Top 10 Obesity and Bariatric Surgery Stories of 2017

Published in December Issue             

The year 2017 saw new reports from the CDC on the higher than ever prevalence of obesity in America and the rise of obesity-related cancers. There was also a troubling report that most of America’s children, if current trends continue, will have obesity by the time their 35.

But the news is not all bad in that several studies further documented the safety, effectiveness and durability of bariatric surgery, and its impact on diabetes and cancer. This year also saw a superstar undergo gastric sleeve surgery, in what may the highest profile person yet to have bariatric surgery.

Read our Top 10 Stories for the year that was 2017.

1. Obesity Among US Adults Reaches All-Time High

The Centers for Disease Control and Prevention (CDC) put out a report in October that showed almost 40 percent of American adults and nearly 20 percent of adolescents have obesity — the highest rates ever recorded for the United States.

Among the findings:

  • The prevalence of obesity was higher among middle-aged adults (42.8%) than among younger adults (35.7%).
  • The prevalence of obesity was higher among youth aged 6–11 years (18.4%) and adolescents aged 12–19 years (20.6%) compared with children aged 2–5 years (13.9%).
  • The overall prevalence of obesity was higher among non-Hispanic black and Hispanic adults than among non-Hispanic white and non-Hispanic Asian adults. The same pattern was seen among youth.

2. Cancers Associated with Overweight and Obesity Make up 40% of Cancers

The CDC reported that overweight and obesity are associated with increased risk of 13 types of cancer, which accounted for about 40 percent (630,000) of all cancers diagnosed in the U.S. in 2014. About 55 percent of the cancers were diagnosed in women and 24 percent
in men.

Overall, the rate of new cancer cases has dropped since the 1990s, but increases in overweight- and obesity-related cancers are likely slowing this progress. The rates of obesity-related cancers, not including colorectal cancer, increased by 7 percent between 2005 and 2014. The rates of non-obesity related cancers declined by about 13 percent during the same time.

“A majority of American adults weigh more than recommended – and being overweight or obese puts people at higher risk for a number of cancers – so these findings are a cause for concern,” said CDC Director Brenda Fitzgerald, MD, in a news release. “By getting to and keeping a healthy weight, we all can play a role in cancer prevention.”

3. Over Half of U.S. Children Will be Obese by Age 35

A study published in the Nov. 30, 2017 issue of The New England Journal of Medicine predicts that more than 57 percent of today’s children and youth will have obesity by age 35. Excess weight gained during childhood can put children on a trajectory that is difficult to change, the study authors said.

Harvard T.H. Chan School of Public Health researchers found that excess weight in childhood is predictive of adult obesity, and that only children currently at a healthy weight have less than a 50 percent chance of having obesity as adults. The findings were based on a simulation model, that according to study authors, provides the most accurate predictions to date of obesity prevalence at various ages.

“Our findings highlight the importance of prevention efforts for all children as they grow up, and of providing early interventions for children with obesity to minimize their risk of serious illness in the future,” said lead author Zachary Ward, programmer/analyst at Harvard Chan School’s Center for Health Decision Science.

The study also found that racial and ethnic disparities in obesity are already present at age 2 and persist into adulthood, with non-Hispanic black and Hispanic individuals more likely to have obesity than white individuals at all ages from ages 2-35.

Senior study author Steven Gortmaker, professor of the practice of health sociology at Harvard Chan School, said given the risk to children, “It is critically important to implement policies and programs to prevent excess weight gain, starting at an early age. Plenty of cost-effective strategies have been identified that promote healthy foods, beverages, and physical activity within school and community settings.”

4. Half of US Adults have High Blood Pressure in
New Guidelines

High blood pressure should be treated earlier with lifestyle changes and in some patients with medication – at 130/80 mm Hg rather than 140/90, according to new guidelines from the American Heart Association (AHA), American College of Cardiology (ACC) and nine other health professional organizations. The new guidelines, which were published in November in the journal, Hypertension and the Journal of American College of Cardiology are the first clinical update since 2003.

These lower systolic and diastolic measurements mean 30 million more Americans now have high blood pressure, bringing its prevalence to nearly half (46 percent) the U.S. adult population. The impact of the new guidelines is expected to be greatest among younger people, with the prevalence expected to triple among men under age 45, and double among women under 45.

5. Bariatric Surgery Lowers Cancer Risk by a Third
or More

Patients with severe obesity who undergo bariatric surgery lowered their risk of developing any cancer by a third, and obesity-associated cancers by more than 40 percent, according to a new study published online in Annals of Surgery.

The findings of the National Cancer Institute of the National Institutes of Health (NIH)-funded study echo previous research that demonstrates the effect weight loss and bariatric surgery have on reducing the incidence of cancer – the second leading cause of death in the United States.

"What's surprising is how great the risk of cancer was reduced," said lead author Daniel Schauer, MD, associate professor in the University of Cincinnati (UC) Division of General Internal Medicine, in a press release.

6. Major Study in JAMA Surgery Shows Don’t Wait to Have Bariatric Surgery

A study published in July’s JAMA Surgery suggests bariatric surgery may yield better results for patients whose body mass index (BMI) has not yet reached 40.

