Bariatric Times

DEC 2017

A peer-reviewed, evidence-based journal that promotes clinical development and metabolic insights in total bariatric patient care for the healthcare professional

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20 News and Trends Bariatric Times • December 2017 NATIONAL STUDY ON PERCEPTIONS OF OBESITY SUGGESTS MORE EDUCATION REQUIRED FOR PRIMARY CARE CLINICIANS, EMPLOYERS DENVER, Colorado—A recent study strongly suggests that primary c are health professionals and employers who provide health benefits and employee wellness programs need more obesity education. Despite increasing awareness of obesity as a disease, the Awareness, Care and Treatment in Obesity Management (ACTION) study identified barriers preventing people with obesity from getting adequate and appropriate care. The study found that of the 71 percent of people with obesity who say they have spoken with a health care professional about their weight in the past five years, only 55 percent report receiving a diagnosis of obesity. Less than 24 percent were offered follow-up care for the disease. Results from the study were published in the journal Obesity and were presented during Obesity Week and National Obesity Care Week in Washington, D.C. Study co-author and steering committee member, Angela Golden, DNP, FNP-C, FAANP, of NP from Home in Munds Park, Ariz., said there were two significant takeaway messages from the study. "First, 65 percent of the health care professionals surveyed said they thought their patients would be embarrassed to be asked about obesity. In reality, only 15 percent of patients said they would be uncomfortable if their provider initiated a conversation about their weight," she said. While the study supports the notion that patients want to talk to their health care providers about treatments to help them lose weight, "this demonstrates a significant gap in perceptions between patients and primary care providers that must be improved," Golden said. Golden is a member of the Obesity Medicine Association, a national health care organization made up of medical professionals who use a c omprehensive, scientific, and individualized approach to treat obesity. "The study also reinforced the concept that obesity medicine c linicians need to do a better job of getting information about medical obesity treatments into the hands of primary care providers to help them better treat their patients, as well as employers to help them better support their employees with obesity," she said. Golden said the results of the study provide a unique opportunity to improve outreach and obesity education to primary care providers and employers. "In my experience, health care providers are very receptive to learning more about new treatments that will benefit their patients," she said. But the length of an average appointment limits the amount of time for both clinicians and patients to talk about complex health problems. The study provides an opportunity for obesity medicine clinicians to connect, or reconnect, with their primary care colleagues. Golden said the study also alerts clinicians to the need to spend more time educating employers about obesity. According to the study, 77 percent of employers surveyed offer health and wellness information to employees. But there is a growing realization that these wellness programs may be harmful, not helpful, for people with obesity. The study found that only 17 percent of people with obesity thought employee wellness programs were helpful in supporting weight loss, while 72 percent of employers perceived them as beneficial. Compounding matters, only 13 percent of patients with obesity said their employers cover obesity medicine treatment. "Clearly, we need to make more inroads with employers and stress how important obesity medicine treatment is and why it should be covered," Golden said. Her own experience supports this ongoing effort—she was recently i nvited by a large employer in her area to present findings about obesity medicine and current treatments. As a result of this meeting, the employer re-evaluated their insurance benefits p ackage and adjusted it to include coverage of medical obesity treatments. For more information, visit https://obesitymedicine.org/study- suggests-obesity-education- required/ PHYSICIANS REPORT EARLY SUCCESSES ACROSS MULTIPLE APPLICATIONS IN FIRST-IN- HUMAN USES OF GORE® SYNECOR PREPERITONEAL BIOMATERIAL HERNIA REPAIR DEVICE FLAGSTAFF, Arizona— Physicians among the first to use the GORE® SYNECOR Preperitoneal Biomaterial, a unique hybrid device for hernia repair, are reporting positive experiences in using the device in a range of applications, according to W. L. Gore & Associates (Gore). The company today shared feedback from physicians focused on bariatric, hernia, and plastic surgery who have used the GORE® SYNECOR Preperitoneal Biomaterial hernia repair device since it received 510(k) clearance from the Food and Drug Administration in June. GORE SYNECOR Preperitoneal Biomaterial was designed to provide high strength with rapid tissue ingrowth on both sides in a single device, and is ideal for procedures requiring both of those benefits and for techniques such as transversus abdominis muscle release (TAR). "The ability to do a procedure once and be confident it won't require reintervention is especially crucial in complex procedures like TAR. Once the muscle layers have been dissected, any recurrence or reoperation becomes riskier and more difficult," said Marcos Michelotti, MD, FACS, Loma Linda University Medical Center, who used GORE SYNECOR Preperitoneal B iomaterial in a recent TAR procedure. Dr. Michelotti has also used the device in an onlay procedure to repair a hernia caused when a trocar was inserted to p erform a sleeve gastrectomy. "The new Gore device allows for a single- stage repair even in complex cases. It handles well and is extremely durable. I asked my two residents to try to tear the leftover material in half, and they couldn't -- even at the edges. I'm very pleased my hospital is adding this new device to our current GORE SYNECOR Biomaterial consignment." The hybrid, biosynthetic hernia repair solution is intended for single-stage preperitoneal, onlay, and retromuscular placements through open, laparoscopic, and robotic applications. It is comprised of three layers: A macroporous knit of dense, monofilament polytetrafluoroethylene (PTFE) fibers provides strength for a durable single-stage repair and is designed to minimize harboring of bacteria, while two surrounding layers of GORE® BIO-A® Web, a bioabsorbable copolymer scaffold, facilitate tissue ingrowth and vascularization on both sides of the device. The GORE BIO-A Web 3-D scaffold of interconnected pores fills quickly with collagen and facilitates 1:1 tissue generation within the thickness of the material, with complete absorption by the body in about six months. The combination of strong permanent synthetic mesh with a bioabsorbable scaffold minimizes remaining material and may reduce common complications such as hernia recurrence and mesh splitting to improve patient quality of life. Common applications for this device, besides TAR, include other component separation techniques, preperitoneal ventral hernia repair, and high-risk ventral hernia repair. For additional detail, visit goremedical.com/synecorpre. News and Trends DECEMBER 2017 B ariatric Times. 2017;14(12):20. E xploring the Latest Bariatric and Metabolic Medicine in the Media

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