Research Committee
in the Spotlight:

An Interview with Dr. Ranjan Sudan,
Chair of the ASMBS Research Committee

Published in September 2013 Issue             

The ASMBS Research Committee was formed to advance the science and understanding of metabolic and bariatric surgery through research. It is accomplishing its goal by evaluating the increasing number of grant requests from ASMBS members and awarding ASMBS Foundation research dollars to the most promising studies and investigators.

connect recently interviewed ASMBS Research Committee Chair Dr. Ranjan Sudan, Vice Chair of Education, Department of Surgery at Duke University, to learn more about the changing nature of research into obesity and metabolic and bariatric surgery, how the 30-member committee selects grant recipients,  and how the committee is working to transform the BOLD database into a more effective and accessible research tool for
ASMBS members.

connect: What is the state of research in bariatric and metabolic surgery?

Interest in obesity and metabolic and bariatric surgery research remains strong though research dollars are increasingly difficult to obtain. Fortunately, funding sources, including the ASMBS Foundation, are filling in the gaps and the significant impact of obesity on our nation's health keeps the science of obesity high on the research agenda.

Research continues to be the driving force behind the advances we've made in our field in terms of treatment and outcomes and patient selection and evaluation. It also contributes to our understanding of the mechanisms by which surgery affects obesity and related diseases including Type 2 diabetes and heart disease, to name a couple . Research also serves another purpose. It provides the evidence required to change outdated and misinformed coverage policies that may unnecessarily delay or deny coverage for bariatric and metabolic surgery.

connect: How does the ASMBS select research grant recipients?

The ASMBS Research Committee is responsible for reviewing and evaluating grant requests from ASMBS members on behalf of the ASMBS  Research Grant Award Program. Awards are conferred on a competitive basis and approved by our committee. We then monitor the progress of the various research projects.

In the last few years, we have been receiving more and more applications for grants and the quality of these applications continues to improve making selection very difficult. In 2013 alone, the committee reviewed 22 grant proposals, which were each scored according to standards set by the National Institutes of Health (NIH). These standards ensure a peer-review and numerical scoring process for identifying the most promising medical research. Each proposal is assigned  at least three reviewers for scoring and then sent to Research Committee chairs. The 10 highest scoring proposals are then individually assigned to a discussant who presents a summary to the Committee. The proposals are then put to a vote and narrowed down to five. The remaining five proposals are sent to all reviewers for analysis and ranking. The top proposal is awarded the grant. This year, funding was available to award one grant.

connect: Who was awarded the ASMBS Foundation Research Grant this year?

The 2013 recipient is Dr. Kimberley E. Steele, Assistant Professor, Surgery, Johns Hopkins Bayview Medical Center, who will receive $50,000 to conduct research on “Neurobiologic Alterations Induced by Bariatric Surgery: The Gut Brain Axis and its Relationship to Weight Loss,” after receiving IRB approval. Dr. Steele will accept the award at the 30th Annual Meeting of the ASMBS at ObesityWeek in Atlanta.

connect: How many research grants have been awarded over the years?

Since 2004, 24 members have received grants amounting to over $1 million.These recipients come from both academic centers and private practice. Previous recipients include both established and up-and-coming researchers.

connect: Does the committee track the progress of the research?

Yes. We have established a formal process for tracking the productivity of grant recipients as they complete their investigations over a two-year timeframe. Every six months investigators are required to provide a progress report, and after completion of the study, submit a formal report of their project. Subsequently, they must present an abstract during the ASMBS Annual Meeting and publish their findings in SOARD.

connect: What are some of the current research projects?

Projects currently include research into the identification of molecular markers for NASH, autonomic nervous system function and novel determinants of glucose homeostasis following bariatric surgery and the effects of obesity on airway inflammation and asthma, metabolic and cardiovascular disease risk reduction following gastric bypass surgery, and optimizing long-term weight control after bariatric surgery. A full list can be found at the ASMBS Foundation website.

connect: Has a general theme emerged in the kinds of research that has
been funded?

We are seeing a lot of interest in the study of gut bacteria and hormones and how it may affect appetite, satiation and inflammation particularly after bariatric surgery. Others are looking at brain chemistry and how it affects weight loss and metabolic disease before and after surgery. Still others are looking at quality measures and quality improvement in metabolic and bariatric surgery, an emerging area, given its increasing focus across health care. Basic science research is another hot topic area.

connect: What have been some of the most significant studies that have come out of the ASMBS  Research Grant Award Program?

There have been many. The committee is in the final stages of developing a research paper booklet that includes abstracts of  papers published as a result of research funded through the  Research Grant Program. This booklet should be available by ObesityWeek in November. A sampling of some of the most significant studies include:

  • Melissa A. Kalarchian, PhD, “Optimizing Long-Term Weight Control after Bariatric Surgery”
  • Stacy A. Brethauer, MD, “Obesity-Induced Diabetes - Searching for a Cure Through Bariatric Surgery”
  • Michael B. Peters, Jr., MD, “Autonomic Nervous System Function and Novel Determinants of Glucose Homeostasis Following Bariatric Surgery”

connect: Since 2012, the ASMBS Research Committee has been responsible for the management of the BOLD database and converting its format. How is
that going?

The ASMBS Executive Council charged the Research Committee with transitioning to a new process for accessing the BOLD database and reformatting the raw data for statistical programs and analysis. As a result, the committee oversees the Research Advisory Committee, Data Access Committee and the Data Dissemination Committee. Phase I of this transition is expected to be completed by ObesityWeek. Data conversion is a long process, but once completed, it will better serve our members' individual research needs.

connect: What other activities is the committee involved in?

The committee serves as a resource for the ASMBS in its policy and advocacy work. For example, when CMS reopened the national coverage determination to consider new evidence for the inclusion of sleeve gastrectomy as a primary procedure, the ASMBS submitted a letter to the agency supporting the move. The Research Committee helped to collect and organize the research that was instrumental in helping the ASMBS convince CMS to include sleeve gastrectomy, which today, is routinely covered nationwide. We are also providing research support for the ASMBS Revision Task Force.

The ASMBS Research Committee also lends its voice to promote high quality research at a national and international level wherever it can. In 2010, the NIH released its Draft Strategic Plan for Obesity Research, which the committee supported and offered suggestions on research areas that would support NIH efforts to address obesity.

The research committee has also offered a research post graduate course at the ASMBS Annual Meeting each of the last three years and will be offering another course this year at Obesity Week. Through this course we foster the development of researchers among the ASMBS membership. This year’s course will be offered in conjunction with the Society for Surgery of the Alimentary Tract (SSAT) and is an example of how the committee is extending the reach of ASMBS to other sister societies.

connect: What can we expect in the future from the ASMBS
Research Committee?

We are very excited about the prospect of initiating a large, multi-institution, randomized clinical trial examining the long-term safety and effectiveness of bariatric and metabolic surgery. We are in the planning stages and hope this project can move forward. This has the potential to be the definitive answer to those who still doubt the power of these
lifesaving operations.