Bariatric Surgery Significantly Reduces Risk of Certain Cancers…More Proof Accreditation Reduces Complications after Bariatric Surgery…‘Metabolically Healthy Obesity’ May Not Be Tied to Increased Mortality Risk…Researchers Discover How Obesity Triggers Inflammation…Record Number of Children in UK have Severe Obesity…South Korea’s ‘War on Obesity’
Bariatric Surgery in the News
Bariatric Surgery Slashes Hormone-Related Cancer Risk (MedPage Today)
Bariatric surgery was associated with a five-fold reduced risk of developing three hormone-related cancers (breast, endometrium, and prostate) in a national, population-based cohort study published in the British Journal of Surgery. Gastric bypass was associated with the largest risk reduction for all three hormone-related cancers (OR 0.16), followed by sleeve gastrectomy (OR 0.21), and gastric banding (OR 0.34). “I think this is an important study,” said Samer G. Mattar, MD, ASMBS president and medical director, Swedish Weight Loss Services in Seattle. “The study is meticulously designed, takes advantage of a very large administrative database, and confirms what we’ve known for several years.” This is a great information for all providers since bariatric surgery is about so much more than losing weight. It’s about improving overall health, and protection from obesity-related disease.” Bariatric surgery offers protection against primary cancers and increases survivorship in patients who have already been diagnosed with cancer, he said. “Those who lose weight live longer.” Mattar pointed to previous research from McGill University Health Center in Canada that showed bariatric surgery significantly reduced the number of physician/hospital visits in patients with obesity with any cancer diagnosis compared to controls with cancer who didn’t have bariatric surgery. “We used to wait for 5 years after a cancer diagnosis to perform bariatric surgery,” Mattar said. “Now we operate right after treatment for acute cancer, especially in patients with breast or endometrial cancer.” While only gastric bypass was associated with a significant reduction in prostate cancer, it was also associated with twice the risk of colorectal cancer. More study is needed to determine the mechanisms behind this, Dr. Mattar commented. “We need more data in order to make recommendations on more frequent colonoscopy.”
Accredited Bariatric Center Reduces Postop Complications while Increasing Surgical Volume (Medical Xpress)
California-based Stanford Bariatric greatly lowered its rates of several postoperative complications, including first month rehospitalization, surgical site and urinary tract infections, and bleeding, despite almost doubling its surgical volume over five years, according to a presentation at the American College of Surgeons (ACS) 2018 Quality and Safety Conference. Stanford Bariatric is one of the more than 800 bariatric centers in the country that have earned Metabolic Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) accreditation. “MBSAQIP accreditation drives quality improvement,” said principal investigator John Morton, MD, MPH, FACS, FASMBS, chief of bariatric and minimally invasive surgery, Stanford University School of Medicine and past president of ASMBS. “Accreditation at hospitals performing bariatric surgery has been shown to decrease complications, costs, and deaths.” Stanford’s bariatric surgery program identified complications needing improvement by reviewing the MBSAQIP Semiannual Report, which Dr. Morton likened to a report card that helps identify opportunities for improvement. In monthly meetings, the entire bariatric program staff reviewed outcomes data, identified the root causes of specific outcomes that occurred, and discussed how to prevent these complications. From 2013 to 2017, the number of bariatric operations performed annually at Stanford rose from 234 to 438, Dr. Morton reported, yet, over the same five-year period, the program reduced 30-day readmissions from 4.7 percent to 2.1 percent of surgical cases and surgical sight infections from 2.5 percent to 0.5 percent. The key to their successful quality improvement was persistence, said Dr. Morton. “It paid off—like putting money in the bank and getting interest.”
Obesity in the News
‘Metabolically Healthy Obesity’ May Not Raise Mortality Risk (Medscape)
Obesity in the absence of any other metabolic abnormalities may not raise the risk for all-cause mortality, new research published in Clinical Obesity suggests. Using follow-up data from five cohort studies involving more than 50,000 adults, researchers from York University in Toronto conclude that ‘metabolically healthy obesity’ is “not associated with increased risk for all-cause mortality as compared to normal weight individuals. However, obesity combined with even just one other risk factor was associated with significantly increased mortality (HR=1.80), and in the absence of obesity, diabetes (HR=1.94), preclinical hypertension (HR=1.36), hypertension (HR=1.64), and dyslipidemia (HR=1.17) were all significantly associated with increased all-cause mortality, compared with that of lean healthy individuals. The new data contradicts findings from previous studies on ‘metabolically healthy obesity.’ A recent study that used data from the Nurses’ Health Study showed that obesity remains a risk factor for cardiovascular disease even among individuals who are otherwise “metabolically healthy,” as did another study that relied on a large UK database.
UVA Researchers Discover How Obesity May Trigger Harmful Inflammation (News-Medical)
Researchers from the University of Virginia believe they have identified how obesity may trigger damaging inflammation. Damaging “free radicals” react with substances known as lipids inside fat tissue and prompts them to cause inflammation. “When we compare healthy and obese tissue, what seems to change is the ratio of full-length and truncated oxidized lipids,” said researcher Vlad Serbulea, PhD. “Our studies show that the full-length, or longer, oxidized lipids are quite inflammatory. They promote inflammation within these immune cells, and we think that instigates and perpetuates the disease process within [fat] tissue during obesity.” The researchers say that now that we know which oxidized lipids are causing problems, and how, they can seek to block them to prevent inflammation.
Record number of severely obese children (BBC News)
More than 22,000 children aged 10 to 11 years in England had severe obesity in 2016-2017, the highest levels ever recorded. Levels of childhood obesity have remained stable in recent years, but the new analysis from the National Child Measurement Programme shows that severe obesity has been on an upward trend over the last decade. “It’s very concerning that the number of children with a weight that is classified as severely obese is now at an all-time high,” said Caroline Cerny, of the Obesity Health Alliance. “Children with obesity are five times more likely to have obesity as adults, putting them at risk of diseases including Type 2 diabetes, cancer, heart and liver disease, as well as associated mental health conditions.”
Government Declares War on Obesity (Korea Bizwire)
The South Korean government has declared a ‘war on obesity’ by implementing measures in the four areas of nutrition, exercise, obesity treatment and improved awareness. As part of its goal to keep its obesity rate below 35 percent, public health insurance will start covering surgical procedures that are performed to aid patients suffering from obesity, and starting in 2020, medical consultations and dietary training will also be eligible for partial coverage under the national insurance plan. The South Korean government will also introduce a new “health incentive system” that rewards citizens who take good care of their physical well-being.