The American Society for Metabolic and Bariatric Surgery (ASMBS) Plans for 2022

| January 1, 2022

This column is dedicated to sharing the vast knowledge and opinions of the American Society for Metabolic and Bariatric Surgery (ASMBS) leadership—past and present—on relevant topics in the field of obesity and bariatric surgery.

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(1):14.

An interview with: Shanu N. Kothari, MD, FACS, FASMBS

President of the American Society for Metabolic and Bariatric Surgery (ASMBS), Chair of Surgery – Prisma Health, Professor of Surgery – University of South Carolina, Greenville, South Carolina

The American Society for Metabolic and Bariatric Surgery (ASMBS) has a slew of ideas planned for 2022. Bariatric Times Co-clinical Editor Dr. Richard Peterson, MD, MPH, FACS, FASMBS, sat down with ASMBS President Shanu N. Kothari, MD, FACS, FASMBS, to discuss his plans for 2022. See the URL at the end of the Q&A to watch the video of the full interview.

I want to take a few minutes to talk to you about the presidential direction and the direction of the ASMBS. 

Dr. Kothari: Thank you for this opportunity. Matt Hutter, MD, got us through some really challenging times, but it’s time to come back now on the offense. We have a laundry list of initiatives that I would like to see done in a short time. We have such an amazing Executive Council and committee members that I think that we can accomplish many of these things.

One of the things I’m most passionate about is the inaugural ASMBS Academy. I’ve always aspired to be a better leader, whether that’s in the operating room, the board room, in my committee work, or in my community, so I have dedicated myself to leadership development. We have an exciting course planned for current fellows in the country, dovetailing with our weekend meeting in Las Vegas, and it’s already sold out. We kept it at 50 fellows, and we’re going to cover a variety of leadership topics that will equip them to lead their respective communities. They have no idea the power that doing this fellowship will do, not only in terms of how they’re going to be looked up to and respected locally, but for their careers as well.

Also, after 50 years of being a specialty, the American Board of Surgery is recognizing the powerful field of metabolic and bariatric surgery with our Focused Practice Designation. That exam is going to be taking place on April 1, 2022, and we have our first review course coming up in January.

What exciting things are happening within the ASMBS this year?

Dr. Kothari: Our Diversity and Inclusion Committee, who I’m so thankful for, are running a mentorship program. I love the idea of matching mentor to mentee within the ASMBS. Monique Hassan, Michael Edwards, Farah Husain, and others are spearheading this. Hopefully, mentors and mentees will be able to meet in-person at our Dallas meeting in June.

I’m excited about the mentorship program.

Dr. Kothari: I hope you sign up to do it.

I absolutely will! Do you have any plans to improve public and physician outreach?

Dr. Kothari: We’re also doing what I call NORC 2.0, which is the National Opinion Research Center. Hard to believe it’s been five years since we’ve had this national organization query America through 1,000 patients about their perceptions around the disease of obesity. We learned a lot through that process, and we got a lot of mileage in terms of advertising and understanding from a marketing perspective. It was picked up by the New York Times and other news outlets. We want to know, what is the public’s perception around the disease of obesity in the COVID-19 or post-COVID-19 era? Why did we see record numbers of patients inquiring about metabolic and bariatric surgery? Is it possible that it has to do with the fact that patients and providers are now recognizing obesity for the disease that it is? We’re going to find out through this updated survey, coming out later this year.

For members, we’re trialing a platform called DocMatter. It is an area where you can ask clinical questions in a safe environment. The data is curated, and the questions are reviewed. I posted a challenging scenario and already got 20 responses to help me with an upcoming case. You can follow it by threads, so if you want to know about advocacy, single anastomosis duodeno-ileal bypass with sleeve gastrectomy, or emerging technology, you can pick and choose the threads you want to follow and get those emailed to you. We’ve already got over 1,100 of our members that are registered users now!

Do you have any ideas to encourage collaboration across the country?

Dr. Kothari: I’m excited about the multicenter trails group. We have this rich database, the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP).  We’re going to have our millionth patient enrolled in it this year, and we’ve gotten a lot of papers and publications out of it. However, there are some granular questions we still aren’t able to ask. For instance, maybe your deep vein thrombosis (DVT) chemoprophylaxis arrangement is better than mine, but we don’t get that level of data. We just get bleed rates and DVT rates. We are now creating a multicenter trials group through our research committee where we are going to do a deeper dive. 

I was thrilled to know there were over 100 centers that signed up to be part of the inaugural Zoom meeting where we discussed this. We’re going to be able to start answering some of those deeper clinical questions through collaboration with these programs. We can create a bell-shaped curve around DVT rates and see who’s got the lowest rates. Then, we can reach out to them to see what they’re doing. We can start to answer some of these questions through that retrospective data, take the two best head-to-head ones, and start talking about what is it going to take to get a prospective randomized trial with the best evidence that we have culminated.

This multicenter group is going to give us an unbelievable ability to cross-talk. It will provide best practices that can be generalized across the board. Are there any other big projects you plan to tackle?

Dr. Kothari: It’s time to abolish and/or replace or update the 1991 National Institutes of Health Consensus Conference guidelines. I dare not ask what grade you were in in 1991, Rich, but I can tell you the number 1 movie was Silence of the Lambs. There is no other society I know that quotes a 30-year-old document as their guidelines. Just think of the American College of Chest Physicians or the American Cardiology Association using a 30-year-old document. We have to get rid of this. Our goal is to update this to the 2022 ASMBS Guidelines for Indications for Metabolic and Bariatric Surgery. That’s well underway right now.

I agree with you about the guideline change. Can you tell us more about the upcoming ASMBS meetings?

Dr. Kothari: ASMSB re-UNITED is the weekend meeting from January 20 to 22. We’re, hopefully, physically going to get together again for the first time in a couple of years. We have rich content, and the day before the meeting is the Focused Practice Designation review course, led by Ann Rogers, MD, as well as the leadership course. With regard to the Dallas meeting, we try to always work around a thematic element. We have powerful literature now to support why patients live longer after metabolic and bariatric surgery compared to their nonsurgical counterparts, because we know they have less cardiac events, but guess what else they have less of. Less cancers. You know that overweight and obesity is a risk factor for 13 cancers, but most of our frontline primary care doctors and patients don’t know this, so the theme is going to be around cancer prevention. We have Dr. Edward Sauter as our Mason Lecturer. Our powerful prevention, at the cellular level, decreases cancer risk, and the National Cancer Institute has funded two studies that are open over the next year to look at this issue.

This interview has been edited for length and clarity.

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