beer, 21%; and wine, 39%."[144] "...stone formation decreased by the following amount for each 240-mL (8-oz) serving consumed daily: 10% for caffeinated coffee, 9% for decaffeinated coffee, 8% for tea, and 59% for wine." (CI data excised from last two quotes.).[145]

Long term excessive intake of alcohol can lead to damage to the central nervous system and the peripheral nervous system resulting in loss of sexual desire and impotence in men.[146] This is caused by reduction of testosterone from ethanol-induced testicular atrophy, resulting in increased feminisation of males and is a clinical feature of alcohol abusing males who have cirrhosis of the liver.[147]

Excessive alcohol intake can result in hyperoestrogenisation.[148] It has been speculated that alcohol beverages may contain estrogen like compounds. In men, high levels of estrogen can lead to testicular failure and the development of feminine traits including development of male breasts, called gynecomastia.[149][150] In women, increased levels of estrogen due to excessive alcohol intake have been related to an increased risk of breast cancer.[150][151]

A meta-analysis found with data from 477,200 individuals determined the dose-response relationships by sex and end point using lifetime abstainers as the reference group. The search revealed 20 cohort studies that met our inclusion criteria. A U-shaped relationship was found for both sexes. Compared with lifetime abstainers, the relative risk (RR) for type 2 diabetes among men was most protective when consuming 22 g/day alcohol (RR 0.87 [95% CI 0.761.00]) and became deleterious at just over 60 g/day alcohol (1.01 [0.711.44]). Among women, consumption of 24 g/day alcohol was most protective (0.60 [0.520.69]) and became deleterious at about 50 g/day alcohol (1.02 [0.831.26]).

Because former drinkers may be inspired to abstain due to health concerns, they may actually be at increased risk of developing diabetes, known as the sick-quitter effect. Moreover, the balance of risk of alcohol consumption on other diseases and health outcomes, even at moderate levels of consumption, may outweigh the positive benefits with regard to diabetes.

Additionally, the way in which alcohol is consumed (i.e., with meals or bingeing on weekends) affects various health outcomes. Thus, it may be the case that the risk of diabetes associated with heavy alcohol consumption is due to consumption mainly on the weekend as opposed to the same amount spread over a week.[152] In the United Kingdom "advice on weekly consumption is avoided".

Also, a twenty-year twin study from Finland has shown that moderate alcohol consumption may reduce the risk of type 2 diabetes in men and women. However, binge drinking and high alcohol consumption was found to increase the risk of type 2 diabetes in women. [153] A study in mice has suggested a beneficial effect of alcohol in promoting insulin sensitivity.[154]

Regular consumption of alcohol is associated with an increased risk of gouty arthritis[155][156] and a decreased risk of rheumatoid arthritis.[157][158][159][160][161] Two recent studies report that the more alcohol consumed, the lower the risk of developing rheumatoid arthritis. Among those who drank regularly, the one-quarter who drank the most were up to 50% less likely to develop the disease compared to the half who drank the least.[162]

The researchers noted that moderate alcohol consumption also reduces the risk of other inflammatory processes such as cardiovascualar disease. Some of the biological mechanisms by which ethanol reduces the risk of destructive arthritis and prevents the loss of bone mineral density (BMD), which is part of the disease process.[163]

A study concluded, "Alcohol either protects from RA or, subjects with RA curtail their drinking after the manifestation of RA".[164] Another study found, "Postmenopausal women who averaged more than 14 alcoholic drinks per week had a reduced risk of rheumatoid arthritis..."[165]

Moderate alcohol consumption is associated with higher bone mineral density in postmenopausal women. "...Alcohol consumption significantly decreased the likelihood [of osteoporosis]."[166] "Moderate alcohol intake was associated with higher BMD in postmenopausal elderly women."[167] "Social drinking is associated with higher bone mineral density in men and women [over 45]."[168] However, alcohol abuse is associated with bone loss.[169][170]

Chronic excessive alcohol abuse is associated with a wide range of skin disorders including urticaria, porphyria cutanea tarda, flushing, cutaneous stigmata of cirrhosis, psoriasis, pruritus, seborrheic dermatitis and rosacea.[171]

A 2010 study concluded, "Nonlight beer intake is associated with an increased risk of developing psoriasis among women. Other alcoholic beverages did not increase the risk of psoriasis in this study."[172]

There is a protective effect of alcohol consumption against active infection with H. pylori[173] In contrast, alcohol intake (comparing those who drink > 30g of alcohol per day to non-drinkers) is not associated with higher risk of duodenal ulcer.[174] Excessive alcohol consumption seen in alcoholics is a known risk factor for pneumonia.

