Raising the Standard: ASMBS Annual Meeting 2022 Recap
by Anthony T. Petrick , MD, FACS, FASMBS, and Dominick Gadaleta, MD, FACS, FASMBS
Dr. Petrick is the Chief Quality Officer, Geisinger Clinic; Director of Bariatric and Foregut Surgery, Geisinger Health System in Danville, Pennsylvania. Dr. Gadaleta is the Chair, Department of Surgery, South Shore University Hospital; Director, Metabolic and Bariatric Surgery, North Shore and South Shore University Hosiptals, Northwell Health in Manhasset, New York; and Associate Professor of Surgery, Zucker School of Medicine at Hofstra/Northwell in Hempstead, New York.
Funding: No funding was provided for this article.
Disclosures: The authors report no conflicts of interest relevant to the content of this article.
Bariatric Times. 2022;19(8):16–17.
In this month’s column, we provide an overview of the 38th annual meeting of the American Society for Metabolic and Bariatric Surgery (ASMBS), which took place June 5 to 9, 2022, in Dallas, Texas. This is always a difficult task. The important work done to educate our members and their teams far exceeds the space available in our column; however, we will attempt to recognize some of the highlights. This year’s meeting continued our society’s progress toward pre-COVID-19 attendance levels, with a theme of bariatric surgery as “A Pathway to Cancer Prevention.” A secondary theme throughout the conference centered around diversity, inclusion, and healthcare equity.
The first two days of the meeting featured both hands-on and review courses. The close collaboration between the Metabolic and Bariatric Surgery Quality Improvement Program (MBSAQIP) and ASMBS continued with courses for MBSAQIP coordinators and clinical reviewers, as well as the popular Quality Improvement 101 course. Hands-on labs for bariatric endoscopy were available, and members had the opportunity to complete the Bariatric Endoscopy Skill Acquisition Focused Evaluation (BE-SAFE) to verify their endoscopic skills.
The scientific sessions kicked off on Tuesday with the Integrated Health (IH) Keynote Speaker and Presidential Address. The IH Keynote Address was given by Dr. Lisa Tussing-Humphreys, who is an Associate Professor of Kinesiology and Nutrition at the University of Illinois, Chicago, and Co-Leader of the Cancer Prevention and Control program of the University of Illinois Cancer Center. Dr. Tussing-Humphrey presented “Obesity and Colorectal Cancer: Weighing the Mechanistic and Interventional Evidence” and has studied the role of bile acids (BAs), dietary fat, and fibers on colorectal cancer. She explained the potential mechanisms by which metabolic and bariatric surgery (MBS) could interrupt these pathways to colorectal cancer. Dr. Tussing-Humphries also noted that Black/African American patients have the highest incidence of and death rates from colorectal cancer in the United States (US) and “are more likely to live in a food environment with an inequitable access to BA mitigating nutrients.”1
The Mason Keynote lecture, “From Bedside to Bench: Translating Clinic Evidence to Scientific Proof that Bariatric Surgery Decreases Cancer Risk,” was given by Dr. Edward Sauter, who serves as a medical and program officer for the Breast and Gynecologic Cancer Research Group. Dr. Sauter provided an overview of the protective effect of MBS on nearly all common types of cancer. There is evidence that female patients benefit more from MBS than male patients, although he acknowledged that there is some data suggesting there might be an increase in colorectal cancer in both male and female patients undergoing MBS. The potential benefit appears to vary based on cancer, sex, surgical procedure, and other variables. Dr. Sauter’s key message was to advocate for further studies to better understand the links between obesity and cancer and the potential impact of MBS on cancer. He emphasized the role of the National Institutes of Health (NIH) in MBS and cancer research and encouraged MBS providers to seek funding for studies to better understand both the potential protective effects of MBS and the mechanism(s) by which MBS influences cancer.2
Several of the 10 papers selected for presentation in two Top Papers sessions focused on cancer and bariatric surgery. Dr. Jared Miller from Gunderson Health presented his group’s findings in “Cancer Incidence, Type and Survival After Bariatric Surgery.” Their group matched patients undergoing bariatric surgery with a control group to identify the incidence of cancer 10 years after bariatric surgery. They found a new diagnosis of cancer in about five percent of MBS patients, compared to 13 percent of control non-MBS patients (p<0.001).
