Ask the Leadership
This column is dedicated to sharing the vast knowledge and opinions of the American Society for Metabolic and Bariatric Surgery leadership on relevant topics in the field of bariatric surgery.
This Month’s Interview With:
Jaime Ponce, MD, FACS
Director of Bariatric Surgery, Hamilton Medical Center, Dalton, Georgia; and Co-Director of Bariatric Surgery, Memorial Hospital, Chattanooga, Tennessee; ASMBS Past President.
Bariatric Times. 2013;10(12):8.
Dr. Rosenthal: What was the impact of American Medical Association’s decision to consider Obesity a disease?
Dr. Ponce: The American Medical Association (AMA) just reinforced what other organizations like the National Institutes of Health (NIH), American Association of Clinical Endocrinologists (AACE), among others have concluded based on the best evidence. When we talk about obesity, we are dealing with a complex, multi-factorial disease that requires treatment. In the present environment, we hope that the AMA decision will impact on the payer’s recognition for the needed therapy of this disease. This will help to deal with a better argument when discussing coverage based in the new Affordable Care Act healthcare plan.
Dr. Rosenthal: How would you summarize the result of the Obesity Week conference held in Atlanta, Georgia last month?
Dr. Ponce: Outstanding! This was a huge success as the largest obesity meeting in the world. It brought 4,800 attendees, including more than 700 international registrants representing 60 countries. Great papers were presented, including six years metabolic data after gastric bypass, insurance-mandated medical weight loss programs, sleeve gastrectomy, and the antireflux barrier. The Bariatric Outcomes Longitudinal Database (BOLD) data, long-term diabetes remission in Swedish Obese Subjects (SOS), the impact of accreditation in bariatric surgery, and revision surgery. Also, the first Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) Quality Collaborative dedicated to reduce readmissions rates was presented and led by John Morton, MD.
We had news media coverage from big outlets, including the Associated Press, Wall Street Journal, CBS and NBC News, NPR, MedPage Today, Telemundo, Reuters Health, Los Angeles Times, Medscape, and HealthDay.
We had remarkable keynote presentations by Thomas Farley, MD, MPH, the New York City Health Commissioner, and Bruce Spiegelman, PhD, Professor of Cell Biology at Harvard Medical School. Spiegelman discussed his groundbreaking findings on the “beiging of fat.” Bruce Wolfe, MD, past president of ASMBS, presented this year’s Edward E. Mason Founder’s Lecture on bariatric surgery and the NIH.
Approximately 170 exhibitors participated, including 65 new companies.
Also, a new tradition, the ASMBS Foundation L.E.A.D. Awards Lunch, awarded ASMBS Past President Alan Wittgrove, MD, with the 2013 Outstanding Achievement Award for his contributions to the field of metabolic and bariatric surgery. This year marks the 20th anniversary of the first laparoscopic Roux-en-Y gastric bypass (RYGB).
As well, it was my honor to lead the 30th anniversary celebration for our Society with my presidential address: “30 Years of Accomplishments: Where Do We Go from Here?”
The success of this meeting was credited to the outstanding job by the Program Committee led by Ninh Nguyen, MD.
Dr. Rosenthal: What are the next steps you consider vital for ASMBS to regain accreditation from the Centers for Medicare and Medicaid Services?
Dr. Ponce: The data will be looked at and further requests will be based on it.
For now, accreditation is widely accepted by private insurance companies, professional societies, our members, and associated multi-disciplinary teams taking care of patients. Our quality improvement process and data collection will enable us to continue to document our argument.
Dr. Rosenthal: What are the current trends regarding most common bariatric procedures performed in United States and worldwide?
Dr. Ponce: The use of gastric banding is declining worldwide and has been concentrated in centers that have the willingness to dedicate resources for the follow up and band adjustments required and, of course, that have been able to obtain acceptable results with their management. For the most part, the sleeve gastrectomy is becoming the most popular procedure. It has replaced many banding and some bypass cases. It is relatively new to many around the world, and the growth will likely continue.
Dr. Rosenthal: Why do you think that laparoscopic sleeve gastrectomy has grown so much and so fast?
Dr. Ponce: Many are seeing the sleeve as an intermediate risk procedure, with acceptable results and with the ability to revise if needed. Data have shown both complication rates and weight loss in between the band and the bypass. Also, the sleeve was initially conceptualized as a first-stage of a two-staged procedure, so by its nature, can be revised if needed. In addition, data have been promising at least during the first five years postoperatively.
Dr. Rosenthal: Dr. Ponce, thank you for taking the time to speak with us and thank you for a wonderful term as ASMBS President. We wish you much success in your future endeavors.
Funding: No funding was provided in the preparation of this manuscript.
Financial disclosures: The author reports no conflicts of interest relevant to the content of this article.