A study on the common cold found that "Greater numbers of alcoholic drinks (up to three or four per day) were associated with decreased risk for developing colds because drinking was associated with decreased illness following infection. However, the benefits of drinking occurred only among nonsmokers. [...] Although alcohol consumption did not influence risk of clinical illness for smokers, moderate alcohol consumption was associated with decreased risk for nonsmokers."[175]

Another study concluded, "Findings suggest that wine intake, especially red wine, may have a protective effect against common cold. Beer, spirits, and total alcohol intakes do not seem to affect the incidence of common cold."[176]

In 1988 the International Agency for Research on Cancer (Centre International de Recherche sur le Cancer) of the World Health Organization classified alcohol as a Group 1 carcinogen, stating "There is sufficient evidence for the carcinogenicity of alcoholic beverages in humans.... Alcoholic beverages are carcinogenic to humans (Group 1)."[177] The U.S. Department of Health & Human Services National Toxicology Program in 2000 listed alcohol as a known carcinogen.[178]

It was estimated in 2006 that "3.6% of all cancer cases worldwide are related to alcohol drinking, resulting in 3.5% of all cancer deaths."[179] A European study from 2011 found that one in 10 of all cancers in men and one in 33 in women were caused by past or current alcohol intake.[180][181] The World Cancer Research Fund panel report Food, Nutrition, Physical Activity and the Prevention of Cancer: a Global Perspective finds the evidence "convincing" that alcoholic drinks increase the risk of the following cancers: mouth, pharynx and larynx, oesophagus, colorectum (men), breast (pre- and postmenopause).[182]

Acetaldehyde, a metabolic product of alcohol, is suspected to promote cancer. Typically the liver eliminates 99% of acetaldehyde produced. However, liver disease and certain genetic enzyme deficiencies result in high acetaldehyde levels. Heavy drinkers who are exposed to high acetaldehyde levels due to a genetic defect in alcohol dehydrogenase have been found to be at greater risk of developing cancers of the upper gastrointestinal tract and liver.[183] A review in 2007 found "convincing evidence that acetaldehyde... is responsible for the carcinogenic effect of ethanol... owing to its multiple mutagenic effects on DNA."[184] Acetaldehyde can react with DNA to create DNA adducts including the Cr-Pdg adduct. This Cr-PdG adduct "is likely to play a central role in the mechanism of alcoholic beverage related carcinogenesis."[185] Some have pointed out that even moderate levels of alcohol consumption are associated with an increased risk of certain forms of cancer.[11]

Fetal alcohol syndrome or FAS is a birth defect that occurs in the offspring of women who drink alcohol during pregnancy. Drinking heavily or during the early stages of prenatal development has been conclusively linked to FAS; moderate consumption is associated with fetal damage.[11] Alcohol crosses the placental barrier and can stunt fetal growth or weight, create distinctive facial stigmata, damaged neurons and brain structures, and cause other physical, mental, or behavioural problems.[186] Fetal alcohol exposure is the leading known cause of intellectual disability in the Western world.[187] Alcohol consumption during pregnancy is associated with brain insulin and insulin-like growth factor resistance.[169]

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Long-term effects of alcohol consumption - Wikipedia

AUSTIN, Texas--(BUSINESS WIRE)--

There are millions of Americans struggling with weight loss, no matter how hard they diet and exercise. AlternaScript has figured out how to help make it easier for Americans to lose weight, shared Kathy Ireland, supermodel and entrepreneur.

This Smart News Release features multimedia. View the full release here: http://www.businesswire.com/news/home/20170413005246/en/

AlternaScript is a health tech startup founded in 2013 based in Austin, TX. Lucas Siegel, 26-year-old CEO and co-founder, started the company in college because he wanted to create products that made the world a better place while helping people get and stay healthy. AlternaScript has since launched four products that allow people to not just exist, but to thrive. The company is driven by purpose, donating 5% of their profits to help people recovering from off-label prescription drug abuse.

As a child, Siegel immensely struggled with weight and was thought of as chubby. Like many Americans, he had a problematic relationship with food and sugar. Siegel said, I didnt understand the fundamental building blocks of nutrition and successful strategies for weight management. He tried and failed every fad diet, one after the other.

A year and a half ago, Siegel was at a gas station outside of Austin, Texas and looked around. He realized that everyone was immensely overweight. This was shocking and horrifying, yet all too familiar. He began analyzing what was on the shelves and what people were buying, then it became pretty clear what was going on. Americas food system is poisoned with highly addictive food scientifically designed with specific amounts of sugar to get people addicted to them. The result is Americans are victims of bad food choices out of convenience and misleading advertising. This was a turning point for Siegel. It was at this moment, he had to create a product that could help people get fit again, but in a natural and healthy way that was truly sustainable.

NatureThin is the latest addition to AlternaScripts portfolio. Siegel developed NatureThin after an incredibly frustrating experience testing hundreds of weight management products and ingredients that did not work. With leading researchers, biochemists, and nutritionists, AlternaScript developed a natural way for people to get and stay thin that was supported by science and made of the earth. NatureThin is a botanical based weight management multivitamin and contains no stimulants. It is a vegetarian combination of essential vitamins and shortfall nutrients that have over ten years of research supporting its efficacy, as well as two gold standard, double blind placebo controlled clinical studies on healthy human populations. Shortfall nutrients are identified by the USDA as nutrients Americans are deficient in such as Vitamin D and potassium, both of which have been scientifically curated in NatureThin.

