P R E S S   R E L E A S E

        Obesity is a major culprit for many chronic disabling conditions including cardiovascular diseases, degenerative joint, gall bladder diseases as well as gynaecological and gastrointestinal malignancies.  Apart from its close associations with risk factors such as high blood pressure, high blood glucose and abnormal fat levels, there is now evidence showing that fat cells can secrete many harmful hormones or proteins, which can directly cause tissue damage.

        The Chinese University of Hong Kong has studied more than 700 patients attending the medical clinics at the Prince of Wales Hospital.  The average body mass index (BMI) of these patients was 25.7 kg/㎡ and average waist circumferences were 86 cm (34 inches) and 77 cm (31 inches) in male and female respectively.  Compared to subjects with BMI < 20 kg/㎡ and waist circumference < 70 cm (28 inches), obese people (with a BMI ≧ 25 kg/ ㎡ or waist circumference ≧ 85 cm (34 inches) in men and ≧ 75 cm (30 inches) in women) had 4-fold increased risk of having either high blood glucose, high blood pressure, abnormal blood fat level or increased protein in the urine.  This risk increased substantially to 50-fold for subjects with a BMI ≧ 27 kg/㎡ or waist circumference ≧ 90 cm (36 inches).  More importantly, the number of risk factors increases with levels of obesity.  It is noteworthy that 10-20% subjects with two or more of these risk factors will die or develop a major cardiovascular event such as stroke or heart attack in 10 years time.

        In a pilot programme involving 60 young obese patients with an average age of 35 years and a BMI of 33 kg/㎡, it is found that a 6-month treatment with an anti-obesity drug that reduces fat absorption resulted in 4-10% reduction in BMI and waist circumference.  This modest weight reduction was accompanied by 10-50% reduction in all risk factors, in particular the blood glucose and cholesterol levels.  Then, the anti-obesity drugs were discontinued in all patients.  Half of the patients joined a structured behaviour modification programme, which involved monthly visits to a nutritionist and periodic assessments by doctors.  During each session, patients were taught to assess and document their food intake and physical activity as well as their relationships with daily schedule and emotional status.  All patients were also encouraged to share their experience in their attempts to lose weight under the guidance of healthcare professionals.  At the end of another 6 months, subjects who underwent the structured care programme maintained their body weight while the other 30 patients all regained their previous body weight with deterioration in their risk profiles.

        In conclusion, a modest reduction in weight can lead to major health benefits.  However, effective weight management is no easy job and requires patients' realistic expectations and the involvement of multidisciplinary professionals.  Patient empowerment with particular focus on knowledge and skill acquisition including the appropriate use of anti-obesity drugs is of utmost importance.  The incorporation of a strategy of positive reinforcement and periodic feedback to boost patients' confidence in losing their weight will further enhance the effectiveness of the programme.

        Based on the results of the pilot programme, the CUHK Diabetes and Endocrine Centre, under the auspices of the Hong Kong Foundation for Research and Development in Diabetes, and the CUHK Centre for Nutritional Studies of the School of Public Health will jointly launch a self-funded 6-month obesity management programme combining pharmacological therapy and behaviour modification to facilitate high risk obese subjects to achieve realistic weight reduction and improvement of their risk profiles.