According to researchers from the University of Michigan, Wayne State University and Henry Ford Health System, 36 percent of bariatric surgery patients, with an average BMI of 48, were able to achieve a BMI of less than 30. Only 8.5 percent of patients with of BMI of 50 or higher were able to match those results.

Researchers reviewed the medical records of 27,320 adults undergoing bariatric surgery between June 2006 and May 2015 at teaching and nonteaching hospitals in Michigan. On average, patients had a BMI of 48 before their operation, and got down to 33 by the end of the first year. The study was funded by Blue Cross Blue Shield of Michigan.

Those who achieved a BMI less than 30 were also more likely to report they were able to stop taking medications for hyperlipidemia (60.7% vs 43.2%), diabetes (insulin: 67.7% vs 50.0%); oral medications; (78.5% vs 64.3%), and hypertension (54.7% vs 34.6%). Sleep apnea remission was also significantly higher (72.5% vs 49.3%), as was patient satisfaction with the surgery (92.8% vs 78.0%).

7. Report on Outcomes 12 Years after Gastric Bypass –
Safe, Effective, Durable

A dozen years after gastric bypass surgery, most patients maintain significant weight loss, have less diabetes, lower blood pressure and fewer cholesterol problems, according to a study published in The New England Journal of Medicine in September.

“The results of this study demonstrated the long-term durability of weight loss following gastric bypass surgery,” said Ted Adams, PhD, lead study author and Intermountain Healthcare researcher, in a news release. “The percentage of weight loss among the gastric bypass groups changed very little from six to 12 years. The results also show gastric bypass surgery is effective in the long-term remission of diabetes and is very effective in preventing the occurrence of diabetes.”

Researchers report that the follow-up rate exceeded 90 percent in the prospective study of 1156 patients.

“One of the biggest benefits of gastric bypass surgery, beyond long-term weight loss, was the impact on diabetes,” said Paul Hopkins, MD, professor of Internal Medicine at the University of Utah Health, a study co-author. “If a patient received the surgery early in the course of diabetes, either before they were taking medication or before they began treating the disease with insulin injections, we found that 73 percent of patients remained in remission from diabetes.”

The surgery group had higher remission rates and lower incidence rates of hypertension and dyslipidemia than did the non-surgery group.

8. Metabolic Surgery Remains Key Treatment Strategy in ADA Standards of Care in Diabetes

The American Diabetes Association (ADA) continues to recommend metabolic surgery to treat type 2 diabetes in patients with severe obesity (BMI>40), regardless the level of glycemic control or complexity of glucose-lowering regimens. This is among the treatment strategies included in the ADA's Standards of Medical Care in Diabetes – 2018, issued in December.

The standards also say metabolic surgery should be an option for those with BMI 30.0 to 34.9, when hyperglycemia is inadequately controlled despite lifestyle and optimal medical therapy.

The recommendations on metabolic surgery conclude that the safety of operations has improved significantly over the last two decades, with morbidity declining “dramatically” and mortality rates now similar to cholecystectomy or hysterectomy.

9. ObesityWeek 2017 – Bariatric Surgery Studies
Making News

Studies on bariatric surgery and diabetes, its use in people 65 and older, same-day gastric sleeve surgery and the waiting period for surgery, made news at ObesityWeek 2017.

Here are the highlights:

  • Seven years after bariatric surgery, 44 percent of patients with severe obesity had their diabetes under control and were able to stop taking insulin, and 15 percent achieved diabetes remission, according to researchers from the Cleveland Clinic in Ohio.

  • Researchers from Geisinger Medical Center in Danville, PA, reported that bariatric surgery in patients age 60 and older is safe and effective, producing results comparable to those seen in younger adults.

  • Research from Stanford University School of Medicine suggested mandatory waiting requirements do nothing to improve weight loss after surgery. Six months after surgery, patients on average lost more than 25 percent of their body weight no matter how long they waited to have surgery. Some patients were reported to have waited as much as five years.

  • Gastric sleeve surgery is one of the safest and most popular methods of weight loss surgery in America, but a study from University of California, Irvine School of Medicine raised some cautions about performing the operation on an outpatient basis. Same-day gastric sleeve surgery was associated with a 30-day mortality rate that was low at 0.10 percent, but still five times higher than patients who were discharged a day later. These patients had a mortality rate of 0.02 percent, most likely due to respiratory failure. There were no statistically significant differences for overall complications (0.98% vs. 0.86%), reoperations (0.54% vs. 0.33%), or readmissions (2.41% vs 2.10%).

10. Mariah Carey has Gastric Sleeve Surgery

Page 6, a website that covers news and gossip about entertainment, politics and sports, broke the story that superstar singer, entertainer and diva, Mariah Carey had gastric sleeve surgery sometime in October. Carey was reportedly spurred on to get the surgery after receiving a lot of online criticism from body shamers. According to Entertainment Tonight, the singer has lost 25 pounds since surgery, and is now back to performing after recently suffering a respiratory infection. She tweeted a picture of herself to her 19.9 million followers as she prepared to perform at the World AIDS Day 2017 concert in November.

Which are your top 10 stories of 2017 and what do you think will be the top stories of 2018? Click here to submit your top stories.