Bariatric Times

APR 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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Ask the Leadership 19 Bariatric Times • April 2018 How popular do you expect the procedure to be for patients compared to more traditional forms of bariatric surgery? Dr. Mattar: It is difficult to predict how popular these devices will be. Of course, we must bear in mind some of the limitations inherent to these devices. Intragastric balloons are approved for patients with a BMI of 30 to 40, so based on United States Food and Drug Administration (FDA) regulations, not every patient will be a candidate. Moreover, the device is meant to be positioned for a finite duration of six months, after which it is removed (or biodegrades) and is followed by six months of monthly counseling and support. One thing for certain is that while it is evident that intragastric balloons have their recognized place within the continuum of care, they should never be considered of equal efficacy to the more traditional metabolic operations we offer our patients, nor should they undergo head-to- head comparisons with these other procedures. This is unfair and serves no other purpose but to diminish the value of intragastric balloons as one of the many options that we can offer our deserving patients. FUNDING: No funding was provided for this article. DISCLOSURES: The author has no conflicts of interest relevant to the content of this article. ADDRESS FOR CORRESPONDENCE: Samer Mattar, MD, FACS, FRCS, FASMBS; Email: samer.mattar@swedish.org. BT MORE EVIDENCE WEIGHT LOSS SURGERY CAN IMPROVE DIABETES SYMPTOMS A study in France confirmed what many other studies have found: patients with obesity who get bariatric surgery are less likely to need medication for diabetes than patients who don't have the surgery. The research, which was published in JAMA Surgery, measured the data from 15,650 patients with obesity who had bariatric surgery. * For more information: https://www.reuters.com/article/ us-health-diabetes-obesity-bariatric/ more-evidence-weight-loss-surgery- can-improve-diabetes-symptoms- idUSKCN1GE2S8 SHAME PREVENTS AMERICANS FROM SEEKING WEIGHT LOSS SURGERY, STUDY SAYS A recent study found that a majority of people would support friends if they were to get bariatric surgery. However, those same people said they would be ashamed to admit to others that they are considering or have undergone bariatric surgery themselves, suggesting that shame might be limiting the number of people who seek out the surgery in the first place. * For more information: http:// philadelphia.cbslocal.com/2018/02/27/ weight-loss-surgery/ IT'S NOT YOSEMITE, IT'S THE SURGERY: THE RISE OF MEDICAL TOURISM IN FRESNO Medical tourism has gained popularity in the Fresno, California, area, especially for bariatric surgery. The article cites medical tourism as a $100 billion global industry, reporting that medical tourists often spend 5 to 10 times more money in a location for medical procedures than typical people do while on vacation. * For more information: http:// www.fresnobee.com/news/local/ article203258054.html GASTRIC BYPASS CAN PROVIDE BETTER OUTCOMES FOR PATIENTS WITH OBESITY AND DIABETES THAN LIFESTYLE INTERVENTION Research published in Diabetes Care found that patients with obesity who undergo Roux-en-Y gastric bypass surgery have better health outcomes than patients with obesity who attempt other lifestyle interventions. The article included results from the Surgery or Lifestyle with Intensive Medical Management in the Treatment of Type 2 Diabetes (SLIMM-T2D) study, which included 38 patients with obesity and tracked their progress over a three-year span. * For more information: https://www.news-medical.net/ news/20180302/Gastric-bypass-can- provide-better-outcomes-for-patients- with-obesity-and-diabetes-than- lifestyle-intervention.aspx 2008 GREAT RECESSION LED TO INCREASE IN OBESITY, DIABETES, AND MENTAL HEALTH ISSUES According to a study done by researchers in London, the 2008 Great Recession resulted in 4.1 and 2.4 percentage point increases in obesity and severe obesity, respectively. The article, which was published in Social Science & Medicine, suggests that certain health outcomes get worse during recessions, resulting in a greater strain on health services and longer wait times for patients to receive treatment. * For more information: https:// medicalxpress.com/news/2018-03- great-recession-obesity-diabetes-mental. html?utm_content=bufferb487a&utm_ medium=social&utm_source=twitter. com&utm_campaign=buffer MINIMALLY INVASIVE SURGERIES UNDERUSED BY MEDICARE PATIENTS, STUDY SAYS Minimally invasive surgeries, including bariatric surgery, were underused by Medicare patients compared to younger patients, according to research from Johns Hopkins University. There was also increased rates of complication and hospital readmission following other treatments or surgeries among this group, suggesting that minimally invasive surgeries could be a more cost- effective solution for more patients in the future. * For more information: https:// www.upi.com/Minimally-invasive- surgeries-underused-with-Medicare- patients-study-says/9511520255440/ WHY IS OBESITY SO CHALLENGING? Even though obesity affects millions of Americans, it can be a difficult condition to treat for some doctors, especially if they try to only target the comorbidities instead of the obesity itself. Other issues include the hereditary nature of obesity and the tendency of patients with obesity to vastly underestimate the number of calories consumed daily, which can make the "calorie counting" method of weight loss ineffective. * For more information: https:// www.medscape.com/viewarticle/893068 SHORTER LIFE, HEART RISK LINKED WITH EXCESS WEIGHT Research published in JAMA Cardiology found that there was a positive correlation between obesity and a shorter lifespan and an increased risk of cardiovascular morbidity. The researchers also found that patients who are overweight but don't have obesity are still at a higher risk of developing cardiovascular disease at an earlier age than those of healthy weight. * For more information: https:// www.medpagetoday.com/endocrinology/ obesity/71437 COCA-COLA STOPS FACTORY TRIPS FOR SCHOOL-AGED CHILDREN AMID OBESITY CRISIS While more than 15,000 children visit Coca-Cola factories annually, the company has decided to end these scheduled trips with the childhood obesity crisis continuing to rage across the country. The company is shutting down its Real Business Challenge and educational programs to focus on different ways to interact with the younger generation of people. * For more information: http:// www.independent.co.uk/life-style/ food-and-drink/coca-cola-factory-trips- schoolchildren-stop-obesity-crisis- backlash-uk-a8240421.html BT News and Trends Exploring bariatric and metabolic medicine in the media Bariatric Times. 2018;15(4):19

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