Monday, December 4, 2017            

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

Dr. Oz Points to Research Presented at ObesityWeek 2017… Bariatric Surgery Reduces Psoriasis Risk…Device Maker to Study Metabolic Effects of Weight-Loss Surgery in EU Trial…Most Kids Today Will Have Obesity by Age 35…Rise in Cancer Rates Driven by Obesity, Diabetes…Link Between Obesity and Mortality Weakens with Age…Higher Risk for Infections for People with Obesity, Overweight

Metabolic and Bariatric Surgery in the News…

Benefits, Risks of Bariatric Surgery (The Crescent News)

Host of “The Doctor Oz Show,” Dr. Mehmet Oz and Dr. Mike Roizen, Chief Wellness Officer at Cleveland Clinic, highlight findings from ObesityWeek17 when answering a 65-year-old reader’s question about the safety and efficacy of bariatric surgery. A “major revelation” from the conference was a follow-up study that showed sleeve gastrectomy, or open or laparoscopic gastric bypass are as safe and effective for older adults as for younger. The 90-day major and minor complication rates post-surgery were 5.6 percent and 16 percent, respectively, comparable to the rates of younger patients. At one year out, patients reduced their daily meds by an average of three drugs. Three years after their surgery, the group had shed more than 60 percent of their excess weight, and almost 46 percent were free of Type 2 diabetes. The doctors urge the readers to talk to their surgeons about staying overnight after surgery noting that although the overall risk in either case is low, a University of California, Irvine study found people who had laparoscopic sleeve gastrectomy and were discharged on the same day as that surgery had “over a five-fold increased odds of death versus those who were discharged the following day.”

Bariatric Surgery Associated with Reduced Psoriasis Risk (Healio/Endocrine Today)

Adults with obesity who underwent bariatric surgery were less likely to develop psoriasis versus those who received usual care, according to findings reported in Obesity. Swedish researchers analyzed data from nearly 2,000 patients who had vertical gastroplasty, gastric banding or gastric bypass and 2,000 matched patients who did have surgery. The patients did not have psoriasis or psoriatic arthritis at baseline. During a median follow-up of 18.7 years for the surgery group and 18.1 years for controls, 174 patients developed psoriasis, including 46 patients who developed psoriatic arthritis. The incidence rate was lower among patients in the surgery group (71 vs. 103). “Only vertical banded gastroplasty was significantly associated with a lower incidence of psoriasis compared with conventional treatment,” the researchers wrote. “However, when comparing the three procedures among each other, they did not differ in terms of prevention of psoriasis.”

With $44M Fundraise, Could Fractyl Make Bariatric Surgery the Penicillin of Our Generation? (MedCity News)

Fractyl Laboratories announced it had raised $44 million in new equity financing to help advance the company’s Revita DMR technology; a “minimally invasive procedural therapy” that seeks to mimic the metabolic effects of weight loss surgery. Revita is an endoscopic catheter-based procedure that recreates the benefits of gastric bypass surgeries by making targeted changes to the duodenum. A heated-balloon is used to modulate the intestinal lining while leaving the structure intact. The company is currently recruiting for a new randomized, double-blinded, sham-controlled study in Europe to explore the role of insulin resistance in Type 2 diabetes and, to a lesser extent, NAFLD/NASH.

Obesity in the News…

'Scary' Prediction for U.S. Kids: 57% Could be Obese by Age 35 (USA Today, Reuters, CBS News)

A study published in the New England Journal of Medicine suggests 57 percent of the American children and teens will have obesity by age 35 if current trends continue. While the study does not look at underlying causes, it suggests that increased risks start accumulating early. A 5-year-old child with severe obesity faces an 89 percent risk of midlife-obesity; a normal-weight peer has a 53 percent risk. At age 19, a teen with severe obesity faces a 94 percent risk of obesity at 35; a normal-weight peer has a 30 percent risk. “This study is the first to make precise predictions for today’s generation of children,” and the news is not good, said lead author Zachary Ward, a researcher at the Harvard T.H. Chan School of Public Health. The findings, he said, show the need for stepped-up prevention efforts from infancy through young adulthood.

'Alarming' Rise in Cancer Rates Driven by Diabetes, Obesity (Medical News Today)

Researchers from Imperial College London and the International Agency for Research on Cancer of the World Health Organization in Lyon, France have found an increasingly high incidence of cancers related to metabolic diseases, and in particular diabetes and obesity. Of all cancer cases throughout the world in 2012, 5.6 percent were linked to pre-existing diabetes and a BMI over 25, and of this total, 3.9 percent of cases were attributable to diabetes, according to the study published in the Lancet Diabetes & Endocrinology. Using data provided by GLOBOCAN, the researchers studied the incidence of 12 types of cancer across 175 countries in 2012, taking into account patient age and sex. The 38.2 percent of cases of cancer cases that were related to diabetes and a high BMI could be pinpointed to high-income Western countries. The second highest occurrence was noted in east and southeast Asian countries, accounting for 24.1 percent of cases. According to the study’s lead investigator, "Increases in diabetes and high BMI worldwide could lead to a substantial increase in the proportion of cancers attributable to these risk factors, if nothing is done to reduce them."

Link Between Obesity, Mortality Weakens as Patients Age (Healio/Endocrine Today)

Associations between obesity and mortality decreased as patients aged, according to findings recently published in Obesity. Researchers wrote that the findings overturned previous studies that indicated that age strengthened the association between obesity and mortality. Researchers calculated age-specific hazard ratios (Hrs) of mortality for grade 2 or grade 3 obesity compared with a BMI between 18.5 kg/m2 and 25 kg/m2. HRs seemed to increase with age when the model included age at the time of the survey as a single value, the researchers reported; however, when researchers included adults with various ages during the survey, HRs were higher among younger adults compared with older adults with the same duration of follow-up.

Why Overweight People May Be More Likely to Die from Infections like Pneumonia and Sepsis (Vox)

A study published in the International Journal of Obesity, found that adolescents with obesity or overweight are at a higher risk of death from infectious diseases -- such as sepsis or pneumonia -- before the age of 60. For the study, researchers from the Israeli Defense Forces drew from a data set of 2.3 million Israelis ages 17 to 19 who were screened for fitness, height and weight before starting mandatory military service between 1967 and 2010. The researchers then linked this youth data with cause of death information from the Ministry of Health, focusing on the relationship between BMI and deaths from infectious diseases. Of the 2.3 million people in the study, 689 had died from infectious diseases by middle age. Researchers found that women with obesity were at a sevenfold higher risk for infectious diseases death compared to normal-weight women, while men with obesity were at a 2.3-fold higher risk of infectious diseases death compared to normal-weight men. For every unit increase in a person’s BMI, their risk of death from an infectious disease also increased. For men, there was a 4 percent increase in risk with every unit of BMI, and for women,
a 15 percent increase.