Bariatric Times

FEB 2018

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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25 Bariatric Times • February 2018 Obituary Journal Watch A systematic review of the long- term effectiveness of work-based lifestyle interventions to tackle overweight and obesity. Tam G, Yeung MPS. Prev Med. 2017 Nov 16. pii: S0091-7435(17)30452–8. Synopsis: This review examined studies that focused on "multicomponent lifestyle interventions in the workplace targeting obesity" using the 2010 CONsolidated Standards of Reporting Trials (CONSORT). The reviewers found that the studies generally weren't high quality, but that five of the 11 had positive results. Only two of the studies found significant decreases in body mass index (BMI) among its participants. Overall, the researchers determined that there is still a gap in the available literature for long-term effectiveness of changes in work-based lifestyles. PMID: 29155225 The effect of cost sharing on an employee weight loss program: a randomized trial. John LK, Troxel AB, Yancy WS Jr, et al. Am J Health Promot. 2018 Jan;32(1):170–176. Synopsis: Researchers investigated whether employer subsidies for participating in nationally available weight management programs would impact their employees' decision to participate in such programs and achieve weight loss success. The researchers measured four different subsidy levels, including as low as 50 percent and as high as 100 percent. The study included 23,023 employees in two companies in the United States, and researchers found that companies who offered the 100-percent subsidy had the highest enrollment at 7.7 percent, and the lowest enrollment was a hybrid subsidy that would start at 50 percent with the potential to reach 100 percent if certain attendance goals were met. The researchers concluded that even though there was no difference in weight loss between the four subsidy groups, attendance is positively correlated with the increase in subsidy. PMID: 29277125 Barriers to engagement in a workplace weight management program: a qualitative study. Clancy SM, Stroo M, Schoenfisch A, et al. Am J Health Promot. 2017 Jan 1:890117117696373. Synopsis: Eight focus groups were used to measure engagement in a weight management program, including what would prevent employees from enrolling in one, and how companies can improvement engagement. The study included 26 of the 550 employees from the Steps to Health Study. The employees noted that the coaches were more successful at engaging participants, especially when they were more interactive and did so more frequently. The main barriers identified in the study were unflexibility, expense, location, and lack of institutional support for healthier living. PMID: 29214814 Designing equitable workplace dietary interventions: perceptions of intervention deliverers. Smith SA, Visram S, O'Malley C, et al. BMC Public Health. 2017 Oct 16;17(1):808. Synopsis: While the workplace offers the opportunity for dietary and related lifestyle interventions, researchers note that there's still very little research on how to effectively implement these interventions and how effective they are. The study included 11 participants who took part in 1-on-1 interviews about how they would incorporate appropriate interventions into their workplace. The general consensus was that the interventions should be cost- neutral, unstructured, supportive, time flexible, and communicated via a variety of media. The participants mentioned that while incentives should be offered to those who take part in the program, they shouldn't necessarily be monetary. Overall, the researchers determined that these programs should be "equally and easily accessible for all staff." PMID: 29037187, PMCID: PMC5644102 BT A quick look at the noteworthy articles in bariatric and metabolic research THIS MONTH'S TOPIC: OBESITY AND THE WORKPLACE Remembering Charles Ernest "Chug" Morton III I am saddened to report the loss of Charles Ernest Morton III, a bariatric surgeon from Nashville, Tennessee, who passed away due to metastatic colon cancer. Known to his colleagues and friends as "Chug," he was my practice partner, friend, and a tireless advocate for his patients. Chug was a 1968 Auburn graduate, and attended medical school at Univeristy of Tennessee Memphis. In 1978, he completed his general surgical residency at St. Thomas Hospital in Nashville. He went straight to work at the newly constructed Southern Hills Hospital on the outskirts of Nashville, built by the fledgling Hospital Corporation of America. He helped build the surgical department from the ground up, and over the ensuing three decades, he served in innumerable leadership roles. Chug enjoyed a classic, broad- based practice of general, vascular, and surgical oncology. An early adopter of laparoscopic surgery, he built a sizable minimally invasive practice, with a particular interest in reflux surgery. This skill set positioned him well for his transition into bariatric surgery. Early on, Chug was invited by Inamed to serve as preceptor and educator for the Lap Band®. He trained dozens of surgeons in the proper placement and management of the band in the years that followed. In 2009, he gave up his general surgery practice to focus solely on weight loss surgery, leaving Southern Hills to become medical director for the Metabolic Surgery Center at St. Thomas Health. Hundreds of his patients followed him, a testament to the special relationship he enjoyed with them. Outside work, Chug was an avid golfer, hunter, and gardener. He enjoyed tinkering and could fix anything. He had a keen sense of humor. He was known for telling jokes, but was often unable to get the punch line out because of his own uncontrolled laughter. He despised bureaucracy. He is survived by his wife Rhonda, three children, a brother, and numerous grandchildren. In the 20 months since he stopped working, I have cared for many of his patients. I have learned from them that Chug was never harried, and he was always willing to listen. But mostly I've learned that he regarded the practice of surgery as a tremendous privilege. In these days of subacute rehabilitation, electronic medical records, and relative value units, that seems a valuable lesson indeed. by GEORGE LYNCH, MD, FACS BT Bariatric Times. 2018;15(2)25

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