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

Metabolic Surgery Expected to Play Bigger Role in Treating Type 2 Diabetes

And Other Metabolic Diseases

Aug 22, 2007, 01:00 ET from American Society for Metabolic & Bariatric Surgery (ASMBS)

    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
     -- 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
     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
     (Logo: )
     CONTACT:  Keith Taylor
               (212) 527-7537
               Vanessa Kelepecz
               (212) 527-7544

SOURCE American Society for Metabolic & Bariatric Surgery (ASMBS)