Statistics Suggest that Obesity Thrives on a Low Income

| August 18, 2011

Dear Bariatric Times friends and colleagues:

I was glued to the radio trying to figure out what was going on with the stock market (bad idea) when I came across a very interesting radio show on WLRN (public radio and television for South Florida) that discussed the increased prevalence of obesity in France. The French, lovers of haute cuisine (i.e., fine dining) and fine wine are expressing concern that 14 percent of the population has obesity, and the numbers show an increasing trend. What impressed me the most from the program was to learn that the French government is already setting up an agenda to fight obesity by increasing awareness and education. They have taken action by removing vending machines from schools, and they are running TV ads that discourage consuming sweet products between meals. Based on the statistics reviewed by the French Ministry of Health, obesity was spreading in majority among the low-income population. The following presents the most troubling news from the interview: With the European and United States economies in shambles, we can expect that the percentage of population with low income will rise on both sides of the Atlantic ocean and the obesity problem will continue to thrive as well.

In the United States, more than 45 million Americans are living on food stamps and I am sure that fast food hamburgers, fries, and muffins are main components of their diet. Change in lifestyle? How can we expect a citizen that has two jobs and a family to care for to go to the gym every day and to stay on a high-protein diet? I’m not sure what the solution is, but I feel we should at least be aware of the problem and start thinking about what we can do to prevent this from becoming a catastrophe.

In this issue of Bariatric Times, Alan Wittgrove MD, FASMBS, the father of laparoscopic gastric bypass, presents setp-by-step instructions on how to perform a Roux-en-Y gastric bypass (RYGB) using a circular stapling device.

We also present an article by Michele Shermak, MD, FACS, on reconstructive surgery after massive weight loss explaining how important it is to not only trim the redundant skin, but also to add some volume to patients when performing body contouring procedures.

Moses Shieh, DO, presents a nice review on the surgical management of complex incisional hernias in patients with morbid obesity population using bovine pericardium.

As usual, we provide our readers with the most recent events related to obesity, and in this issue we present to you the highlights of the Minimally Invasive Surgery Symposium (MISS) held by Philip R. Schauer, MD, in Salt Lake City, Utah, February 2011.

We are also glad to update you on the American Society for Metabolic and Bariatric Surgery (ASMBS) Foundation’s past and upcoming events. In this month’s ASMBS News and Update, ASMBS President Robin Blackstone, MD, FACS, FASMBS, presents summaries of recent white papers and guidelines set up by ASMBS. Regarding a brief comment on the preoperative weight loss or medically supervised diet requested by most insurances before approving bariatric surgery, I cannot agree more with the white paper written by the Clinical Outcomes Committee of ASMBS stating that this rule has no scientific or evidenced-based support. We all know that diets work in getting patients to lose weight, but the problem is not the weight loss, it is the inability of 98 percent of the patients to maintain the weight loss achieved. I personally put my patients on a two-week liquid (high-protein) diet preoperatively in order to get that left liver lobe to shrink, but I do not expect them to loose “X” amount of weight.

Please remember to register for the ASMBS fall event September 23 and 24, 2011, in Chicago, Illinois. The fall is the best time of the year to be in that wonderful city. I look forward to seeing you there.
I hope you will enjoy this issue of Bariatric Times.

Sincerely,

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

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