American Heart Association States Bariatric Surgery Has Benefits that May Outweigh Hazards

| April 15, 2011

Dear Bariatric Times fans:
I’d like to start this editorial by briefly mentioning two articles on obesity and its treatment. The first article by Poirier et al[1] details the scientific statement from the American Heart Association on bariatric surgery and cardiovascular risk, which states that people with severe obesity benefit from weight loss surgery. The statement says that gastric bypass and gastric banding may lead to weight loss and improvements in diabetes, cholesterol, and blood pressure, and those benefits may outweigh the hazards. Poirier et al conclude that since efforts with diet, exercise, and drugs have been “disappointing,” doctors need to look at surgical options to control obesity and get the associated disease processes into remission. Eckel, a professor of medicine at the University of Colorado, Anschutz Medical Campus, Aurora, Colorado, supports that surgery is the “treatment of choice” for people with a body mass index (BMI) of 40kg/m2 or more.

The second article reported the results of a study performed by researchers at Northwestern University on religion, diet, and obesity. Feinstein et al[2] concluded that “people with a high frequency of religious participation in young adulthood were 50 percent more likely to become obese by middle age than those with no religious participation in young adulthood.” This study, presented at the American Heart Association, reviewed and followed 2,433 individuals between the ages of 20 and 32 for 18 years. At the beginning of the study period, all subjects were of normal weight. By the end, however, those who had attended a religious function at least once a week were more likely to be obese, posting a BMI of 30kg/m2 or more.

In this issue of Bariatric Times, we present a new column guest edited by Samuel Szomstein, MD, FACS, on abdominal wall hernias entitled, “The Hole in the Wall.” The first installment, by featured expert Martin Newman, MD, FACS, discusses abdominal wall reconstruction in patients after massive weight loss. We invite your comments, column submissions, and any topic ideas you might have for this new column.
Ming and Gornichec present another very important topic, the treatment of osteoporosis in the bariatric patient. We all know how difficult it is for our patients to take their calcium supplementation and how crucial their adherence is in order to prevent osteoporosis and hyperparathyroidism. On a related topic, in this month’s “Nutritional Considerations in the Bariatric Patient,” Goldenberg presents an outstanding contribution on mechanisms of metabolic bone disease in bariatric surgery patients.

Finally, I recommend you pour a nice glass of wine (Malbec, if possible) and sit down to read the article by Joseph, Blackburn, and Jones on the recent United States Food and Drug Administration (FDA) approval of bariatric surgery in patients with BMI 30 to 35kg/m2. It is a must read. As I have mentioned in previous editorials, I do believe that we should perform bariatric procedures in this patient population provided they failed medical attempts and have comorbid conditions. Whether we should ideally use banding, sleeve, or bypass remains to be determined in the next 100 years or so.

Sincerely,

Raul J. Rosenthal, MD, FACS
Editor, Bariatric Times

References
1.    Poirier P, Cornier MA, Mazzone T, et al. Bariatric surgery and cardiovascular risk factors: a scientific statement from the American Heart Association. Circulation. 2011 Mar 14. [Epub ahead of print]
2.    Mapes D. Praise the lard? Religion linked to obesity in young adults. http://www.msnbc.msn.com/id/42256829/ns/health-diet_and_nutrition/ Accessed March 25, 2011.

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