Prevention and Treatment of Obesity in Adolescents: A Worldwide Challenge

Dear Friends, Colleagues and Readers of Bariatric Times:
As this year comes to an end, we are privileged to share with you another exciting issue of Bariatric Times. I am especially excited to introduce to our readership a new column entitled, “Ed Mason at Large.” I first met Dr. Mason in 2007 at the Foregut meeting in Coral Gables, Florida, and ever since, I have had the privilege of communicating with him through e-mail, mainly on the topic of bariatric surgery. Every single e-mail that Ed sends to me is worth a book chapter on medicine and life. Every paragraph he writes is an eye opener, a piece of American history or evolution of medicine. One day, Ed said to me, “Raul, we need a bariatric procedure that doesn’t need too much follow up and doesn’t create new problems as the current ones we have (including LAGB of course).” This was the trigger for me to look deeper into new frontiers and embrace the sleeve gastrectomy procedure, introduced by Dr. Michel Gagner.

Dr. Mason also told me that “most of the complications of patients after bariatric surgery can be recognized early in the postoperative period just by looking at oxygen saturation.” This generated my curiosity in vital signs after bariatric surgery, which has since resulted in a recent publication in Obesity Surgery entitled, “Understanding the significance, reasons and patterns of abnormal vital signs after gastric bypass for morbid obesity.”[1]

In one of those sparks of emotional thinking I rarely have, I have realized that these e-mails from Dr. Mason are too valuable to just be sitting on my desk without sharing them with the Bariatric Times readership. So I decided to invite Dr. Mason to write a column for the journal, and luckily, he agreed to do so. I hope you will all cherish and enjoy this column as much as I enjoy his e-mails. Thank you, Ed, for sharing with us your personal life and wisdom. We look forward to hearing your stories and ideas in 2012 issues of Bariatric Times.

Also in this issue, Drs. Marc Michalsky and Tom Inge provide a perspective of bariatric surgery in adolescents. This topic is a very important one in America, mainly because we have the heaviest adolescent population on the planet. The obesity disease has penetrated all ages and cultures, and our kids are unfortunately affected as well. Europe has reported obesity-related type 2 diabetes in children starting at age five. Malta, a southern European country, has the highest incidence of obesity in the pediatric population together with the United States. The big challenge and the questions we need to answer are: 1) How can we stop this disease from spreading amongst the young? 2) What kind of treatment modalities can we implement to prevent diabetes from occurringing at such a young age? and 3) Which surgical procedure should we choose? I hope that you will read this article and come up with some answers. Send your comments to Bariatric Times to [email protected] or [email protected]. We’d love to hear from you.

In this month’s “Surgical Pearls: Techniques in Bariatric Surgery,” Dr. Michael Schweitzer presents a surgical approach to close mesenteric defects after Roux-en-Y gastric bypass (RYGB) using a transumbilical approach (I’m holding my breath). Despite my discontent with this approach, I believe that in patients with chronic abdominal pain after RYGB, a diagnostic laparoscopy should be indicated and defects explored. Needless to say, you can only afford this approach in an elective setting when patients are not obstructed, otherwise the lack of visibility with dilated loops of bowel and the diminished traction and counter traction might result in incidental enterotomies.

In this month’s ASMBS Foundation News and Update, Dr. David Provost, President of the Foundation, lists achievements of 2011. He also calls for donations. I am privileged to serve as a Secretary Treasurer of the Foundation and I cannot tell you enough how important it is for us to help the Foundation support the efforts of research and education in bariatric surgery.

In this issue, we also present a brief report of the newly founded International Society for the Perioperative Care of the Obese Patient (ISPCOP, www.ispcop.org) that met at the 2011 Annual Meeting of the American Society of Anesthesiologists (ASA) in Chicago, Illinois, this past October.

Lastly, our Bariatric Center Spotlight introduces us to the New Life Center for Bariatric Surgery in Knoxville, Tenessee, a Bariatric Surgery Center of Excellence with a full state-of-the-art team.

As we close 2011, I would like to take this opportunity on behalf of our team to wish you all a happy holiday season and a great start in 2012.

Sincerely,
Raul J. Rosenthal, MD, FACS
Editor, Bariatric Times

REFERENCES
1.    Bellorin O, Abdemur A, Sucandy I, Szomstein S, Rosenthal RJ. Understanding the significance, reasons and patterns of abnormal vital signs after gastric bypass for morbid obesity. Obes Surg. 2011;21(6):707–713.

Tags: Dr. Raul Rosenthal

Category: Editorial Message, Past Articles