Bariatric Times

MAR 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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C l i n i c a l D e v e l o p m e n t s a n d M e t a b o l i c I n s i g h t s i n To t a l B a r i a t r i c P a t i e n t C a r e Volume 15, Number 3 March 2018 A P e e r - R e v i e w e d P u b l i c a t i o n Follow us. Inside EDITORIAL MESSAGES ................ 3 A Message from Dr. John M. Morton: Blue Skies Ahead for Bariatric Surgery A Message from Dr. Christopher Still: So What is an Obesity Medicine Specialist Anyway? THE MEDICAL STUDENT NOTEBOOK ................................ 8 Equity in Bariatric Surgery: Access and Outcomes JOURNAL WATCH .................... 11 ORIGINAL RESEARCH .............. 12 Bariatric Surgery: Not the 'Easy Way' Out, the 'Healthy Way' Out ORIGINAL RESEARCH .............. 16 The Prevalence of Musculoskeletal Injuries in Bariatric Surgeons SOCIETY UPDATE ..................... 20 ISPCOP: An Update on How Far We Have Come in the Past 7 Years ASK THE LEADERSHIP ............. 23 Q&A on Bariatric Surgery Coverage for PA State Employees NEWS AND TRENDS ................ 24 WALTER PORIES CARTOON ...... 25 CALENDAR OF EVENTS ............ 25 ADVERTISER INDEX ................. 25 CLASSIFIED AD INFO ............... 25 ORIGINAL RESEARCH Bariatric Surgery: Not the 'Easy Way' Out, the 'Healthy Way' Out by MARY ANN ROSE, EdD, RN; MARY LISA PORIES, PhD, LCSW; DONNA ROBERSON, PhD, RN; and JANICE A. NEIL, PhD, RN INTRODUCTION Stigma directed against individuals with obesity is still pervasive in Western society. Numerous studies 1–8 have confirmed its existence among not only lay people but also among healthcare professionals. People with obesity are often viewed as lazy, unmotivated, lacking in self-discipline, and sloppy. 9 The existence and effects of stigma directed at a patient who is either considering bariatric surgery or who has undergone bariatric surgery has been described less fully. There is evidence that bariatric surgery is considered "low effort," unnecessary, and of less value than lifestyle changes that would result in weight loss. For example, Groven 10 conducted a qualitative study of Norwegian post-operative surgical patients in which a major theme identified was that those participants strongly rebutted the notion that weight loss surgery (WLS) was the "low effort" approach to weight loss. Vartanian and Fardouly 11 investigated whether teaching individuals about the lifestyle changes required after bariatric surgery would mitigate their negative attitudes, and found that this was to some extent successful. Negative attitudes regarding surgery were noted in a recent study 12 in which participants were asked what factors motivated them to move forward with the surgery. The major theme identified was that health concerns rather than weight loss, per se, prompted the decision to undergo surgery, and many noted that it was simply their "last resort" after repeated weight loss failures. Page 12 Download the BT app for your mobile device! iTunes Google (Android) Scan this QR code with your QR reader for the digital edition of Bariatric Times. Page 8 Presorted Standard U.S. Postage PAID Lebanon Junction, KY Permit #344 Equity in Bariatric Surgery: Access and Outcomes INTRODUCTION Morbid obesity is one of the foremost public health crises in the United States. Obesity and the associated health risks disproportionately affect those with low socioeconomic status, racial minorities, and other traditionally marginalized groups. Bariatric surgery is the only treatment currently offered that results in sustained weight loss, as well as a reduction in related health risks, including diabetes, hypertension, and hyperlipidemia. 1 However, the sociodemographic characteristics of Americans with morbid obesity do not match the bariatric surgery demographics in the US. 1 It is imperative that patients of all sociodemographic groups have access to equitable bariatric care, with outcomes that match their well-off, white peers. This article assesses how the current landscape of bariatric care deals with the inequity of obesity in the population, who gets access to care, patient perceptions of bariatric surgery access, and outcomes. The Medical Student Notebook COLUMN EDITOR Daniel B. Jones, MD, MS, FASMBS FEATURED STUDENT Bryn Falahee, MPhil

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