We took over 200 botanicals and injected them into human fat cells to see if they would shrink. After looking at these results, we found three that did. Then we wanted to see if these three worked together to reduce fat cells even more than when alone. Our scientists tested different concentration levels of each ingredient when blended together to see which formulation would result in maximum fat cell reduction, said Lucas Siegel, CEO, AlternaScript.

NatureThin is going to help millions of Americans lose weight because it uses premium targeted botanicals and vitamins that have been meticulously studied as key ingredients in supporting healthy weight loss, stated Dr. Catherine Adams Hutt, certified food scientist, and registered dietician. Results were recorded in as little as two weeks and remained constant beyond the typical twelve week weight loss plateau in both men and women. Since starting NatureThin, I've lost 8 pounds and have been religiously taking my OptiMind and feel (with three kids) like I have the energy to keep up ALL DAY! The products are real and the people are awesome! The thing I love most about NatureThin is that it works. That, and the honesty behind it, said Meghan Arnold from Charlotte, Texas.

According to Dr. Barbara Davis, molecular biologist and registered dietician, Participants in the trial of the active ingredient in NatureThin experienced a total weight loss of nearly twelve pounds and a two inch reduction in waist circumference by the end of sixteen weeks. Davis added, This trial demonstrates steady, consistent weight loss starting early, and supporting long-term success with a targeted reduction in waist circumference, and maintenance of lean body mass.

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I just turned 68, and as I get older, its harder to maintain my ideal weight with a slower metabolism. I cant seem to lose weight where I want to. Since discovering NatureThin, Ive lost 12 pounds in the past month with easy adjustments like cutting back on sugar and going on walks, shares Patricia Heighton, former Miss San Diego and mother of six.

All AlternaScript products undergo a rigorous testing and verification process to guarantee high quality standards and are made in the USA in cGMP certified labs with purity testing of all ingredients. To continue its commitment to holistic well-being and sustainability, AlternaScript produces NatureThin and all their offerings in a facility powered by over 200 rooftop solar panels and uses 40% less energy than conventional manufacturing plants.

About AlternaScript

AlternaScript is a premium health tech company disrupting the healthcare industry by challenging traditional business models. AlternaScripts direct-to-consumer model leverages technology, scientific advancements, and personalized care to modernize the health industry and bring products direct to consumers. The company has built a philosophy focused on personalized care, guided by clinical studies, hard science, individual thought, and patience.

Since starting in 2013, AlternaScript has given away over $2 million in free samples to their rapidly expanding customer base. AlternaScripts Customer Love Team is available 24/7 to provide quality support by real, thinking humans. Other AlternaScript products include Americas best selling nootropic, OptiMind; a premium restorative non-habit forming sleep aid, RestUp; and a ground-breaking biome cleansing probiotic and prebiotic, NuCulture. All products have a 100% happiness guarantee with a no-questions asked, full refund policy.

AlternaScript donates 5% of profits to helping people in recovery from off-label prescription drug abuse and addiction through the AlternaScript Recovery Fund, a network of charities specializing in prescription drug rehabilitation.

View source version on businesswire.com: http://www.businesswire.com/news/home/20170413005246/en/

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AlternaScript Helps Makes It Easier for Americans to Lose Weight - Yahoo Finance

Youd think that by now wed all stop falling for supplements which promise to blast belly fat or drop pounds while still eating cupcakes, but youd be wrong. Powerful marketing continues to dupe vulnerable people into wasting their money. Here are the common selling points (ahem, lies) that youll find on the label.

Weight loss supplements are a general category designed to accelerate weight loss, typically by one of several ways: suppressing your appetite, blocking absorption of nutrients, or increasing the number of calories you burn. These benefits come from any number of key active ingredients. You might have heard of some: ephedrine, capsaicin, caffeine, and yohimbine; and brand names such as Hydroxycut and Alli.

This Mens Health article cuts through the bullshit of the most common marketing promises on these supplement labels:

Some supplements can work if you use them alongsidesurprisegood ol diet and exercise, but be warned: there are plenty of sometimes dangerous side effects. The beneficial effects, if any, are typically so small that youre better off just saving your money and just exercising and eating right.

Contributing writer. Nomad. Miscellaneous ramblings at http://thefyslife.com.

