Monday, April 17, 2017            

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

Bariatric Surgery Raises Odds of Abdominal Surgery During Pregnancy… SHAPE Magazine: Balloon Pills For Weight Loss… Obesity And Diabetes More Deadly Than Initially Thought… Diabetes Continues to Rise… Obesity a Risk Factor for Alzheimer’s… Migraine Risk Tied to Obesity… For Women, Obesity May Make RA Tough to Spot… Teens With Obesity At Risk of High BP… Self-Control Training for Preschoolers Fails to Prevent Obesity

Metabolic and Bariatric Surgery in the News…

Weight Loss Surgery Raises Odds of Abdominal Surgery During Pregnancy (Reuters)

Women who have had bariatric surgery are six times more likely to need abdominal surgery during pregnancy compared to pregnant women with obesity who haven’t had a prior weight loss surgery, a Swedish study in Obstetrics and Gynecology suggests. The most common reason for the abdominal surgeries was intestinal obstruction, a complication that affects 2% of Swedish bariatric surgery patients. Researchers analyzed data from 1987 through 2011 and identified about 2,500 women who had bariatric surgeries, usually gastric bypass, before giving birth, including about 1,200 first-time pregnancies, and compared them to more than 21,000 women who had a BMI in the obese range at the beginning of their pregnancies but no history of bariatric surgery. About 1.5% of pregnant women with a history of bariatric surgery also had abdominal surgery during their pregnancy due to intestinal obstruction, compared to 0.02% of women who did not have bariatric surgery. An additional 1.5% of the pregnant women with prior bariatric surgery underwent surgical diagnostic procedures without finding any diagnosis, compared to 0.1% of pregnant women without prior bariatric surgery.

Why Are People Are Taking Pills That Turn Into Balloons In Their Stomachs? (SHAPE) reports that “weight-loss surgeries such as gastric bypass, banding, or sleeves are more popular than ever. And studies suggest that most bariatric surgery patients are successfully maintaining their weight loss,” and a new product, the Obalon Balloon System, may have “the benefits of bariatric surgery—but in pill form.” Results have been positive with the average weight loss being between 15 and 50 pounds. And on average, 89.5% of the total weight lost was maintained after one year, research shows. However, it is noted that the system isn't currently covered by insurance, unlike bariatric surgery, and could cost patients as much as $9,000.

Obesity in the News…

Obesity And Diabetes Kill More Than Initially Thought, According To New Study (Forbes)

A study in PLoS ONE has revealed that diabetes may be killing around four times as many people as originally thought, which also means obesity is likely “killing many more people than realized.” Researchers analyzed data on patients who had participated in the National Health and Nutrition Survey and the National Health Interview Survey to determine which patients had diabetes and likely died from complications of the disease. Then they searched the death certificates of these individuals to find the recorded cause of death. Based on the data, over 11.5% of the patients had died from diabetes complications. This was close to four times the percentage of patients who had diabetes complications mentioned on their death certificates (3.3–3.7%). With obesity being a major cause of the disease, “there's a good chance that obesity is the top killer in the U.S… The challenge with obesity and diabetes is that they aren't obvious killers, but instead more devious, insidious and thus in many ways more dangerous.”

Diabetes Continues Its Relentless Rise (HealthDay)

Two new studies on diabetes were published this week in the New England Journal of Medicine. The first study showed from 2002 to 2012, the rates for Type 1 and Type 2 diabetes in U.S. children increased, especially among racial and ethnic minorities. The rate of Type 2 diabetes increased 4.8% a year. The annual increase in Type 2 diabetes in black children was 6.3%. For Asian/Pacific Islanders, the yearly increase was 8.5%, and for Native Americans, it was almost 9%. The second study reported a drop in the incidence of heart disease and stroke in adults with both types of the disease. The study looked at people registered in a Swedish National Database from 1998 through 2012, and followed their health through 2014. The database has nearly 37,000 people with Type 1 diabetes and more than 457,000 with Type 2 diabetes. These patients were compared to similar people without diabetes. In people with Type 2 diabetes, there was roughly a 20% greater drop in heart disease and stroke compared to the control group. However, when it came to deaths during the study period, people with Type 2 diabetes had smaller reductions in deaths versus the control group. Even with these improvements, people with either type of diabetes still have much higher overall rates of premature death and heart disease than the control groups, the study authors noted.

