Blog 4 Research Annotated
With the amount of information now available to a researcher, organization becomes increasingly vital. An important tool available for reference is the annotated bibliography, which ideally toes the line effectively between brevity and clarity. Much is made as to the different software options which allow the researcher to be strategic in how they organize their information. As I progress in my academic career I am swiftly realizing that this type of software is swiftly transforming from convenient to necessary. Regardless of how comfortable you may find it to dive into new bibliographic software, it seems that annotating references is a valuable practice, and something I have neglected as of yet to engage in with in regards to my paper on obesity–
Sabin Janice A., Marini ,Maddalena, Nosek, Brian A.
2012 Implicit and Explicit Anti-Fat Bias among a Large Sample of Medical Doctors by BMI, Race/Ethnicity and Gender. PLoS ONE 7(11): e48448.
This article is a survey to measure the implicit and explicit reactions that medical doctors have towards obesity and fatness in general. It would likely interest the psychologist, sociologist, anthropologist and clinician. This paper is typically structured as introduction, methods, results and discussion. The methods separate the implicit and explicit opinions of doctors. Explicit is measured as self-reported by MD’s as their opinion and comfort level with treating obese patients. Implicit reactions are measured by ease of association of thin and fat with positive and negative words. The question to be answered is whether MD’s have differing anti-fat bias from that of the general public. The general public have anti-fat bias both implicitly and explicitly.
This paper supports the contention that anti-fat stigma is pervasive in the general public. It also answers the question as to the reactions and feelings that MD’s have toward fatness and obesity. Most revealing in this paper is finding that the majority of doctors explicitly have anti-fat sentiments. This finding is important in two ways-
1. It supports my claims about culture and its influence in medicine. This is direct evidence that the dissemination of health care may not be blind to cultural influence. This anti-fat bias surprisingly and most interestingly is not necessarily a risk to obese patients. In fact, there is evidence to support that obese patients with heart disease risk factors have better outcomes than those with matching factors and whom are of normal weight. The hypothesis here is that doctors with their anti-fat bias treat their obese patients symptoms more aggressively and urgently, and thus their patients have better outcomes.
2. Also evident in this paper is that anti-fat bias is acceptable. Explicit responses from MD’s measure the amount of bias they freely admit to. This suggests that a large portion of primary care doctors believe it is acceptable to have such bias. This result really amplifies the contention that even among those of our population who are supposed to be the most neutral in terms of patient bias, they still find it ok to admit to biased thinking. I contend in my paper that obesity of one of the remaining acceptable forms of discrimination; this paper will be pivotal to that assertion. This article tackles questions about fatness clinically, psychologically and socially and is a very important piece of the obesity picture in that it makes connections with those three fields.
Kantartzis, Machann, Schick, Rittig, Machicao, Fritsche, Häring, Stefan
2011 Effects of a lifestyle intervention in metabolically benign and malign obesity. Diabetologia 54:864–868
This article describes a study that aims to bolster the mounting evidence supporting the separation of the metabolically healthy and unhealthy obese for the purposes of treatment. The experiment is lifestyle intervention (9 months), diet and exercise, and a comparison of the effectiveness of this change between the obese insulin resistant and the obese insulin sensitive. This intervention is designed to increase insulin sensitivity. This paper is especially relevant for primary care physicians and anthropologist who are interested in first-line treatment in over-weight patients. Methods, results and discussion aim to support the growing contention that special and separate consideration needs to be taken towards obese patients that have healthy insulin sensitivity. Moreover, this study also aims to show that patients who are obese and insulin resistance should be treated more aggressively since their insulin sensitivity can be quickly increased.
This article fits nicely into the popular topic of healthy obesity. The primary literature on this topic has been mostly speculation and experimentation on why this sub-phenotype exists and in what way we can therefore learn about the etiologies of obesity. This study firmly supports the assessment of an obese patient’s insulin resistance as the first step in developing a treatment strategy.
This paper has importance to the practical aspects of a resource limited field like health care. It struck me almost as a type of triage where the obese patient that can benefit most from the intervention should be given priority. In fact this paper could have effectively been reframed with a type of Malthusian tilt towards resource management.
This paper is especially relevant to my work since I am arguing that obesity is erroneously painted with the same brush. Since it is as much about appearance and cultural interpretation of health with modern issues of obesity, I argue that the assumption that all obesity should be treated wholesale is not biologically defensible. This paper is also complemented by several other papers that have tested obesity with respect to heart disease- they too have found that a significant sub-group of obese are not at any elevated risk, and that lifestyle interventions do not always improve outcomes.
Sims, Ethan A.H.
2001 Are there persons who are obese, but metabolically healthy? Metabolism 50: 12: pp 1499-1504
This is an early paper on those who are obese yet have a healthy metabolism. This article is much more like an anthropological discussion than it is like a medical one; it even begins with a lengthy anecdote about a woman who is doing everything to lose weight yet remains unsuccessful. This paper is important for anthropology and medical theory as it addresses why some obese are more metabolically ‘normal’ than others and how this is relevant to the practice of medicine. The organization of this article is reminiscent of a logical discussion as to the evidence of this sub-group, the number of studies that suggest this, explanations as to why this might be the case, and why this is important news clinically and academically. This paper effectively answers the question of so what; why should be care about healthy obesity. It also thoroughly addresses ideas about what to do in the future, and what this might mean as far as the obesity epidemic.
This is one of the seminal papers about healthy obesity. In fact the term MHO (metabolically healthy obese) had not been coined yet. This type of investigation into healthy obesity stems from some of the anomalous findings in the data when comparing BMI to health. This study is one of the first to suggest that these anomalies are because of this healthy sub-population, whose physiology operates as if they were of normal weight. This paper is quite bold in offering explanations as to why this might be -which is of great interest to my work. It suggests that healthy obesity may involve adaptive mechanism in the body. The authors claim that people who have been obese since early childhood preferentially display healthy obesity as adults. This claim has not subsequently been supported by evidence, but it has stirred myself into forming ideas as to anthropological perspectives in obesity.
This paper now is quite outdated; the MHO phenomenon has made a serious dent on the landscape of obesity study as of late. It does offer a more anthropological framework than the typical and more recent papers on MHO. It does focus much of its attention on the practical aspects of MHO; diagnosis in particular, but also more generally commentary on clinical thinking and physiological theory, aspects that I intend to be focused heavily on in my work on obesity.