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The Most Common Lies Told By Gimmicky Weight Loss Supplements - Lifehacker Australia

Psychology Today (blog)

Intermittent Fasting for Weight Loss and Other Benefits Psychology Today (blog) Long-term use of IF may, in fact, shift the substrate the body uses for energy preferentially to fat, though it's not clear how often you need to fast to bring about this shift. One concern about every-other-day fasting, however, is that it might ... and more »

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Intermittent Fasting for Weight Loss and Other Benefits - Psychology Today (blog)

Kenny Jastrow, Shannon Medical Center 12:28 p.m. CT April 11, 2017

Kenny Jastrow, general surgeon at Shannon Medical Center(Photo: Shannon Medical Center)

Obesity is a rapidly increasing epidemic more than one third of the adult population in our country is obese. This serious condition leads to additional health problems including diabetes, heart disease and stroke.

If left untreated, obesity can be fatal.

Higher medical costs are another cause for concern regarding obesity. The Centers for Disease Control and Prevention state medical costs for obese patients are about $1,500 higher than patients of normal weight.

Bariatric surgery is a tool to help obese patients with their battle to regain control of their health. Sleeve gastrectomy, a type of bariatric surgery offered nationwide, is now available via the Shannon Weight Loss Center.

The goal of bariatric surgery is to reduce the patients caloric intake and to curb hunger. The sleeve gastrectomy is a restrictive procedure which narrows the size of the stomach, causing the patient to consume fewer calories. The operation removes the receptors that trigger hunger which causes the appetite to decrease.

Bariatric surgery is a permanent change to the body. The team at the Shannon Weight Loss Center must make sure patients are mentally and physically capable of tolerating the procedure. Therefore, we follow patients pre-and post-operatively to help them succeed. National standards are used to determine if a patient qualifies for surgery.

Patients should expect to lose 60 to 70 percent of their excess body weight after the sleeve gastrectomy procedure. How quickly the weight is lost varies for each patient. They may be able to stop taking medications and reverse conditions such as hypertension, high cholesterol and diabetes.

Surgery is only one part of our patients weight loss journey. We can make sure the operation is a success, but the patient plays a huge role in making sure the surgery is successful.

They must adhere to a diet and make sure they exercise. The post-operative follow-up is intense because we want to make sure they are adhering to the program. Patients are given a bariatric manual that offers an in-depth look into the operation itself including pre-and post-operative care and dietary plans.

We think it is important to offer this procedure to patients locally. We have had patients undergo the surgery and they go off their medications, their diabetes improves, and their blood pressure goes down. These factors combined can provide long-term quality of life. It is a huge help to some of our patients and that is always our goal.

For more information about the sleeve gastrectomy procedure, please call the Shannon Weight Loss Center at 325-481-2344 or visit shannonhealth.com/services/weight-loss-center.aspx to read the testimonial of a patient who is experiencing a second chance of life after her surgery.

Kenny Jastrow III is a general surgeon at Shannon Medical Center.

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HOUSE CALL: Comprehensive approach to weight loss - San Angelo Standard Times

A Google search for ways to lose weight for women garners 51,200,000 results. For men, its 48,600,000. A Google search for anti aging products for women gets approximately 1,590,000 results. For men, its 1,440,000.

If you spend five minutes watching TV, youll see commercials for dozens of these products, which dont live up to their hype.

For example, Garcinia cambogia, a small, green fruit shaped like a pumpkin has been known as a popular diet supplement since it was featured on the Dr. Oz show in 2012. Even though animal studies were promising, one study conducted by Columbia University showed no effectiveness, and 12 others found that, on average, the supplement can help people lose about only 2 pounds over several weeks.

The fruit didnt measure up to its hype. So which of these many products work?

Weight loss

Authoritynutrition.com ranked 12 different weight loss supplements. Two of their winners are glucomannan and Orlistat (Alli).

Glucomannan is a fiber found in roots of elephant yam. It absorbs water and sits in your gut, which makes you feel full and helps you eat fewer calories. Three studies have shown that this supplement, along with a healthy diet, can help someone lose 8-10 pounds in five weeks. It can also lower blood pressure, cholesterol and is effective against constipation.

Orlistat works by inhibiting the breakdown of fat, making a person take in fewer calories from fat. According to authoritynutrition.com, 11 studies have shown that this supplement can increase weight loss by 6 pounds compared to dummy pills. Other studies have shown that it slightly reduces blood pressure and the risk of developing type 2 diabetes.

Hydroxycut is one of the most advertised and most popular weight loss supplements in the world. It contains several ingredients that claim to help with weight loss, including caffeine and various plant extracts.

While its wildly popular, only one study has shown that it helps people lose weight and theres no data on long-term effectiveness. This study showed that it caused someone to lose 21 pounds over a three-month period.

Caffeine is another popular weight loss supplement that often tops lists, and its easy to market since people regularly ingest it when they drink their morning coffee or tea.

Multiple short-term studies have shown that caffeine can boost someones metabolism by 3-11 percent, and increase fat burning by up to 29 percent. A few studies have even show that caffeine may cause some weight loss. While studies have encouraging results, building up a tolerance decreases these effects.

Anti aging

Numerous dermatologists told stylecaster.com that BB creams are not worth the hype, and are just overrated tinted moisturizers. The doctors also said that stretch mark creams and dark spot remover creams are not effective.

