Monday, October 9, 2017            

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

Patient with Severe Obesity Have Lower Cancer Risk After Bariatric Surgery…EndoBarrier Studied as Late-Onset Diabetes Treatment…Mortality Risk from Obesity Comorbidities Persists During Weight Loss…12 of 13 Obesity-Related Cancers on the Rise…Two New Studies Examine Link Between Circadian Rhythm and Obesity… Obesity Associated with Limited Mobility After TKA and THR

Metabolic and Bariatric Surgery in the News…

Bariatric Surgery Lowers Cancer Risk for Severely Obese
(Medical News Today, Newsmax Health, Medical Xpress)

Patients with severe obesity who have bariatric surgery lower their risk of developing cancer by at least a third, according to new research published online in Annals of Surgery. The benefit was greatest among obesity-associated cancers. Among bariatric surgery patients there was a 42 percent lower risk of postmenopausal breast cancer and a 50 percent lower risk of endometrial cancer. The risk of colon cancer was also 41 percent lower, and the risk of pancreatic cancer dropped by 54 percent. Researchers suggest the reductions were linked to modified levels of estrogen due to the high percentage of women in the study, and reduced insulin resistance which is a risk factor for pancreatic cancer.

New Device Could Help People with Diabetes Lose Weight (Healthline)

EndoBarrier may provide an endoscopic alternative to gastric bypass surgery for people with late-onset diabetes associated with obesity, researchers suggested at the European Association for the Study of Diabetes (EASD) annual meeting. Dr. Robert Ryder, chief investigator for the Association of British Clinical Diabetologists’ presented data from an EndoBarrier clinic in the U.K. showing 65 percent of the patients treated with the long tube-like liner, which stops the absorption of food in the intestines, were able to sustain the benefits achieved in blood sugar and weight control, and in insulin-dose reduction. “This study shows that [EndoBarrier] works in even longstanding, hard-to-control cases of type 2 diabetes,” said Dr. Thomas A. Buchanan, chief of the Division of Endocrinology and Diabetes at University of Southern California. “Surgical approaches are used relatively late, usually for severe obesity… We need approaches that can fix obesity for long periods of time. And we probably need to use them earlier and for lesser degrees of obesity than is the current practice. This [EndoBarrier] sleeve is a new approach that has great potential in that regard.”

Obese People Face High Death Risk Even When Losing Weight (Healthline)

People with obesity face a myriad of problems even after losing weight if “mass related” health issues such as heart disease, sleep apnea, and joint problems persist. Studies show that death rates for heart disease, stroke, and other vascular diseases rise 40 percent for every five-point increase in BMI. The recent death of the world’s heaviest woman highlights the health problems faced by people with obesity even when they’re losing significant weight. Eman Ahmed Abd El Aty had a thyroid problem and a genetic disorder led her to a weight of 1,100 pounds; she lost 550 pounds after laparoscopic sleeve gastrectomy. “One of the problems for people who are that heavy is that they can get down to a lower weight but still be morbidly obese,” Dr. Peter LePort, medical director of the Memorial Care Center for Obesity in California. “So, your comorbid health conditions can get better, but they don’t usually go away completely unless you get down to about 50 pounds over your normal body weight.” Still, up to 70 percent of comorbid conditions like diabetes and high blood pressure will resolve themselves once the weight comes off, according to Leport, and in that regard bariatric surgery can yield impressive results.

Obesity in the News…

Obesity-Related Cancers Rising, Threatening Gains in U.S. Cancer Rates
(Reuters, TIME, Healio/Endocrine Today)

According to the U.S. Centers for Disease Control and Prevention, more than 630,000 people were diagnosed with one of the 13 cancers linked with obesity or overweightness in 2014, which accounted for about 40 percent of all cancers diagnosed. Researchers observed a 7 percent increase in the incidence of 12 out of 13 obesity-associated cancers, which included meningioma, multiple myeloma, adenocarcinoma of the esophagus, and cancers of the thyroid, postmenopausal breast, gallbladder, stomach, liver, pancreas, kidney, ovaries and uterus. However, a decline of 23 percent was seen in colorectal cancer, which was attributed to increased use of screening tests. About half of Americans are not aware of the link between cancer and obesity, according to Dr. Anne Schuchat, a spokesperson for the CDC. The findings suggest that U.S. healthcare providers need to make clear to patients the link between obesity and cancer, and encourage patients to achieve a healthy weight.

Shift Work Increases Risk of Apple-Shaped Overweight/Obesity (Medscape)

Shift workers, especially those who work permanent night shift, are more likely to be overweight or have obesity compared to people who don't work shifts, and most frequently, their obesity is in the form of abdominal fat. The findings are based on a meta-analysis published online in Obesity Reviews. Researchers point to disruption in circadian rhythms as a potential underlying cause as it “may lead to a disturbance of body homeostasis and produce abnormal metabolic profiles."

Circadian Rhythm Influences Obesity, CVD (Healio/Cardiology Today)

A presentation at the Cardiometabolic Health Congress reaffirmed that variations in circadian rhythms can increase the risk for obesity as well as cardiovascular disease (CVD). The circadian system can influence cardiovascular (CV) risk factors, including cortisol, platelet activation and PAI-1 fibrinolysis inhibitor, while heart rate and the sympathetic nervous system play an intermediate role, said Dr. Frank Scheer, professor of medicine at Harvard Medical School. “It’s just not misalignment of the light/dark cycle in the essential clock, but of all the components of behavior,” Scheer said. “Even between different organs, there can
be misalignment.”

Obese Older Women at Higher Risk for Mobility Limitation After Total Knee or Hip Replacement for OA (Healio/Rheumatology)

Obesity was associated with an increased risk of late-life mobility limitation among older women who had total knee or total hip replacement for osteoarthritis, according to recently published study results. Women in the overweight, obese and severely obese categories had a significantly increased risk for survival to age 85 with mobility limitation when compared with women of normal weight. Women with severe obesity had the strongest risk, as well as an increased risk of death before age 85. There was increased risk of survival with mobility limitation but not death before age 85 in women who had total hip replacement. Among women with total knee replacement for osteoarthritis, high BMI, waist circumference and waist-hip ratio had an association with significantly increased risk for late-life mobility limitation and death.