Bariatric Times - December 2008 - (Page 33)

Bariatric Times • December 2008 News & Trends 33 Bariatric News & Trends WEIGHT LOSS SURGERY HELPS WITH PREGNANCY: STUDY CHICAGO (Reuters)—Women who get pregnant after weight loss surgery tend to be healthier and less likely to deliver a baby born with complications compared to obese women, researchers said on Tuesday. An obese woman who has weightloss, or bariatric, surgery also may increase her chances of getting pregnant in the first place by normalizing her menstrual cycles and hormone levels, the researchers found. Obese women are more likely to have difficulty getting pregnant, but after the surgery “There is some suggestion of increased fertility,” Dr. Melinda Maggard, a surgeon and researcher at the Rand Corp think tank in Santa Monica, California, said in a telephone interview. Bariatric surgery alters the digestive system’s anatomy and reduces the volume of food that can be eaten and digested. The most common form is gastric bypass, which makes the stomach smaller and permits food to bypass part of the small intestine. While losing weight naturally is preferable, weight-loss surgery does reduce the risks of pregnancy-related problems such as diabetes and high blood pressure that can harm the mother and her newborn, said the RAND researchers who analyzed data from 75 earlier studies. The risks of premature delivery, having a low birth weight baby, or delivering an exceedingly large-bodied baby were reduced for women who had bariatric surgery compared to obese women, the report published in the Journal of the American Medical Association said. In some cases, pregnancy-related risks after surgery were comparable to those for normal-weight women. The study was requested by a group representing obstetricians and gynecologists. retailers in the US as their leading brand into this “test market” for products designed for weight loss surgery patients,” said Thomas L. Kinder, President and CEO of Catalina Lifesciences, Inc., parent of Bariatric Advantage. CMS PROPOSED NCD ON BARIATRIC SURGERY TO TREAT DIABETES On November 17th, the Centers for Medicare & Medicaid Services (CMS) released a proposed decision memo regarding surgery for diabetes stating the following: 1) The evidence is not adequate to conclude that open and laparoscopic Roux-en-Y gastric bypass (RYGBP), laparoscopic adjustable gastric banding (LAGB), and open and laparoscopic biliopancreatic diversion with duodenal switch (BPD/DS) improve health outcomes in Medicare beneficiaries who have type 2 diabetes mellitus (T2DM) and a body mass index (BMI)<35. Therefore, we are proposing that these procedures are not reasonable and necessary for patients with type 2 diabetes and BMI 35. Thus, we are proposing that type 2 diabetes mellitus is a comorbid condition related to obesity as defined in NCD Manual 100.1 (Bariatric Surgery for Treatment of Morbid Obesity). This decision proposes no changes to National Coverage Determination (NCD) Manual section 100.8 (Intestinal Bypass Surgery) and section 100.11 (Gastric Balloon for Treatment of Obesity). Treatments for obesity alone remain noncovered, as does the use of the open or laparoscopic sleeve gastrectomy procedure regardless of the patient’s BMI or comorbidity status. CMS is soliciting public comments on the agency’s proposed decision memo through December 17, 2008. In comments submitted to CMS on June 11, 2008, regarding the agency’s initial announcement to consider covering surgery for diabetes, ASMBS stated that the society “believes that there are studies which show significant benefit for the surgical treatment of T2DM patients with a BMI>30kg/m2 and that a cutoff BMI>30kg/m2 may be discriminatory for T2DM in certain minority groups, such as Asian Americans, who have the metabolic syndrome at lower BMIs.” At press time, ASMBS was in the process of reviewing the lengthy decision memo in preparation for submitting comments by the mid-December deadline. For more information and the full proposed decision memo, please visit: www.cms.hhs.gov/mcd/viewdraftdecisionmemo.asp?id=219. NEW NATIONAL PATIENT AND SURGEON SURVEYS SHOW POSTSURGICAL CARE CRITICAL TO OPTIMAL WEIGHT LOSS AFTER BARIATRIC SURGERY GAINESVILLE, FL—Those patients who were most compliant with surgeon recommendations after bariatric surgery lost 35 percent more weight the first year and tend to keep more weight off even after five years, according to new patient and bariatric surgeon surveys conducted by Harris Interactive® for the American Society for Metabolic and Bariatric Surgery (ASMBS). The survey of 208 gastric bypass patients and 201 gastric band patients found that, on average, compliant patients lost more than 123 pounds the first year, while the less compliant lost 92 pounds. At the five-year mark, compliant bariatric surgery patients lost more than 127 pounds while less compliant patients lost 100 pounds. Bariatric surgeons also place a high value on follow-up care programs. In a separate survey of 282 bariatric surgeons, 94 percent said follow-up care is just as or even more important to successful outcomes than the surgery itself. Both surveys were sponsored by Ethicon Endo-Surgery, Inc. BARIATRIC ADVANTAGE® NOW AVAILABLE AT KROGER Bariatric Advantage has been chosen by Kroger to be their leading nutritional brand of products specifically formulated for weight loss surgery patients. “We are proud to be selected by one the leading food and drug “While surgeons have always understood the importance of followup care, this survey helps quantify how much of a difference it really makes,” said Scott Shikora, MD, ASMBS President and Chief of General Surgery, Bariatric Surgery, and Minimally Invasive Surgery at Tufts Medical Center in Boston. “Compliance can mean the difference between a good result and a great result.” Surgeons typically recommend post-surgical activities, including regular exercise, nutritional counseling, maintaining a food diary, psychological counseling, diet modification, keeping doctor’s appointments, and participation in support groups. However, 66 percent of surgeons believe there is no consensus on what constitutes bariatric surgery follow-up care. About half (48%) say they did not receive bariatric surgery follow-up care education as part of their training or fellowship. Surgeons believe regular exercise (67%), changing eating habits (58%), and support group attendance (34%) are the most difficult components of aftercare for patients and that while both groups of patients face compliance challenges after surgery, gastric band patients have a more difficult time with it than gastric bypass patients (59% vs. 49%). In addition, surgeons indicate that missed doctor appointments, insurance issues, and long-distance travel are the reasons they do not see their patients more often. According to the survey, surgeons believe patients choose gastric bypass over gastric banding because it results in more weight loss (51%), they knew someone who had it (40%), to lose weight more quickly (34%), and for “better comorbidity resolution” (23%). They say patients choose gastric banding over bypass because it is less invasive (63%), safer (59%), reversible (55%), results in fewer complications (41%), and because they knew someone who had it (25%). For more information on this study, please visit www.asmbs.org. TV ADS CONTRIBUTE TO CHILD OBESITY New York Times—By Roni Caryn Rabin—Banning fast food advertise- http://www.cms.hhs.gov/mcd/viewdraftdecisionmemo.asp?id=219 http://www.cms.hhs.gov/mcd/viewdraftdecisionmemo.asp?id=219 http://www.asmbs.org

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Bariatric Times - December 2008 Table of Contents Patient Management Perspective Diabetes Perspective Interview: ASMBS’s Georgeann Mallory Editorial Message Editorial Board Body Contouring Perspective Meeting Perspective Journal Watch Advertiser Index News & Trends

Bariatric Times - December 2008

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