“The Answered and Unanswered Questions in Bariatric Surgery”

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The road to greater understanding and medical, public and payer acceptance of bariatric or weight loss surgery in the treatment of patients with severe obesity has been a long and challenging one, involving many stakeholders including patients, healthcare providers, employers, governments, professional societies, advocacy organizations, the media and industry.

Over the years, questions have been raised about its safety, effectiveness, impact on disease, and cost effectiveness, at times serving as roadblocks to what is considered the most effective, yet most underutilized, long-term treatment for severe obesity.i Many of these questions have been answered with clinical trials and data that show bariatric surgery patients typically lose significant weight, live longer,ii have fewer heart attacks and strokes,iii and have less type 2 diabetes, hypertension, sleep apnea, and heart disease.iv

And thanks to advancements in device technology, surgical techniques and improvements in training and best practices, bariatric surgery now has a safety profile comparable to gallbladder surgery, appendectomy and knee replacement.v Despite all this, the questions keep coming and the obesity epidemic keeps growing.

Ethicon, a leader in bariatric surgery for more than 20 years, is sponsoring an editorial series entitled, “The Answered and Unanswered Questions in Bariatric Surgery” in the clinical newspaper, General Surgery News.

Each month, two leading experts will provide answers to some of the perennial questions about bariatric surgery and provide perspectives on the questions that remain. The goal is to improve understanding of both obesity and bariatric surgery, dispel myths and misconceptions and overcome the barriers that may prevent patients from getting treatment.

The editorial series will cover the use of metabolic surgery for diabetes compared to standard medical therapy, what constitutes the standard of care for severe obesity and, in its first installment, why still today less than 1 percent of those who are eligible for bariatric surgery receive the treatment in any given year.vi

"Many people struggle with weight and health issues," says Raymond Fryrear, M.D., VP & Integrated Leader, PreClinical, Clinical and Medical Affairs, Johnson & Johnson. "Bariatric surgery can be a safe and effective treatment option for many patients affected by severe obesity who are probably doing their best to become healthy but are unable to achieve the results they need."

Over the last 20 years, Ethicon has led industry efforts in breaking down treatment barriers and advancing bariatric surgery and the science of obesity treatment. We have sponsored landmark studies and randomized clinical trials, developed new technologies, created innovative training and educational opportunities, supported advocacy and policy initiatives and helped expand insurance coverage for bariatric surgery throughout the world.

Our measure of success is the people we impact around the world—the patients who are now enjoying longer, healthier lives and the patients who may soon benefit from initiatives that expand access to life-changing treatments like bariatric surgery. We, along with the entire bariatric and scientific community, have answered so many questions. It’s time to invite the world to listen.


https://journals.lww.com/annalsofsurgery/Abstract/publishahead/Changes_in_Utilization_of_Bariatric_Surgery_in_the.94957.aspx
ii Sjöström L, Narbro K, Sjöström C et al. Effects of Bariatric Surgery on Mortality in Swedish Obese Subjects. New England Journal of Medicine. 2007;357(8):748. doi:10.1056/nejmoa066254
iii Kwok C, Pradhan A, Khan M et al. Bariatric surgery and its impact on cardiovascular disease and mortality: A systematic review and meta-analysis. Int J Cardiol. 2014;173(1):20-28. doi:10.1016/j.ijcard.2014.02.026
iv Chang S, Stoll C, Song J, Varela J, Eagon C, Colditz G. The Effectiveness and Risks of Bariatric Surgery. JAMA Surg. 2014;149(3):281-284. doi:10.1001/jamasurg.2013.3654
Gastric Bypass is as Safe as Commonly Performed Surgeries. Health Essentials from Cleveland Clinic. https://health.clevelandclinic.org/2014/11/gastric-bypass-is-as-safe-as-commonly-performed-surgeries/. Published 2014. Accessed March 11, 2019.
vi https://journals.lww.com/annalsofsurgery/Abstract/publishahead/Changes_in_Utilization_of_Bariatric_Surgery_in_the.94957.aspx