Bariatric Surgical Society Takes on New Name, New Mission and New Surgery
| American Society for Metabolic & Bariatric Surgery logo. (PRNewsFoto/American Society for Metabolic & Bariatric Surgery) GAINESVILLE, FL UNITED STATES | |||
Metabolic Surgery Expected to Play Bigger Role in Treating Type 2 Diabetes
And Other Metabolic Diseases
GAINESVILLE, Fla., Aug. 22 /PRNewswire/ -- Bariatric surgery is known
to be the most effective and long lasting treatment for morbid obesity and
many related conditions, but now mounting evidence suggests it may be among
the most effective treatments for metabolic diseases and conditions
including type 2 diabetes, hypertension, high cholesterol, non-alcoholic
fatty liver disease and obstructive sleep apnea.
"Surgery for severe obesity goes way beyond weight loss. This surgery
results in the complete remission or significant improvement of type 2
diabetes and other life-threatening diseases in most patients. The
Society's new name and mission reflects this expanded and evolving view of
surgery," said Kelvin Higa, MD, clinical professor of surgery, UCSF- Fresno
and president of the newly named American Society for Metabolic & Bariatric
Surgery (ASMBS). "People generally don't think of surgery as a treatment
for diabetes or high blood pressure, but it is, and we expect metabolic
surgery to play an ever increasing role in managing these diseases."
The ASMBS was formerly known as the American Society for Bariatric
Surgery (ASBS). The name change comes nearly 25 years after the Society was
founded. The Society has nearly 3,000 members, which includes surgeons and
other health professionals including nurses, bariatricians, psychologists,
dieticians and other medical specialists.
Metabolism is the process by which the body coverts food to energy at
the cellular level. The most common metabolic disease is type 2 diabetes,
which occurs when the body does not adequately metabolize or regulate blood
sugars due to lack of insulin or the body's inability to respond to the
insulin that is produced. According to the American Diabetes Association
(ADA), nearly 21 million people in the U.S. have type 2 diabetes and
another 54 million have pre-diabetes.
Increased body fat is associated with an increased risk for metabolic
diseases. According to the National Health and Nutrition Examination Survey
(NHANES, 1999-2002), which was conducted by CDC's National Center for
Health Statistics, more than half (51%) of those with diabetes had a body
mass index (BMI) of 30 or more and about 80 percent of those with a BMI of
35 or more had one or more metabolic diseases.
New research indicates that metabolic surgery may improve insulin
resistance and secretion by mechanisms independent of weight loss -- most
likely involving changes in gastrointestinal hormones. Many patients with
type 2 diabetes experience complete remission within days of metabolic
surgery, long before significant weight comes off. This has led to new
thinking that metabolic surgery may also be appropriate for diabetic
individuals who are of normal weight or only slightly overweight.
Walter Pories, MD, professor of surgery and biochemistry at East
Carolina University and past president of the ASMBS, pioneered research
into the effect of bariatric surgery on type 2 diabetes in a landmark paper
published in the Annals of Surgery in 1992. The paper entitled, "Is type II
diabetes mellitus (NIDDM) a surgical disease?" reported the remission of
type 2 diabetes after gastric bypass.
"Twenty-five years ago we were astonished by the curative effect the
surgery had on type 2 diabetes," said Dr. Pories, chairman of the Surgical
Review Corporation, a non-profit corporation that reviews bariatric surgery
centers of excellence. "Today it's one of the main reasons people have
surgery and I'm confident new research into metabolic surgery will lead to
further advances."
Most research into metabolic and bariatric surgery has been limited to
patients who are morbidly obese, meaning 100 pounds or more overweight
(body mass index (BMI) of 40 or more) or 75 pounds or more overweight (BMI
of 35 or more) with an obesity-related condition such as type 2 diabetes.
According to a landmark study published in the Journal of the American
Medical Association (JAMA) in 2004, bariatric surgery patients showed
improvements in the following metabolic conditions:
-- Type 2 diabetes remission in 76.8% and significantly improved in 86% of
patients
-- Hypertension eliminated in 61.7% and significantly improved in 78.5%
of patients
-- High cholesterol reduced in more than 70% of patients
-- Sleep apnea was eliminated 85.7% of patients
Joint disease, asthma and infertility were also dramatically improved
or resolved. The study showed that surgery patients lost between 62 and 75
percent of excess weight.
Earlier this year, 25 international medical organizations and more than
60 leading experts in diabetes and metabolic disease including the ASMBS,
ADA, NAASO - The Obesity Society, and The European Association for the
Study of Diabetes (EASD) convened in Rome, Italy for a summit and consensus
conference to review the medical evidence on the effects of
gastrointestinal operations on diabetes. The group is expected to announce
its findings on the role of metabolic surgery in treating type 2 diabetes
later this year.
"The evidence is extensive. Most studies show prevention, improvement
or remission of type 2 diabetes after surgery with a relatively low rate of
risk in appropriate patients," said Philip Schauer, MD, immediate past
president of the ASMBS, director of the Cleveland Clinic Bariatric and
Metabolic Institute (BMI), and one of the organizers of the Rome summit.
"Metabolic surgery may be the key to battling the twin epidemics of obesity
and diabetes, and surgery is becoming safer and safer."
According to a recent study from the Agency for Healthcare Research and
Quality (AHRQ), the mortality rate associated with bariatric surgery
dropped by a staggering 78.7 percent, from 0.89 percent in 1998 to 0.19
percent in 2004. Meanwhile, the mortality rate from morbid obesity was
reduced by 89 percent after bariatric or metabolic surgery, according to a
study published in the Annals of Surgery in 2004.
In 2006, the ASMBS reports an estimated 177,600 people in the U.S. had
bariatric surgery. Less than 1 percent of those who meet the criteria for
surgery actually have surgery. About 15 million or 1 in 50, adults in the
U.S. have morbid obesity, which is associated with more than 30 other
diseases and conditions including type 2 diabetes, heart disease, sleep
apnea, hypertension, asthma, cancer, joint problems and infertility. The
direct and indirect costs to the health care system associated with obesity
are about $117 billion annually.
The most common procedures include gastric bypass, adjustable gastric
band and biliopancreatic diversion with duodenal switch. Most of these
procedures are performed laparoscopically using minimally invasive
techniques.
AMERICAN SOCIETY FOR METABOLIC & BARIATRIC SURGERY (ASMBS)
The ASMBS is a non-profit organization working to advance the quality
of care and ethical treatment of people with obesity and obesity-related
and metabolic diseases and conditions. The ASMBS educates health
professionals and consumers about the dangers of obesity and metabolic
diseases and the risks and benefits of bariatric and metabolic surgery. The
Society develops and promotes high quality standards and practices that
lead to improved patient outcomes and supports research into emerging
treatments for obesity and metabolic diseases. For more information about
the ASMBS visit http://www.asmbs.org.
(Logo: http://www.newscom.com/cgi-bin/prnh/20070822/NYW021LOGO )
CONTACT: Keith Taylor
(212) 527-7537
Vanessa Kelepecz
(212) 527-7544
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