Other over-hyped anti-aging products included skin tighteners, overpriced moisturizers, pore strips, and detox products.

When it comes to products that could be worth your money, Goodhousekeeping.com has done the research. They tested 84 products over the course of 11 months. Here are the results.

Neutrogena Rapid Wrinkle repair Moisturizer SPF 30 ($21 for 1 oz) was their best rated facial moisturizer. La Prairie Cellular Power Charge Night ($272 for 1.35 oz) was the best rated night cream. Another cheaper night cream option was Boots No7 Light Luminate Night Cream, which costs $25 for 1.6 oz.

If youre aiming to firm skin or correct skin tone, goodhousekeeping.com recommends Lancme Visionnaire Advanced Skin Corrector ($79 for 1 oz.), and LOreal Paris Youth Code Dark Spot Correcting Illuminating Serum Corrector ($25 for 1 oz.).

The best wrinkle smoother was Skyn Iceland Angelica Line Smoother at $65 for 1.5 oz.

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Do weight loss and anti-aging products work? - Fenton Tri County Times

WESTON, WV--(Marketwired - April 11, 2017) - The hCG diet has been around for decades but is often misunderstood. Although quite effective in promoting rapid weight loss, it can be risky. The original hCG diet was developed by Dr. ATW Simeons in the early 1950s as a starvation-based diet that limited daily consumption to 500 calories. Dieters lost up to one pound per day by following an extremely low calorie diet and intaking small doses of hCG (human chorionic gonadotropin).

hCG is a hormone produced during pregnancy that contains 244 amino acids and has been linked to rapid weight loss by supposedly reducing "abnormal" fat from cells and around internal organs. When applied to a starvation diet like the original hCG diet, however, it can result in negative effects like extreme weakness, hair loss, and muscle decrease. Over time, the original hCG diet, also known as the Simeons method, became regarded as 'unsafe' by medical professionals, nutritionists, and leading weight loss centers like Diet Doc.

While the original hCG diet based on the Simeons method has been discredited, researchers have learned a lot about the hCG hormone and safer ways to apply it. Now, higher calorie programs for hCG treatment are available. These programs generally involve undergoing hCG treatment while consuming between 800 to 1250 calories every day. Individuals are able to lose weight consistently and the negative side effects seen with the Simeons method are minimized.

Diet Doc, a nationally recognized weight loss program, has continuously discouraged the Simeons method of hCG dieting and suggests high-calorie programs that involve safer weight loss. Doctor-supervision and diet customization based on nutritional needs are also highly recommended.

Regardless of their weight loss history or individual struggles, Diet Doc helps patients develop an individualized diet based on their nutritional needs or even their genetics. All Diet Doc programs, provide a doctor-supervised, customized diet plan. Instead of encouraging patients to adopt harmful dietary practices with no prior medical knowledge, Diet Doc consults with patients to provide a detailed weight loss plan based on their nutritional needs and medical history.

Losing weight with Diet Doc is safe, simple and affordable. Nutrition plans, exercise guidance, motivational support, and dietary supplements are all part of the package. Over 90% of Diet Doc patients report an average weight loss of 20 or more pounds every month and long-term weight loss maintenance is made possible through continuous counseling.

Patients can get started immediately, with materials shipped directly to their home or office. They can also maintain weight loss in the long-term through weekly consultations, customized diet plans, motivational coaches and a powerful prescription program. With Diet Doc, the doctor is only a short phone call away and a fully dedicated team of qualified professionals is available 6 days per week to answer questions, address concerns and support patients.

Getting started with Diet Doc is very simple and affordable. New patients can easily visit https://www.dietdoc.com to quickly complete a health questionnaire and schedule an immediate, free online consultation.

About the Company:Diet Doc Weight Loss is the nation's leader in medical, weight loss offering a full line of prescription medication, doctor, nurse and nutritional coaching support. For over a decade, Diet Doc has produced a sophisticated, doctor designed weight loss program that addresses each individual specific health need to promote fast, safe and long term weight loss.

Twitter: https://twitter.com/DietDocMedicalFacebook: https://www.facebook.com/DietDocMedicalWeightLoss/LinkedIn: https://www.LinkedIn.com/company/diet-doc-weight-loss?trk=biz-brand-tree-co-logo

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Diet Doc Patients Avoid the Dangerous hCG Diet Plan and Lose Weight Fast With Doctor-Customized Diets - Marketwired (press release)

Want to know what works for treating overweight and obesity?

This past week, the National Academy of Medicine (NAM, formerly Institute of Medicine) hosted two events in which I participated: (1) a full-afternoon discussion on obesity prevention and management, (2) a full-day workshop on treating overweight and obesity.

