STORIES OF THE WEEK

Monday, January 23, 2017            

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

Study Shows Lap Band Surgery Has ‘Significant Benefits’ for Teens… Bariatric Surgery Patients Less Likely to Develop Diabetic Retinopathy… Obesity Widely Ignored by US Med Schools… Fate of Obamas' Obesity Legacy Uncertain Under New President… Being Overweight or Obese May Help Patients Survive Heart Surgery… Latin America Seeing Surge in Obesity Rates, UN Report Shows… Childhood Asthma Linked to Obesity

Metabolic and Bariatric Surgery in the News…

Lap Band Surgery Benefits Very Obese Adolescents (Science Daily)

A study published in Obesity Surgery shows lap band surgery has significant benefits for teens with severe obesity, suggesting the procedure should still be considered as an option to manage obesity during adolescence. The study is the first to show medium to long-term follow-up (3-5 years) of lap band surgery in Aussie adolescents. Researchers followed 21 patients between ages 14 and 18 who had lap band surgery in the South Australian Health Service from 2009 to 2013. The study found that weight and BMI improved significantly at all follow-up times postoperatively up to 45 months and, in some cases, as long as 5 years. BMI loss was between 7.1 and 14.7 kg/m2. “Lap band surgery is reversible and allows time for adolescents to mature to make a more informed decision on a permanent surgical procedure if required later on in life. This is not the case for other surgeries currently offered for obesity management,” the study’s lead author commented. "It is also important that teenagers undergoing this surgery have access to an experienced surgeon as part of a multidisciplinary pediatric team of doctors and Health professionals to ensure there is long-term regular follow-up."

Bariatric Surgery May Prevent New Cases of Diabetic Retinopathy (Healio.com)

Patients with type 2 diabetes who underwent bariatric surgery were less likely to develop diabetic retinopathy compared to those treated medically, according to a meta-analysis published in Obesity Review. However, researchers note, whether bariatric surgery is associated with a regression of the condition remains unclear. Data was analyzed from seven studies assessing the appearance, deterioration or improvement of diabetic retinopathy in patients undergoing bariatric surgery compared to patients undergoing medical treatment. Researchers found that incident cases of retinopathy were fewer with bariatric surgery vs. medical treatment in all but one study. Type of bariatric surgery was not associated with retinopathy incidence, and researchers did not find a correlation between new cases of retinopathy or change in retinopathy score and BMI, HbA1c or diastolic blood pressure. The researchers note that there were too few cases to show meaningful differences between surgical approaches, and that the short follow-up periods for the studies were short, which may have hidden other cases of retinopathy that developed later.

Obesity in the News…

Are U.S. Med Schools Skimping on Obesity Treatment? (HealthDay)

A Northwestern University study shows, despite being a major health threat, obesity isn't widely discussed in US medical schools and is “barely mentioned” in US medical students' licensing exams, according to researchers at the university’s School of Medicine. With so few test items about obesity prevention and treatment, medical schools have less incentive to educate students about obesity -- and students have less incentive to learn about it, the investigators said. "It's a trickle-down effect. If it's not being tested, it won't be taught as robustly as it should be," commented Dr. Robert Kushner, a professor of medicine. For the study, six obesity specialists examined the obesity-related content of the three United States Medical Licensing Examinations taken by all medical students and first-year residents. The few exam items about obesity focused on assessment and management of obesity-related illnesses such as diabetes and obstructive sleep disorder, rather than the diagnosis and management of obesity itself. It also revealed that important concepts of obesity prevention and treatment were poorly represented. The study was published recently in the journal Teaching and Learning in Medicine.

The Obamas' Other Health Legacy (US News & World Report)

US News reports that whether President Trump and his family will continue the anti-obesity efforts initiated by the Obamas is unclear, despite evidence that programs started by Barack and Michelle are working. The Obama administration undertook reducing obesity as a priority during the last eight years, setting up its Task Force on Childhood Obesity, overhauling nutrition requirements in school lunches, passing requirements for calories to be labeled on menus and moving to ban trans fat from foods. Progress against obesity has been limited, and rates among adults continued to climb from 33.7% when Obama took office to 37.7% by 2014. The CDC also recently revealed that the agency had failed to reach its goals for tackling childhood obesity. However, a report from the Robert Wood Johnson Foundation shows the country is beginning to see hints of advancement in combating obesity as some demographics have seen improvements. Moreover, advocates believe initiatives started under Obama’s administration should continue because progress will take more than eight years and will require even more federal investment. However, “Obama's health care law is under siege by the Republican-controlled Congress,” and health advocates are less optimistic about what will happen under a Trump presidency as the new leader has “brought soda and fast-food industry executives into his inner circle.”

Obese People More Likely to Survive Heart Surgery (Newsmax Health)

A British study found that people who were overweight or had obesity were more likely to survive heart surgery than those of normal weight. Patients who were underweight had the highest risk of dying. Researchers studied data on more than 400,000 adults who had undergone cardiac surgery between April 2002 and March 2013 and divided them into six groups from underweight to Class II obesity based on BMI. Normal weight patients were almost twice as likely to die in the hospital following heart surgery as those who were overweight or had obesity, 4.4% compared to 2.8% who were overweight and 2.7% who had obesity. However, 8.5% of those who were underweight died. "Obesity is a reason often given for not offering patients surgery. With this study, we show that, for cardiac patients at least, being obese should not be a reason to turn patients away from surgery," the study authors commented.

As More Latin Americans Eat Processed Food, Obesity Rates Surge (Reuters)

According to a report from the United Nations, Latin America is facing a “surge in obesity ” as nearly 58% of the region's inhabitants, or close to 360 million people, now overweight or obese – a result of processed food gradually replacing traditionally prepared dishes. Obesity has increasingly affected Latinos "regardless of their economic situation, place of residence or ethnic origin.” The jump in obesity rates occurred partly as economic growth, increased urbanization, higher average incomes and the region's integration into international markets have reduced the consumption of traditional foods. The countries with the highest levels of obesity are the Bahamas, Mexico and Chile, with rates of 69%, 64% and 63%, respectively. However, Latin America is still home to the nation with the highest rate of undernourishment -- Haiti at 53%.

Childhood Asthma May Encourage Obesity, Study Suggests
(US News & World Report)

A young child with asthma has a greater risk of obesity than one without the chronic respiratory condition, a new study suggests. However, kids who used "rescue" inhalers are less likely to become obese compared to those who do not treat flare-ups. Among nearly 2,200 elementary school students in California, researchers from the University of Southern California found that childhood asthma was linked to a 51% increased risk of obesity over the next 10 years. Previous research has shown children with obesity are at an increased risk of developing asthma. However, the results of the current study demonstrate the opposite association, and researchers suggest this might be because children with asthma could be less physically active, have sleep disturbances or asthma could have common genetic underpinnings. The researchers also pointed out that weight gain is a side effect of many asthma medications.