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Editorial: Research needed to overcome bariatric surgery objections
October 16, 2007Bariatric surgery has become more acceptable, but additional research is needed to demonstrate to insurance companies and the public that it is the best long-term treatment for obesity, according to an editorial in the October issue of Archives of Surgery, one of the JAMA/Archives journals. The editorial, written by Edward H. Livingston, M.D., of the University of Texas Southwestern Medical Center, Dallas, is part of a theme issue on bariatric surgery.
"The studies presented in this issue of the Archives provide us with more knowledge about these procedures' risks, outcomes, complication profiles, improved functionality associated with surgically induced weight loss, need for long-term monitoring and equivalency of the various laparoscopic banding operations," Dr. Livingston writes. "However, we will need more to convince the non-believers in bariatric surgery that it is the appropriate therapy for morbidly obese patients who have, or may develop, complications from their excessive weight."
Papers in the theme issue suggest that:
* Routine upper gastrointestinal (GI) studies-expensive tests typically performed following bariatric procedures-may not be necessary
* Current techniques for examining the upper GI in patients with abdominal symptoms can be modified to accommodate those who have had gastric bypass
* Anastomotic leaks at the surgical site can have devastating consequences and should be treated as early as possible
* About 4.4 percent of patients experience bowel obstructions after gastric bypass
Such ongoing research is necessary due to the lack of alternatives for obese patients, Dr. Livingston notes. "Nonsurgical weight loss efforts in the morbidly obese result in transient weight loss, if any at all," he writes. "There are no anti-obesity drugs in the pipeline that will be released soon, and even so, none of the medications in development appear to have major impact on morbid obesity. Thus, weight loss surgery is here to stay since it is the only treatment modality with proven success at inducing profound and sustained weight loss for the morbidly obese."
"This edition of the Archives goes a long way to addressing the critical issues facing this field," Dr. Livingston concludes.
JAMA and Archives Journals
* Routine upper gastrointestinal (GI) studies-expensive tests typically performed following bariatric procedures-may not be necessary
* Current techniques for examining the upper GI in patients with abdominal symptoms can be modified to accommodate those who have had gastric bypass
* Anastomotic leaks at the surgical site can have devastating consequences and should be treated as early as possible
* About 4.4 percent of patients experience bowel obstructions after gastric bypass
Such ongoing research is necessary due to the lack of alternatives for obese patients, Dr. Livingston notes. "Nonsurgical weight loss efforts in the morbidly obese result in transient weight loss, if any at all," he writes. "There are no anti-obesity drugs in the pipeline that will be released soon, and even so, none of the medications in development appear to have major impact on morbid obesity. Thus, weight loss surgery is here to stay since it is the only treatment modality with proven success at inducing profound and sustained weight loss for the morbidly obese."
"This edition of the Archives goes a long way to addressing the critical issues facing this field," Dr. Livingston concludes.
JAMA and Archives Journals
Bariatric Surgery Current Events and Bariatric Surgery News RSSEnergy gap useful tool for successful weight loss maintenance strategy
Americans continue to get heavier. Most weight control methods short of bariatric surgery are generally considered ineffective in preventing obesity or reducing weight.
Addressing obesity via the 'energy gap'
The November issue of the Journal of the American Dietetic Association features a commentary by James O. Hill, an honorary ADA member, professor of pediatrics and medicine and director of the Center for Human Nutrition at the University of Colorado-Denver.
'Superobesity,' chronic disease burden associated with risk of death following bariatric surgery
Veterans classified as superobese and those with a higher chronic disease burden appear more likely to die within a year of having bariatric surgery, according to a report in the October issue of Archives of Surgery, one of the JAMA/Archives journals.
NIH study finds low short-term risks after bariatric surgery for extreme obesity
Short-term complications and death rates were low following bariatric surgery to limit the amount of food that can enter the stomach, decrease absorption of food or both, according to the Longitudinal Assessment of Bariatric Surgery (LABS-1).
Study: Bariatric surgery patients have 67 percent lower chance of complications at top hospitals
The HealthGrades Fourth Annual Bariatric Surgery Trends in American Hospitals Study released today identifies 88 hospitals as "best" performers (five-star rated), with mortality rates, complication rates and patient lengths of stay that are dramatically lower than poorly rated hospitals.
A simpler definition for major depressive disorder
Researchers from Rhode Island Hospital's department of psychiatry propose that the definition for major depressive disorder (MDD) should be shortened to include only the mood and cognitive symptoms that have been part of the definition in the Diagnostic and Statistical Manual of Mental Disorders (DSM) for the past 35 years.
Roux-en-Y weight loss surgery raises kidney stone risk
The most popular type of gastric bypass surgery appears to nearly double the chance that a patient will develop kidney stones, despite earlier assumptions that it would not, Johns Hopkins doctors report in a new study.
Physiological response may explain why some severely obese patients overeat
Don't feel like you are getting full when eating a large meal? New research from The Miriam Hospital suggests that a physiological response may partially explain why severely obese individuals may not feel satisfied after eating and often have difficulty controlling the amount of food they consume during a meal.
Waiting times too long for bariatric surgery
Obesity is now acknowledged as a chronic disease with a number of related complications, and its prevalence has reached alarming epidemic proportions.
Calorie restriction causes temporal changes in liver metabolism
Moderate calorie restriction causes temporal changes in the liver and skeletal muscle metabolism, whereas moderate weight loss affects muscle.
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