Bariatric Times

MAY 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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12 Survey Results Bariatric Times • May 2018 clinical and administrative duties (65.5%). • Only 18 percent reported that their position required taking call; of those, only four percent reported specific compensation for taking call. • Opportunities for incentives or productivity bonuses from employers were rare (14.3%). For employees offered incentives or bonuses, the majority of respondents indicated that these were based on group, individual, or system-wide productivity metrics or if budget goals were achieved. The survey also inquired about the yearly compensation and benefits provided by their employers. The median salary reported by registered dietitians and certified clinical nutritionists working in bariatrics was $65,000, and the median salary for registered nurses was $89,000. Additional integrated health professional salaries are in Table 1. Benefits most frequently offered by their employers are medical insurance (83.8%), retirement plan contributions (77.9%), dental insurance (69.0%), and continuing education coverage (67.5%) (Figure 2). CONCLUSION "The care of weight-loss surgery patients can be complex and multifaceted," said Amber Saucier, MS, RD, at Lafayette General Health in Lafayette, Louisiana, and member of the ASMBS Multidisciplinary Care Committee. "Greater understanding of how integrated health professionals are utilized and compensated for bariatric patient care across the United States can help programs select the multidisciplinary services that are best suited for their patients' needs." Limitations of the survey results include the low response rate and the over-representation of nurses compared to other integrated health disciplines (46.5%) and female respondents (92.2%). REFERENCES 1. Mechanick JI, Youdim A, Jones DB, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient—2013 update: cosponsored by American Association of Clinical Endocrinologists, the Obesity Society, and American Society for Metabolic & Bariatric Surgery. Surg Obes Relat Dis. 2013;9(2):159–191. FUNDING: No funding was provided for this article. DISCLOSURES: The author reports no conflicts of interest relevant to the content of this manuscript. AUTHOR AFFILIATION: Dr. Lent is with the Philadelphia College of Osteopathic Medicine in Philadelphia, Pennsylvania, and the Geisinger Medical Center in Danville, Pennsylvania. ADDRESS FOR CORRESPONDENCE: Michelle R. Lent, PhD; Email: mrlent1@geisinger.edu BT FIGURE 2. Percentage of integrated health professionals provided benefits by their employers (n=271 out of 282 respondents) ROUX-EN-Y SURGERY LINKED WITH MORE NON-VERTEBRAL FRACTURES THAN ADJUSTABLE GASTRIC BANDING Patients undergoing Roux-en-Y gastric bypass (RYGB) surgery might be at greater risk for non-vertebral fracture than those having adjustable gastric banding (AGB), a new population-based study reports. The results, which included data from 50,649 adults, were presented March 17 at ENDO 2018 in Chicago, Illinois. * https://www.endocrine.org/news- room/2018/roux-en-y-surgery-linked- with-more-non-vertebral-fractures-than- adjustable-gastric-banding#.WrJ2d7nsuc8. email WEIGHT LOSS SURGERY TIED TO INCREASE IN DIVORCES AND IN MARRIAGES Recent research published in JAMA Surgery found that patients who have bariatric surgery are more likely to either get divorced or enter into a new relationship/marriage. The study included 999 patients who were single at the beginning of the research period, and almost 21 percent of that cohort had either gotten married or were in a new relationship. * https://www.reuters.com/article/ us-health-obesity-surgery-relationships/ weight-loss-surgery-tied-to-increases-in- divorces-marriages-idUSKCN1HA2G6 INTERMITTENT FASTING AS A FORM OF DIET This article overviews the positives of intentional fasting for periods longer than the normal 8 to 12 hours overnight in between dinner and breakfast, including reduced caloric intake, improved cholesterol, and reduced inflammation. The article notes, however, that children and nursing mothers should not fast, and that any patients with diabetes or high blood pressure should consult with their doctors before fasting. * https://obesitymedicine.org/ intermittent-fasting/ TENNESSEE MEDICAL CENTER, PACIRA PHARMACEUTICALS, AND CQ-INSIGHTS ANNOUNCE COLLABORATION TO MINIMIZE OPIOID USE AFTER HERNIA SURGERY To improve patient outcomes and combat a segment of the national opioid epidemic, The University of Tennessee Medical Center and Pacira Pharmaceuticals, Inc. announced a continuous quality improvement (CQI) project designed to develop low- or no- opioid postsurgical pain management pathways for patients undergoing one of the most common surgical procedures, hernia surgery. * http://investor.pacira.com/ phoenix.zhtml?c=220759&p=irol- newsArticle&ID=2334853 WEIGHT AND METABOLIC OUTCOMES 12 YEARS AFTER GASTRIC BYPASS Three letters were submitted to the New England Journal of Medicine, commenting on an important article published in 2018 titled "Weight and Metabolic Outcomes 12 Years after Gastric Bypass." One of the letters argues that the original article, which mentioned the psychosocial side effects of bariatric surgery, did not spend enough time discussing the topic and how it could affect patients who elect to have the surgery. * http://www.nejm.org/doi/ full/10.1056/NEJMc1714001 RACE, PRE-PREGNANCY BMI MIGHT HELP PREDICT MATERNAL WEIGHT GAIN Race and pre-pregnancy body mass index (BMI) both affect leptin and adiponectin levels, and leptin levels in mid-pregnancy could be an important predictor of weight gain during pregnancy, new research suggests. The results were presented in a poster at ENDO 2018, the 100th annual meeting of the Endocrine Society. * https://www.endocrine.org/news- room/2018/race-pre-pregnancy-bmi-may- help-predict-maternal-weight-gain News and Trends Exploring bariatric and metabolic medicine in the media Bariatric Times. 2018;15(5):12. News and Trends continued on Page 15

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