STORIES OF THE WEEK

Published January 15, 2017             

The following is a summary/brief analysis of the obesity and surgery stories making news this week:

Bariatric Surgery Improves Heart Health in Teens with Severe Obesity …Bariatric Surgery Decreases Pain Sensitization…Low Rates of 30-Day Major Complications Associated with Bariatric Surgery...Severe Obesity Declines for Low-Income Children…Healthy Eating Stands to Benefit People with Genetic Risk of Obesity…Large-Scale Study Finds 14 Gene Variants Linked to Obesity…Study: Taxing Junk-Food to Curb Obesity Legally Viable, Practicable

Metabolic and Bariatric Surgery in the News…

Bariatric Surgery Helps Teens With Severe Obesity Reduce Heart Disease Risk (NPR, HealthDay)

Teens with severe obesity who underwent bariatric surgery had significantly improved cardiac risk factors including elevated blood pressure, high cholesterol, inflammation and insulin levels three years after surgery, in a new study published in the journal Pediatrics. The 242 teens, ages 15 to 18 at the start of the study, had BMIs between 34 and 88, with half over 51. Three years after surgery, the 161 teens who underwent a gastric bypass had a 27 percent drop in their BMI. Similarly, the 67 teens who had sleeve gastrectomy had a 26 percent drop. The 14 teens who had gastric banding saw an 8 percent drop in BMI. Three years after surgery, more than half of the teens (52%) had no cardiac risk factors, compared to 3 percent before surgery. The percentage of teens that had all four risk factors dropped from 5 percent before bariatric surgery to zero three years after. Moreover, the majority of the participants (83%) had only one or no risk factors three years after their surgeries. The study’s lead author commented "Severe obesity is notoriously difficult to treat with anything other than surgery. The results of this study suggest that performing surgery at a BMI even lower than 52 would provide even better outcomes."

Pain Sensitization Declines After Bariatric Tx in Obese Patients
(MedPage Today)

Weight loss following bariatric surgery was associated with improvements in pain sensitization among patients with chronic knee pain, a year-long study published in Arthritis Care & Research found. One year post bariatric surgery, pressure pain threshold increased 38.5 percent at the patella and 30.9 percent at the wrist among patients who had gastric bypass or sleeve gastrectomy. No changes in the pressure pain threshold were observed among patients who received medical/lifestyle management. A decrease in the number of painful joints was also observed. According to investigators, the findings support the possibility that central pain sensitization is a mediator of pain reduction in the patients who had bariatric surgery, however other factors may contribute to changes in pain following bariatric surgery such as increased physical activity and improvement in mood and quality of sleep.

Rate of Major Complications Low After Bariatric Surgery (HealthDay via Endocrinology Advisor)

The rates of three major complications at less than 30 days after bariatric surgery are low and vary among surgical procedures, according to research published online in Obesity Reviews. Researchers used data from 71 studies involving 107,874 patients undergoing gastric bypass, sleeve gastrectomy and adjustable gastric banding, and found that at less than 30 days after surgery, the anastomotic leak rate was 1.15 percent, the myocardial infarction rate was 0.37 percent, and the pulmonary embolism rate was 1.17 percent. The rate of anastomotic leak was higher for sleeve gastrectomy than gastric bypass, while the rates of myocardial infarction and pulmonary embolism were higher for gastric bypass than adjustable gastric banding or sleeve gastrectomy.

Obesity in the News…

Severe Obesity Declining Among Low-Income US Kids (Reuters Health)

The proportion of kids in poverty with severe obesity receiving government food assistance has declined following a benefits change in 2009 designed to encourage healthier purchases, a study in JAMA Pediatrics suggests. Researchers followed 22.6 million children enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) from 2000 to 2014. Severe obesity rates increased from 1.8 percent of kids in 2000 to 2.12 percent in 2010, however, by 2014, the proportion of children with severe obesity declined to 1.96 percent. The results suggest that WIC may be contributing to reductions in severe obesity because other studies done over the same time period haven’t found declines in severe obesity among kids across all income levels, said Myles Faith, a researcher at the University at Buffalo, who not involved in the study. “There may be something unique to the WIC and its food package that is driving down severe obesity among its participants.”

Those With 'Obesity Genes' May Gain Most From Healthy Eating
(HealthDay via WebMD)

A new study published in The BMJ suggests that those who have a genetic predisposition to obesity stand to benefit the most from eating healthy foods. The finding stems from a new analysis of diet, lifestyle and medical data on about 14,000 men and women that had been collected for two earlier studies which included information on dietary routines and changes to the participants' BMI, a measure often used to categorize weight. Exercise habits were not assessed. Researchers compared the participants' eating habits with three different diets: the Alternate Healthy Eating Index 2010 (AHEI-2010), the Dietary Approach to Stop Hypertension (DASH) and the Alternate Mediterranean Diet (AMED) and assigned a genetic risk score for obesity to each participant by considering 77 genetic variations that have been linked to BMI status. People whose eating habits over two decades aligned most closely with either the DASH or AHEI-2010 diets experienced a drop in overall body weight and BMI, and the strongest association was among those who had the greatest genetic risk for obesity. In an editorial published with the study, Dr. Nathalie Farpour-Lambert, president-elect of the European Association for the Study of Obesity, noted that the findings "help to dispel misconceptions that a genetic predisposition will inhibit successful weight management.”

Large-Scale Study Identifies 14 Gene Variants Associated with Obesity (New Atlas)

A new large-scale study published in Nature Genetics used the genetic data of more than 700,000 individuals to identify 14 genetic variations associated with obesity and BMI. One of the discoveries was a copy variation in a gene called MC4R, which is found in almost one in 5,000 people and affects the production of a protein that regulates appetite and results in carriers weighing an average of 15 pounds heavier than those without the genetic variant. Another discovery revealed two variants in the GIPR gene, found in about one in 400 people, that corresponds to an average of 4.5 pounds more weight than non-carriers.

Should We Tax Junk Foods To Curb Obesity? (Forbes)

A new study published in the American Journal of Public Health reviewed every scientific paper published on U.S. and international food taxes through May of last year. After analyzing the data, the researchers concluded that an excise tax on junk food manufacturers would be legally viable and relatively easy to administer. Lead author of the study, Jennifer Pomeranz, assistant professor of public health policy and management at NYU’s College of Global Public Health says that although such a tax wouldn’t hit consumers directly, as a sales tax would, it could have an indirect effect on eating choices—and by extension, obesity—in forcing food manufacturers to raise prices. The researchers also note that a national excise tax would incentivize food manufacturers to change the ingredients in their products.