Dear Friends, Colleagues, and Readers of Bariatric Times:
Welcome to the January issue.
First, we present an article titled, “Augmenting Weight Loss Using Technology” by Jennifer Arussi, MS, RD, from Cedars-Sinai Medical Center in Los Angeles, California. I read this review with great interest. Self-monitoring is not a new tool in bariatrics. Industry has offered patients undergoing laparoscopic adjustable gastric banding (LAGB) a comprehensive website where they could enter personal data and follow their progress. This article shows that the available literature on this topic is favorable and supportive for the use of technology; however, I believe that we need to remind ourselves that it can become another challenge to our patients. While some may be adherent to and benefit from self-monitoring, others may see at as a challenge in their already long list of postoperative recommendations. As Arussi mentions in her article, it is important to remember that not everyone is capable of “self assessment.” I personally love pedometers and always use heart monitors when exercising. Knowing the amount of calories we consume and burn is, in my opinion, a vital component of lifestyle changes.
In this month’s “Checklists in Bariatric Surgery,” we review the reasons, diagnosis, and treatment options for patients with marginal ulceration after Roux-en-Y gastric bypass (RYGB). This is a clinical scenario that, in some cases, can become a reason for reversal of a bariatric procedure.
Dr. Wasef Abu Jaish presents a very interesting case of dysphagia lusoria in a patient after RYGB. Dysphagia lusoria is an abnormal condition characterized by difficulty in swallowing caused by aberrant right subclavian artery. This rare etiology should remind us that the bypass is not always the reason for symptoms such as nausea and vomiting after bariatric procedures, and we should always look for other systems as a potential source.
In this month’s “Medical Methods in Obesity Treatment,” Dr. Robert Kushner and Dana Brittan review the current status of the American Board of Obesity Medicine (ABOM), which was founded in 2011. The board will administer the first certifying examination in December 2014. I am proud to say that with the help of Dr. Julie Kim, and under the presidency of Dr. Bruce Wolfe, I prepared the board questions for the bariatric surgery section of the exam. I congratulate Dr. Kushner and members of the ABOM for this important milestone, and I also wish all potential examinees best of luck with their exam.
Also in this issue, we highlight the Davis Clinic, Houston, Texas, in our “Bariatric Center Spotlight,” and Dr. Walter Pories continues to share his wonderful collection of drawings in “Cartoon Corner.”
I read with great interest and learned much from an article published in USA Today featuring Joseph Bresee, an influenza expert from the Centers for Disease Control and Prevention. The article stated that 46 percent of adult patients hospitalized nationwide due to influenza are obese. Though this might be a coincidence, it does support the theory that obesity is an immunosuppressive disease, which might make those affected by the disease prone to get easily infected with the flu virus.
I also enjoyed the article published in PLOS Medicine stating that India is planning on raising the taxes to 20 percent on sweetened beverages in an attempt to control the obesity and diabetes epidemic. According to their calculation, such a measure would avert 11.2 million cases of overweight/obesity and 400,000 cases of type 2 diabetes between 2014 and 2023. Nice move.
I hope you will enjoy this issue of BT.
Raul J. Rosenthal, MD, FACS
Clinical Editor, Bariatric Times, Professor of Surgery and Chairman, Department of General Surgery; Director, The Bariatric and Metabolic Institute; Director, General Surgery Residency Program and Fellowship in Minimally Invasive and Bariatric Surgery, Cleveland Clinic Florida, Weston, Florida
1. Weise A. Almost 50% of people hospitalized for the flu are obese. USA Today. January 13, 2014.
2. Basu S, Vellakkal S, Agrawal S, et al. Averting obesity and type 2 diabetes in India through sugar-sweetened beverage taxation: an economic-epidemiologic modeling study. PLoS Med. 2014;11(1):e1001582.