Continuing the theme of cancer, Dr. Michal Janik, from Warsaw, Poland, preformed a meta-analysis, titled “The Effect of Bariatric Surgery on Reducing the Risk of Colorectal Cancer.” The group searched 327 papers to find 13 studies that met their criteria. They found that patients who underwent bariatric surgery had a 37-percent reduction in the risk of developing colorectal cancer, compared to patients with obesity who had no surgery.
Dr. Shanu Kothari delivered the Presidential Address, in which he summarized the work of the ASMBS over the past year. Key themes from Dr. Kothari’s address, and his work as ASMBS President, included the importance of updating the 1991 NIH consensus guidelines for bariatric surgery. Dr. Kothari emphasized the changes in bariatric surgery over the past 31 years and called attention to the irrationality of applying decades-old guidelines to the care of our bariatric patients. He also proposed the development of an ASMBS leadership academy for bariatric fellows, as well as a mentor/mentee program led by the Diversity and Inclusion Committee. He passionately articulated the critical need for the ASMBS to provide a pathway toward a more diverse membership and leadership. Diversity is meant to include younger members, as well as members of different genders, ethnicities, cultures, and socioeconomic backgrounds. Realization of this goal will result in a fresh perspective and novel approaches to the care of Americans suffering from obesity. It is also likely to prevent us from having to go another 31 years without updated care guidelines from NIH.
Several of the Top Papers addressed diversity and access. Dr. Theresa Jackson, from Kaiser Permanente South Sacramento, authored a study, titled “Medicaid Expansion: The Impact of Health Policy on Bariatric Surgery.” Her group found that the Affordable Care Act’s (ACA) 2014 Medicaid expansion correlated with improved health coverage and access to MBS. They found that social and economic disparities regarding bariatric surgery have improved, with Medicaid beneficiaries in marginalized communities (Black race, Hispanic race, lowest income quartile, and rural communities) making up a larger share of the bariatric surgery population since 2014.
Deborah Hutcheon, RD, from Prisma Health, South Carolina, presented a study, titled “Insurance-Mandated Weight Management Program Completion Prior to Bariatric Surgery Provides No Long-Term Clinical Benefit.” Her group reviewed the weight loss and clinical outcomes in 779 patients who underwent insurance-mandated weight loss programs prior to bariatric surgery and compared them to 277 patients who did not undergo such programs. They found that insurance-mandated program completion prior to bariatric surgery did not result in short- or long-term clinical benefits.
We would be remiss if we failed to acknowledge the ASMBS Foundation for another successful LEAD Awards ceremony. The LEAD Awards preceded the 25th Anniversary Gala, both of which were very well attended. Dr. Natan Zundel was honored with the award for Outstanding Lifetime Achievement. Readers can find all award winners https://asmbsfoundation.org/lead/.
This column highlights just a small sample of the outstanding posters, videos, and papers presented at the meeting this year, not to mention the numerous social and networking opportunities that we missed over the past two years due to COVID-19. Congratulations to the Program Committee for organizing an outstanding event and to the ASMBS.
ASMBS Weekend will be a three-day clinical symposium held November 10 to 12, 2022, in San Antonio, Texas. Planning is underway for next year’s annual meeting, which will be held in 2023 in Las Vegas, Nevada.
References
- Wolf PG, Byrd DA, Kate Cares K, et al. Bile acids,gut microbes, and the neighborhood food environment—a potential driver of colorectal cancer health disparities. mSystems. 2022;7(1):e01174-21.
- Sauter ER, Heckman-Stoddard B. Metabolic surgery and cancer risk: an opportunity for mechanistic research. Cancers (Basel). 2021;13(13):3183.
Category: Past Articles, Raising the Standard
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