Obesity and Malnutrition: An Important Area of Education for All Members of the Multidisciplinary Care Team
A Message from Dr. Raul J. Rosenthal
Raul J. Rosenthal, MD, FACS, FASMBS, Clinical Editor, Bariatric Times; Chief of Staff, Professor of Surgery and Chairman, Department of General Surgery; Director of Minimally Invasive Surgery and The Bariatric and Metabolic Institute; General Surgery Residency Program Director; and Director, Fellowship in MIS and Bariatric Surgery, Cleveland Clinic Florida, Weston, Florida
Dear Readers, Friends, and Colleagues,
This month we have some wonderful contributions that I would like to highlight.
First and foremost, we need to acknowledge the outstanding contribution of Drs. Stephanie and Daniel Jones through the development of the Essentials in Bariatric and Metabolic Surgery application. This educational tool is of great value to all caregivers that participate in the treatment of our patients that are suffering from the disease of obesity. A subsection of the Essentials app is dedicated to anesthesiologists. This month we present an interview with Dr. Stephanie Jones in which she highlights the features and takeaways from this section.
In “The Medical Student Notebook,” Brian Yang presents an outstanding literature review on the impact of obesity and weight loss surgery on joint disease. More importantly, Mr. Yang presents a clear analysis of the benefits of surgically induced weight loss. Overall, patients experience significant less pain, increased range of motion, and physical function.[1–3] I have always been impressed with the quality of articles written by Dr. Jones’s students. Needless to say, Dan has developed a great tool to educate future generations of physicians that will care for patients with obesity.
We are proud to present another continuing education article/activity this month under the direction of Tracy Martinez, RN, BSN, CBN, Department Editor of Integrated Health Continuing Education. In this article, Cassie I. Story, RDN, reviews the important subject of micronutrient supplementation following metaboic and bariatric surgery. I recollect writing a book chapter titled “The obesity disease: a type of malnutrition.” Although the title might be confusing, I have observed for the last 20 years in practice as a bariatric surgeon that patients with severe obesity are deficient in micronutrients. Such deficiencies can create serious clinical derangements postoperatively and long-term irreversible complications, such as polyneuropathy or Wernicke’s encephalopathy. Vitamin D is a common micronutrient in which patients seem to be deficient, specifically postmenopausal women. Everyone on the multidisciplinary care team should be aware of nutrient deficiencies and their potential consequences so we can recognize and help to correct them.
As I write this message, I’m preparing for the 16th Annual Surgery of the Foregut Meeting, the 4th International Congress on Fluorescent Image Guided Surgery, and the 2nd Consensus on Reoperative Bariatric and Metabolic Interventions (RBMI), all taking place during Cleveland Clinic Digestive Disease Institute Week 2017, February 14-19, 2017, at the Boca Resort Hotel in Boca Raton, Florida. I am excited that Dr. Higa and Dr. DeMaria have joined their RBMI conference with us, and I am looking forward to an outstanding meeting with two days filled with world experts that will debate re-operative bariatric interventions.
Given the state of the United States at the present time, I feel compelled to openly express my pain and anger following the executive orders by the new White House administration that include the building of a border wall with Mexico and a travel ban for certain countries. Bariatric Times is proud to serve a community of 13,000 readers from around the world—readers of different ethnicities, religions and cultures. Having been born in Argentina, the son of German-Jewish refugees who escaped and survived Nazi Germany, I take great personal pride in celebrating the diversity of our readership and our country.
I became American by choice. Like many of you, I sought a country of unlimited opportunities, a meritocracy that rewards hard work before gender, nationality, religion or sexual orientation. I consider myself a citizen of planet earth and feel blessed to work in a profession that understands the value and universality of human life. Therefore, I ask you to reflect on our role as medical professionals in protecting these values and creating a better world.
To close this editorial, I would like to clarify that the above mentioned is my personal opinion. It does not reflect the view of the Matrix Medical Communications, publishers of Bariatric Times. As stated in my last editorial, I am glad to return to addressing the readers via a monthly editorial message. I am privileged to work on this journal and I am deeply honored to have served as Clinical Editor since its launch. I hope you enjoy this issue as much as I did!
Raul J. Rosenthal, MD, FACS, FASMBS
1. Groen VA, van de Graaf VA, Scholtes VA, Sprague S, van Wagensveld BA, Poolman RW. Effects of bariatric surgery for knee complaints in (morbidly) obese adult patients: a systematic review. Obes Rev. 2015;16(2):161–170.
2. Gill RS, Al-Adra DP, Shi X, Sharma AM, Birch DW, Karmali S. The benefits of bariatric surgery in obese patients with hip and knee osteoarthritis: a systematic review. Obes Rev. 2011;12(12):1083–1089.
3. Springer BD, Carter JT, McLawhorn AS, et al. Obesity and the role of bariatric surgery in the surgical management of osteoarthritis of the hip and knee: a review of the literature. Surg Obes Relat Dis. 2016. pii: S1550-7289(16)30697-9.