The afternoon discussion occurred through the Innovation Collaborative known by the awkward abbreviation, ICSSPMO (Integrated Clinical and Social Systems for the Prevention and Management of Obesity). As with all NAM collaboratives, ICSSPMO is comprised of national experts representing diverse stakeholder groups. Im not at liberty to share the specifics from ICSSPMO meeting at this time, but rest assured big ideas were discussed that will be ready for wider dissemination soon. I have no doubt that the models and initiatives under development will translate to better care for obese patients and improved health more broadly for communities.

What I am at liberty to share from the NAM last week is the content of the full-day workshop: The Challenge of Treating Obesity and Overweight - Learning What Works and Making it Happen. The workshop was hosted by the Roundtable on Obesity Solutions of NAMs Food and Nutrition Board. It focused on treating obesity (including severe obesity) in adults and children, as well as where things stand and how to move forward in terms of obesity providers, payment, and policy.

Below are some high-level highlights from the day. Full details will be available soon on the NAM website in a full slide deck of presentations and complete video.

If behavioral treatment were a drug, it would be approvable, was one emphasized lesson from the NAM workshop. Unfortunately, the type of behavioral treatment offered most often in primary care offices is not effective. This treatment can take the form of little more than simple advice to eat less and move more, which is not at all helpful ... and in fact creates and blames victims.

Effective behavioral treatment entails not just advising patients what to change but how to change. It includes guidance on stimulus control, goal setting, problem solving, stress reduction, self-monitoring, and relapse prevention.

Intensity of treatment matters too; the more treatment contact (the less patients have to struggle on their own), the better. Intensive lifestyle interventions (e.g., around diet, exercise, sleep, stress reduction, etc.) produce meaningful weight loss and other health benefits.

But even with well-designed, high-intensity lifestyle interventions for behavior modification, there are currently disparities in outcomes. Patient age matters as children are not just little adults and their growth and maturity play roles in success. Race/ethnicity plays a role too as there are racial ethnic disparities in intervention effectiveness (although, reassuringly, disparities tend to diminish over time).

When behavior modification isnt enough, there are weight-loss medications to considernine of them, in fact (five for long-term use). At least that is the case for adults. In children, only two meds are approved for use (or three if you consider kids who are 16 years and older).

Weight reduction early on with medication predicts later success. But effectiveness for the different drugs varies and some side effects can be unpleasant (for adults or children)e.g., flatulence, stomach pain, and greasy anal leakage. Emerging medications may be more personalized, less problematic, and target novel pathways including gene mutations.

Failing behavior modification and medication alone, surgery may be an option. Of the three most common procedures, gastric bypass (Roux-en-Y) seems to be more effective than gastric sleeve (sleeve gastrectomy), and both procedures are more effective than gastric banding (a.k.a. lap band). For all surgeries, the safety has improved dramatically over the years and the complication rates have gone downfor adults and kids.

For kids though, decisional capacity and physiologic maturity are issues. Nonetheless, high-quality evidence supports weight-loss surgery in a pediatric population. In fact (as in adults) bariatric procedures or often termed metabolic surgery because a variety of factors like blood sugar, blood pressure, and cholesterol improve after surgery, largely independent of weight loss.

There are also several less-invasive procedures that are now approved, like gastric balloons, nerve stimulators, and tubes that suck stomach contents into external containers. At the present time, it is not fully clear what the role is for these emerging (and not always pleasant) options.

For the severely obese, combinations are neededcombinations of therapies (with medications added after bariatric surgery to a backbone of behavioral management, for instance) but also combinations in treatment-team members (which might include surgeons, gastroenterologists, obesity medicine physicians, dietitians, psychologists, and various support staff).

In spite of solid and growing evidence for behavioral interventions, medications, and surgery, there are still unanswered questions. For example, can we deliver effective behavioral therapies through modes of contact that are not in-person (e.g., telephone, text, remote sensors and various apps)? What is the long-term efficacy of medications? How do drugs and surgery work in disparities populations? What are the predictors of response to any treatment (demographic, genetic, etc.)?

Several presenters emphasized a need for greater infrastructure, training a provider workforce with specialized knowledge of obesity. Obesity Medicine is the fastest growing specialty field in medicine, and there needs to be additional fellowship opportunities. Also, all physicians need greater training in obesity, and testing for minimal competencies (of note: the current U.S. Medical Licensing Exam lacks any meaningful coverage of obesity).

Physicians need to understand obesity as a complex chronic disease (like hypertension or diabetes), not a moral failing. And allied health personnel, like nurse practitioners, physicians associates, and social workers, would also benefit from training (and certification).

All providers should be knowledgeable about disparities and inequalities, and all should use patient-centered, non-judgmental, patient-first language (e.g., the patient who has obesity [affliction] not the obese patient [stigmatizing identity]). Those providing primary care need not provide all interventions but should know what is out there and be able to link to obesity medicine specialists.

There were anecdotes of elected officials misunderstanding obesity as a problem of deficient will power, and one made worse by government handouts like Food Stamps (not my words, but very nearly a direct quote of one Senator). Policy makers need to understand that obesity is much more complex than mere calorie considerations. In fact, focusing on calories might mislead and harm public health.