Alzheimer’s Risk Factors Study Calls Out Obesity in MidLife (CBS News)

Healthy aging of the brain relies on the health of your heart and blood vessels when you’re younger, a new study reports in the JAMA. MRI scans revealed larger deposits of amyloid, a sticky protein known to clump together and form plaques in the brains of people with Alzheimer’s disease, in the brains of seniors who had obesity when they were middle-aged. This was also seen in those who smoked, had high blood pressure and diabetes or had elevated cholesterol levels. Having two or more risk factors nearly tripled a person’s risk of large amyloid deposits. Obesity in particular stood out as a strong risk factor, on its own doubling a person’s risk of elevated amyloid later in life. For the study researchers examined data from nearly 350 people whose heart health has been tracked since 1987 as part of an ongoing study. The average age of the study participants was 52 at the start of the study. The average follow-up time was almost 24 years.

Migraine Risk Tied to Too-High, Too-Low BMI (MedPage Today)

Patients who have obesity and those who are underweight share an increased risk of migraine, according to a meta-analysis of 12 studies in almost 300,000 people. When results were pooled and adjusted for age and sex, those with a BMI of 30 or higher had a 27% increased risk of migraine compared with those of normal weight while underweight individuals with a BMI of less than 18.5 had a 13% increased risk, researchers reported online in Neurology. Although the increased risk of migraine in those who have obesity is only moderate and similar to the degree of risk associated with ischemic heart disease and bipolar disorder, it supports the need for research to determine the impact of weight reduction on migraine risk, the study authors said. The researchers also noted that limited data suggest that monthly frequency and headache severity is reduced for up to six months in episodic and chronic migraineurs who undergo bariatric surgery for morbid obesity.

Obesity May Make Rheumatoid Arthritis Tough to Spot (WebMD)

Blood tests to diagnose and monitor rheumatoid arthritis may be thrown off by obesity in women, a new study in the journal Arthritis Care & Research suggests. The study included more than 2,100 people with rheumatoid arthritis compared to data from the general population. A higher BMI was associated with greater C-reactive protein (CRP) – a marker of the severity of inflammation in rheumatoid arthritis patients – in women with rheumatoid arthritis and women in the general population, especially in women with severe obesity. There was also a modest association between obesity and erythrocyte sedimentation rate (ESR) – another marker physicians check for RA. Conversely, in men with rheumatoid arthritis, a lower BMI was associated with greater CRP and ESR. The findings may help improve understanding of the link between weight and inflammation, the study authors say.

Obese Teens' Odds of High Blood Pressure Vary by Race (Reuters)

Obesity is a strong predictor of high blood pressure early in life, but a U.S study suggests the connection may be stronger for Hispanic and white teens than for adolescents in other racial and ethnic groups. Data from more than 21,000 secondary school children showed 6.6% of those with obesity had high blood pressure, as did 2.6% of those that were overweight and 1.6% of normal weight adolescents. Obesity was much more likely to increase the risk of high blood pressure in Hispanic and white participants. Participants in the study were 14 years old on average and ranged in age from 10 to 19. Data were collected from 2000 to 2015. About 23% of Hispanic youth, 21% of black students, 13% of white adolescents and 10% of Asian participants had obesity. Black students had the highest prevalence of high blood pressure among normal-weight and overweight study participants. But among obese participants, black youth had the lowest rates of hypertension. Compared to normal weight Hispanic youth, their obese peers were 5.8 times more likely to have hypertension and their overweight counterparts were 2.2 times more likely, the study found. Obese white teens were 4.1 times more likely to have high blood pressure than their normal weight peers, while obese black youth had 2.3 times the risk encountered by their normal weight counterparts.

Self-Control Training for Preschoolers Fails to Prevent Obesity (Reuters)

Teaching preschoolers to regulate their own behavior around food, combined with obesity prevention messages, did not reduce obesity or most obesity-related behaviors in a four-year U.S. trial published in the journal Pediatrics. They tested two interventions, alone and in combination, embedding the experiment within the federally-funded Head Start program for low-income children. During each of four academic years, classrooms were randomly allocated to one of three groups: Head Start alone (HS), Head Start plus the Preschool Obesity Prevention Series (HS+POPS), or Head Start plus POPS and the Incredible Years Series (HS+POPS+IYS). POPS provides obesity prevention messages to preschoolers and their parents while IYS emphasizes positive behavioral management techniques and self-regulation. According to the researchers, HS+POPS+IYS improved the kids' teacher-reported self-regulation compared with HS+POPS and HS alone. But the programs failed to have significant effects on the prevalence of obesity, which was about 14% in both the HS+POPS+IYS and HS+POPS groups after the interventions. Obesity prevalence rose to about 13% among kids in the HS alone group. The interventions also had no effect on other outcomes aside from sugar-sweetened beverage intake.