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Should You Consider Bariatric & Metabolic Surgery for Patients?
Should You Consider Bariatric & Metabolic Surgery for Patients?
Clinical evidence supports bariatric surgery as the most sustainably effective treatment for people living with obesity.1,2 Bariatric surgery can lead to sustained weight loss that is often greater than with nonsurgical treatments.1-4 Bariatric surgery can also improve complications of obesity including type 2 diabetes, sleep disturbances, and osteoarthritis, and even increase life expectancy.2-8 Download information to discuss with your patient.
IMAGES
Latest Guidelines
Current Australian guidelines for managing people living with obesity state that bariatric surgery should be considered for adults with a body mass index (BMI) >40 OR a BMI >35 and obesity-related complications that may improve with weight loss OR a BMI >30 and poorly controlled type 2 diabetes.1,9
Diabetes and Obesity
The Australian Diabetes Society (ADS) have a dedicated type 2 diabetes treatment website which also includes obesity treatment. The resources available may assist HCPs in deciding on suitable treatment options for Australian adults living with obesity and its comorbidities. Ethicon is proud to support the ADS clinical workshop: The Role of Bariatric Surgery in the Management of Obesity.
Discussing Bariatric and Metabolic Surgery with Your Patients
Explain and Reassure
Explain to your patients the multifactorial nature of obesity, with influence from genetics and environment.10 Reassure your patients that their weight loss journey is unique and may consist of ups and downs, including weight regain that is a normal physiologic response after weight loss.2,11,12 Download information to discuss with your patient.
Which Treatment Option?
Eligibility criteria for bariatric surgery considers patient BMI and complications, so remember to weigh your patients to calculate their BMI. Discussing their goals for weight loss and overall health (e.g. reducing complications) can help determine which treatment option is most appropriate.1 Download information to discuss with your patient.
Resources and Support
Ethicon have created a patient website and downloadable resources providing plain-language information on the bariatric surgery journey, the different procedures, financial support, and real patient stories to help patients understand that bariatric surgery is a decision for life.
Public vs Private Pathways to Bariatric Surgery
It may surprise you to learn that <10% of all bariatric surgeries performed in Australia are performed in the public health system. Of over 700 public facilities, only 22 performed bariatric surgery in 2019.16 It is important that all HCPs advocate for more public funding, not just bariatric surgeons.
Weight Loss Surgery Procedures Information
References
1. Australian Diabetes Society. Australian Obesity Management Algorithm. 2022. Available: https://www.diabetessociety.com.au/downloads/20220902%20Diagram%20-
20%Australian%20Obesity%20Management%20Algorithm%202022%20.pdf (accessed September 2022).
2. Pucci A, Batterham RL. Mechanisms underlying the weight loss effects of RYGB and SG: similar, yet different. J Endocrinol Invest. 2019;42(2):117-128.
3. Pareek M, Schauer PR, Kaplan LM, Leiter LA, Rubino F, Bhatt DL. Metabolic Surgery. Weight Loss, Diabetes, and Beyond. J Am Coll Cardiol. 2018;71(6):670-687.
4. Sjöström L. Review of the key results from the Swedish Obese Subjects (SOS) trial – a prospective controlled intervention study of bariatric surgery. J Intern Med.
2013;273(3):219-234.
5. Schauer PR, Bhatt DL, Kirwan JP, Wolski K, Aminian A, Brethauer SA, Navaneethan SD, Singh RP, Pothier CE, Nissen SE, Kashyap SR. Bariatric Surgery versus Intensive Medical
Therapy for Diabetes — 5-Year Outcomes. N Engl J Med. 2017;376(7):641-651. doi:10.1056/NEJMoa1600869.
6. Nastałek P, Polok K, Celejewska-Wójcik N, Kania A, Sładek K, Małczak P, Major P. Impact of bariatric surgery on obstructive sleep apnea severity and continuous positive airway
pressure therapy compliance—prospective observational study. Sci Rep. 2021;11(1):5003.
7. Heuts EAF, de Jong LD, Hazebroek EJ, Wagener M, Somford MP. The influence of bariatric surgery on hip and knee joint pain: a systematic review. Surg Obes Relat Dis.
2021;17(9):1637-1653.
8. Carlsson LMS, Sjöholm K, Jacobson P, Andersson-Assarsson JC, Svensson PA, Taube M, Carlsson B, Peltonen M. Life Expectancy after Bariatric Surgery in the Swedish Obese
Subjects Study. N Engl J Med. 2020;383(16):1535-1543.
9. National Health and Medical Research Council. Clinical practice guidelines for the management of overweight and obesity in adults, adolescents and children in Australia. 2013.
Melbourne: National Health and Medical Research Council.
10. Bray GA, Kim KK, Wilding JPH. Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation Obes Rev. 2017;18(7):715-723.
11. Papamargaritis D, le Roux CW. Do Gut Hormones Contribute to Weight Loss and Glycaemic Outcomes after Bariatric Surgery? Nutrients. 2021;13(3):762.
12. Busetto L, Bettini S, Makaronidis J, Roberts CA, Halford JCG, Batterham RL. Mechanisms of weight regain. [published online ahead of print, 2021 Jan 16]. Eur J Intern Med.
2021;S0953-6205(21)00002-9. DOI:10.1016/j.ejim.2021.01.002
13. Australian & New Zealand Metabolic and Obesity Surgery Society and Collaborative Public Bariatric Surgery Taskforce. Public Bariatric Surgery A National Framework –
Executive Summary Document. October 2020. Available: https://anzmoss.com.au/wp-content/uploads/Public-Bariatric-Surgery-Framework_EXEC-SUM-ONLY.pdf (accessed August
2021).
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