For policy, there is urgency, related in no small part to growth in childhood obesity. Elected officials need to recognize that children develop the same weight-related problems as adults (e.g., diabetes, hypertension, high cholesterol) but carry them longer and have additional unique issues to bear (like orthopedic problems from extra weight burden on immature skeletons). Childhood body weight predicts preventable disease and premature death in adulthood. And beyond health implications, the cost considerations of increasing obesity and obesity-related chronic diseases (for individuals and our society) are staggering.

Given the substantial costs, it is not hard to make a case that treating obesity would be a good return on investment. Payers, of course, have to consider various factors in covering services, but when the same payer bears the cost of the intervention (e.g., medication) and the cost of not treating (e.g., worsening diabetes, hypertension, high cholesterol, arthritis, depression, respiratory illness, etc.), it is hard to understand pervasive coverage denials and ubiquitous prior-authorizations. Still, that is the current experience in practice. Emerging policies, like the Treat and Reduce Obesity Act for Medicare, might help move insurers across the board to better coverage for a variety of obesity treatments.

In the interim, we know a lot about what works (what really works) for the treatment overweight and obesity. As a society, we just need to do a better job of making it happen.

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What works (what REALLY works) for treating overweight and obesity - Huffington Post

New York Times

Tackling Weight Loss and Diabetes With Video Chats New York Times ... J. Abrahamson, an endocrinologist at Beth Israel Deaconess Medical Center and an associate professor of medicine at Harvard Medical School who has no financial ties to Virta, said the new study was a great proof of concept but that he would like ...

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Tackling Weight Loss and Diabetes With Video Chats - New York Times

In the past, the 57-year-old Gilmer, Texas, resident would try fad diets that did nothing but leave her feeling frustrated, she said.

"There was one called a grapefruit diet or something where you didn't eat anything but grapefruit," Henson said. "If you do something like that, that's what I meant by 'diet' being a failure."

She didn't consistently exercise, either. Although she didn't have any serious health conditions, she knew that her lifestyle was killing her. Henson was 5-foot-4 and 332 pounds.

Then, about six years ago, Henson was listening to the radio when an ad for Anytime Fitness blasted through the speakers. She said a quick prayer: "God, I wish we had one of those here."

Two weeks later, a gym opened in her neighborhood.

"I looked at it as an answered prayer," Henson said. "If that hadn't happened, there's a possibility I could have died or have any of the conditions associated with being obese. There's a history of heart disease and diabetes in my family. I was headed in that direction, and I didn't want to go there."

Ever since, Henson has been going to the gym daily with two of her friends and has been preparing healthier meals for herself. She has lost 175 pounds -- more than 50% of her previous body weight -- and she is keeping the weight off, she said. She has ditched fad diets and avoids placing too much emphasis on how much she weighs and instead focuses on how she feels.

But she remembers how easy it was to stick to the same old foods and avoid exercising, and how hard it was to find a healthier routine that led to long-term weight loss.

Experts are now trying to figure out why: whether it's because they don't realize they're at an unhealthy weight, because weight loss is hard or something else entirely.

The new paper showed that more than 30% of Americans said they were obese in 2015, compared with about 19% in 1997. Of those who were overweight or obese, about 49% said they were trying to lose weight in 2014, compared with about 55% in 1994.

"I've pondered that several times, as to why some people would want to be unhealthy when they can be healthy, but there are so many variables in someone's life that you don't know about," Henson said.

"I can't sit in judgment as to why that person wants to or doesn't want to. I just know what I needed and what I needed to do to change," she said. "You can't change what you've tried in the past, but you can set your sights for a better future.

"Everyone's on a different path, a different journey," Henson said.

For the new paper, "we hypothesized that the prevalent misperception may lead to a lack of motivation to lose weight. The current study just provides the missing piece of the puzzle," Zhang said.

"We are stuck in a vicious cycle. More people are getting obese; more are fine with their weight; when they are looking around, they find more persons with even larger bodies, and more are getting less motivated to lose weight, and in turn, we are getting even heavier," he said.

Dr. Randy Rockney, a pediatrician at Hasbro Children's Hospital in Providence, Rhode Island, has noticed the same thing happening among children, he said.

"Increasing obesity and overweight trends probably result in 'new normals,' " said Rockney, who was not involved in the new paper.

"Looking at society in general, overweight and obese people are less likely to perceive themselves as aberrant," he said. "It's really hard to lose weight, but it's not impossible, and I think there are a lot of people who have given up."

Rockney, 63, knows those challenges too well.

Standing at 6-foot-1, Rockney said his weight has fluctuated since he was in medical school, from the mid-180s to a high of 218, which meets the criteria for "overweight."

"The numbers are very sensitive to my weight," he said of his blood-sugar levels. "If I go up by five pounds, it will change the numbers adversely, and then, conversely, losing five pounds makes a significant improvement."

