Some of the Big Stories of 2016
Obesity and bariatric and metabolic surgery continued to be hot topics for the news media in 2016. This year saw major coverage of new numbers from CDC that showed a higher prevalence of obesity in America, particularly among women; the endorsement of metabolic surgery for diabetes; findings from the ASMBS Poll on Obesity; mounting evidence over the cancer risk of obesity; and new long-term data about bariatric surgery; and the availability of new treatments for obesity, including those with moderate obesity.
Many ASMBS members were featured in several of the stories. Here’s a look at what made news this year:
The number of Americans who are overweight or have obesity reached new heights this year, and the news is not especially good for women in particular. According to the Centers for Disease Control and Prevention (CDC), while obesity rates in men have plateaued, they continue to rise among women.
The numbers, published in the Journal of the American Medical Association (JAMA), revealed that for 2013-2014, obesity prevalence among men was 35 percent and 40 percent for women. About 38 percent of all adults have obesity. More than 5 percent of men and nearly 10 percent of women had severe obesity.
Another study also published in JAMA, showed that over the last 25 years, there was a slight increase in obesity among people ages 12 to 19. The prevalence of obesity among kids ages 2 to 5 went down, and leveled off in children ages 6 to 11.
In an editorial Dr. Jody W. Zylke, Deputy Editor of JAMA and Dr. Howard Bauchner, Editor-in-Chief of JAMA, wrote, “The obesity epidemic in the United States is now three decades old, and huge investments have been made in research, clinical care, and development of various programs to counteract obesity. However, few data suggest the epidemic is diminishing.”
Major health groups including the American Diabetes Association, the International Diabetes Federation and the American Society for Metabolic Surgery endorsed new guidelines in May that for the first time recommended bariatric or metabolic surgery as a diabetes treatment rather than an obesity treatment with the added benefit of improving diabetes. The recommendations were published in Diabetes Care.
The guidelines conclude surgery should be a regularly considered option for certain diabetes patients, with the emphasis on controlling blood sugar instead of dropping pounds.
Philip Schauer, MD
Dr. Philip Schauer of Cleveland Clinic and past president of the ASMBS said the new guidelines are important because it gives doctors a powerful tool when treating patients with type 2 diabetes who are not responding well to conventional medical therapy.
“This is a safe and effective operation and I think the consensus of the medical community is finally catching up with the science,” said Dr. Schauer.
The ASMBS released findings on obesity and its treatment from a national survey it did with NORC at the University of Chicago during ObesityWeek 2016. Top healthcare reporter Gina Kolata of The New York Times did a major story featuring commentary from obesity experts who said the survey paints “an alarming picture” that goes “against evidence about the science behind the disease, and showed that outdated notions about obesity persisted, to the detriment of those affected.”
The survey found Americans consider obesity as a big health threat as cancer, and even bigger than heart disease and diabetes. Nearly everyone (94%) agrees that obesity itself increases the risk for an early death, whether or not someone has any other health problems. Yet, despite the seriousness with which they take the threat, the clear majority incorrectly perceive diet and exercise alone to be the most effective long-term weight loss method, and 1-in-3 of those struggling with obesity report that they have never spoken with a doctor or health professional about their weight. Only 12 percent of those with severe obesity and are candidates for weight-loss surgery, say a doctor has ever suggested they consider surgery.
Dr. Raul J. Rosenthal, ASMBS president told The New York Times, “If you think a disease is a potential killer, as serious as cancer, why would you take on its treatment and cure by yourself?” he asked. “The reaction of people to something that is a potential killer
Stories about the survey appeared in a diverse group of media outlets including People magazine, Cosmopolitan, Yahoo News, NPR, Endocrine Today, Managed Care magazine, Medscape, Reuters, WebMD, Medpage Today, Vox, CNBC and scores of local television stations from Boston to San Francisco, among others.
News of the survey was included in more than 1,000 tweets, 1800 retweets and shared more than 1,200 times on Facebook, which combined reach up to 105 million social media users. The New York Times pushed its article out six times on its Twitter account and posted it on its Facebook page. Notables including Dr. Atul Gawande and Dr. Jennifer Ashton from ABC News also tweeted about the survey.
The link between cancer and obesity continues to grab headlines as evidence mounts that the two are related. A longitudinal study on postmenopausal women, published in the journal PLOS Medicine in August, revealed there is a cumulative effect of obesity on cancer risk. Researchers analyzed data on nearly 74,000 women in the U.S. and discovered that, for every 10 years a woman was overweight as an adult, her risk for all obesity-related cancers increased by 7%.
Researchers tracked the long-term progress of 1,787 veterans who had gastric bypass surgery, and reported their findings in JAMA Surgery in August. Matthew Maciejewski at the Duke University School of Medicine collaborated with Dr. David Arterburn, a senior investigator at Group Health Research Institute in Seattle, in analyzing the data.
They found that one year after bariatric surgery, patients lost an average of 98 pounds, and after 1o years, gained back only 7 pounds. Overall, just 3 percent gained most or all of their weight. Nonsurgical patients saw their weight stay about the same after 10 years.
In more news about weight regain, a study of contestants on the eighth season of “The Biggest Loser” found most gained back most, if not all, the weight they lost after six years, and some were even heavier than when they first joined the show. The study also found their metabolism had slowed and that they were burning fewer daily calories.
The study “yielded surprising new discoveries about the physiology of obesity that help explain why so many people struggle unsuccessfully to keep off the weight they lose.” Researcher said it shows “just how hard the body fights back against weight loss.”
In June, the Food and Drug Administration (FDA) approved a new device for weight loss that received a lot of attention and mixed reaction. The AspireAssist uses a surgically-implanted tube to drain a portion of the contents of the stomach after eating. In a clinical trial, the device helped people lose on average more than 12 percent of their body weight compared to 3.6 percent for people who received lifestyle therapy only.
"The AspireAssist approach helps provide effective control of calorie absorption, which is a key principle of weight management therapy," said William Maisel, deputy director for science and chief scientist in the FDA's Center for Device and Radiological Health, in a news release.
The approval, however, was met with controversy with some critics calling weight loss with the device “assisted bulimia.” Late-night TV host Stephen Colbert used the term “abdominal vomiting.” The Academy of Eating Disorders said they wanted the FDA to reverse its approval.
The Wall Street Journal took notice of the spate of recently approved new treatments aimed at those considered moderately obese. An article in July noted, “the new interventions don’t require major surgery and are reversible; several are aimed at the estimated 60 million Americans who are only moderately obese, with a body-mass index of 30 to 40.”
Obesity experts say the new techniques, which include gastric balloons, vBloc therapy, and Aspire Assist, may help fill a large gap in treatment options between lifestyle interventions, such as diet, exercise and weight-loss drugs, and bariatric surgery. Citing limited data, it was noted that “weight loss with the new interventions appears to be less dramatic than with bariatric surgery, but superior to diet and exercise or medications,” and that they generally aren’t covered by insurance.
What do you think were the top obesity and bariatric/metabolic surgery stories of the year? Submit what you think here.