Bariatric Surgical Society Takes on New Name, New Mission and New Surgery

Wednesday, August 22, 2007 General News
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GAINESVILLE, Fla., Aug. 22 Bariatric surgery is known tobe the most effective and long lasting treatment for morbid obesity and manyrelated conditions, but now mounting evidence suggests it may be among themost effective treatments for metabolic diseases and conditions including type2 diabetes, hypertension, high cholesterol, non-alcoholic fatty liver diseaseand obstructive sleep apnea.

"Surgery for severe obesity goes way beyond weight loss. This surgeryresults in the complete remission or significant improvement of type 2diabetes and other life-threatening diseases in most patients. The Society'snew name and mission reflects this expanded and evolving view of surgery,"said Kelvin Higa, MD, clinical professor of surgery, UCSF- Fresno andpresident of the newly named American Society for Metabolic & BariatricSurgery (ASMBS). "People generally don't think of surgery as a treatment fordiabetes or high blood pressure, but it is, and we expect metabolic surgery toplay 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 healthprofessionals including nurses, bariatricians, psychologists, dieticians andother medical specialists.

Metabolism is the process by which the body coverts food to energy at thecellular level. The most common metabolic disease is type 2 diabetes, whichoccurs when the body does not adequately metabolize or regulate blood sugarsdue to lack of insulin or the body's inability to respond to the insulin thatis produced. According to the American Diabetes Association (ADA), nearly 21million people in the U.S. have type 2 diabetes and another 54 million havepre-diabetes.

Increased body fat is associated with an increased risk for metabolicdiseases. According to the National Health and Nutrition Examination Survey(NHANES, 1999-2002), which was conducted by CDC's National Center for HealthStatistics, 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 hadone or more metabolic diseases.

New research indicates that metabolic surgery may improve insulinresistance and secretion by mechanisms independent of weight loss -- mostlikely involving changes in gastrointestinal hormones. Many patients withtype 2 diabetes experience complete remission within days of metabolicsurgery, long before significant weight comes off. This has led to newthinking that metabolic surgery may also be appropriate for diabeticindividuals who are of normal weight or only slightly overweight.

Walter Pories, MD, professor of surgery and biochemistry at East CarolinaUniversity and past president of the ASMBS, pioneered research into the effectof bariatric surgery on type 2 diabetes in a landmark paper published in theAnnals of Surgery in 1992. The paper entitled, "Is type II diabetes mellitus

(NIDDM) a surgical disease?" reported the remission of type 2 diabetes aftergastric bypass.

"Twenty-five years ago we were astonished by the curative effect thesurgery had on type 2 diabetes," said Dr. Pories, chairman of the SurgicalReview Corporation, a non-profit corporation that reviews bariatric surgerycenters of excellence. "Today it's one of the main reasons people havesurgery and I'm confident new research into metabolic surgery will lead tofurther advances."

Most research into metabolic and bariatric surgery has been limited topatients who are morbidly obese, meaning 100 pounds or more overweight (bodymass index (BMI) of 40 or more) or 75 pounds or more overweight (BMI of 35 ormore) with an obesity-related condition such as type 2 diabetes.

According to a landmark study published in the Journal of t

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