So Rockney decided to enroll in a weight loss study at work. He began calculating and restricting his fat and calorie intake, recording the foods and drinks he consumed, and weighing himself. He dropped to 193 pounds.

The weight loss was tough but not impossible, Rockney said. "I am more weight conscientious than I was, particularly regarding diet. I regained some of the weight I lost but remain well under where I started."

He said he currently weighs about 203 pounds, which technically still places his body mass index in the overweight category.

"A lot of physicians are conscious of this, that it's hard to preach healthy diet and exercise and healthy weight if you as a physician are not at a healthy weight," he said. "Among my patients and their families, excess weight continues to be a very common problem. We try to help them, but it can be challenging."

The new paper in JAMA included data on 27,350 overweight and obese adults who reported whether they were trying to lose weight between 1988 and 1994, 1999 and 2004, and 2009 and 2014.

"It's unfortunate that the current study was based on interviews rather than direct observation," Zhang said. "This is the reason we cannot rule out the possibility that many adults are actually fully engaging with a healthy lifestyle, but not on purpose to lose weight."

He added that the data did not include reports from the adults as to why they were not trying to lose weight, but he has some theories.

"First and foremost, it's painful. It's hard to drop pounds. Many of us tried and failed, tried and failed, and finally failed to try any more," Zhang said.

The researchers wrote that some overweight people are not trying to lose "due to body weight misperception reducing motivation to engage in weight loss efforts. ... The chronicity of obesity may also contribute. The longer adults live with obesity, the less they may be willing to attempt weight loss, in particular if they had attempted weight loss multiple times without success."

Yet Kelly Brownell, dean of the Sanford School of Public Policy at Duke University and an expert on obesity, said he would come to a different set of conclusions.

"I think there are other possibilities that might be at least as important. One is that almost everybody who is overweight has tried to lose, and people are recognizing more and more that it's a very difficult challenge," said Brownell, who was not involved in the paper.

"Most approaches to weight loss produce temporary loss. People tend to regain and then go on more diets later, and so some people feel that it's not worth the effort and that the risk of failure is too high," he said. "Most people who are overweight realize that there are negative consequences and would like to lose weight if they could. But they realize that it's a very hard path to go down and that most people are not successful.

"It argues more than ever for the importance of prevention, because once people become overweight, it's very hard to lose, it's even harder to keep the weight off, and therefore preventing the weight gain in the first place has to be a national priority."

The researchers of the new paper, however, also noted that primary care clinicians might not be discussing weight issues with their patients, something that has been found in separate studies.

"Further, this decline was greatest in patients with obesity, patients at most need for physician intervention," she said.

"This may be due to a variety of reasons, including physician discomfort with providing counseling, less time available due to increased other patient conditions or even a greater acceptance of higher rates of obesity," she said. "We know that if physicians simply tell their patients they are overweight, they are more likely to be successful in their weight loss efforts. Therefore, it's critical we find a way to help reverse these trends."

However, pediatrician Rockney said he hasn't observed a decline in weight-related counseling in his own professional experience.

"For a long time, I could sense a deep cynicism about addressing the weight problem," he said. "But in recent times, there are a couple of my colleagues who have really taken on the obesity issue with kids and are really pushing intervention."

Before his weight loss, Rockney said, he sometimes felt self-conscious counseling parents and children about losing weight.

That patient turned to his mother and Rockney and said, "Hey, I think we all could stand to lose 15 or 20 pounds," making a reference to the doctor's weight.

Now, "I feel more confident in terms of advising families, people, what it is that can work for weight loss," Rockney said.

He often advises his patients to eat a healthy breakfast daily and monitor their caloric intake for weight loss. For instance, a blueberry muffin can take up about a third of your daily calories, since it has almost 500 calories, he said.

Rockney also advises his patients to weigh themselves daily, as addressing a lapse in weight loss can prevent even more weight gain, he said.

"One important principle I learned and still think to myself is, 'don't let a lapse become a relapse.' That's where regular weighings help, because I can potentially intervene before things get out of hand," Rockney said.

He said his effort to maintain his current weight or even lose weight again continues.

Beyond the clinic walls, having discussions about weight can be even more uncomfortable, Penn State's Kraschnewski said.

"Studies tell us that the vast majority of people who are overweight are interested in losing weight, but interest doesn't necessarily translate to action," she said.

If a loved one's weight might be putting their health at risk, Kraschnewski offered some advice on how to discuss weight loss.

"Look for opportunities to have a conversation, such as if your loved one makes a comment about their weight. If they aren't happy with their current weight, offer to help them talk to their doctor or look for other weight loss resources in your community," she said.

"Think about ways you could be active together," she said. "Having a partner on the journey to a healthier weight is one of the most effective ways for people to be successful."

Original post:
Why are fewer Americans trying to lose weight? - CNN.com - CNN

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