With more than two-thirds of U.S. adults considered overweight or obese, obesity is the nation’s largest public health epidemic. But just a decade ago, obesity was not “foremost on the minds of many people, or doctors, or healthcare systems,” says Philip Schauer, MD, Director of Advanced Laparoscopic & Bariatric Surgery for Cleveland Clinic’s Bariatric and Metabolic Institute.
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The 10th Annual Cleveland Clinic Obesity Summit will feature “A Decade of Progress” in the management of obesity. It will highlight live bariatric surgery; educational sessions on the latest research in the science of obesity and on interventions including lifestyle, drug therapy, and surgery; and even a contest to win an Apple watch. It will be held Oct. 2 and 3 at the Intercontinental Hotel on Cleveland Clinic’s main campus.
Cleveland Clinic President and CEO, Toby Cosgrove, MD, will kick off the Obesity Summit with a talk about the progress made in the last 10 years and specifically address the benefits of Cleveland Clinic’s program targeted at keeping employees healthy.
Dr. Schauer, who also is the Obesity Summit’s director, says that one key milestone in the past 10 years has been the recognition by the American Medical Association of obesity as a disease in 2013. This has resulted in more doctors embracing obesity treatment, including lifestyle intervention, medication and surgery. Still, Dr. Schauer says, fewer than half insurance companies pay for weight loss medications or surgery, but ironically will cover surgery to treat the results of obesity, such as knee replacement, back surgery and heart surgery.
The Benefits of Surgery to Treat Obesity
Surgery, Dr. Schauer says, is one of the biggest changes that has happened in obesity management in the past decade.
“Ten years ago, we did not have much rigorous scientific analysis of the results of surgery,” he says. “Now we have dozens of very good studies, published in very prominent medical journals like The New England Journal of Medicine and JAMA that are showing that these procedures are quite safe and effective. Recent studies have shown that bariatric operations are about as safe as gallbladder surgery, hysterectomy and appendectomy, which are considered low-risk procedures.”
To fully understand the safety of surgery, Summit attendees will get to witness two types of obesity surgeries. Stacy Brethauer, MD, will perform a gastric bypass operation, while Matthew Kroh, MD, will do a sleeve gastrectomy on a patient.
“Many physicians don’t understand how effective and safe these procedures are,” says Dr. Schauer. “We think if healthcare providers actually see a procedure, they’re going to be better informed at educating their own patients and referring their own patients to surgery.”
In fact, surgery not only causes weight loss, but also often puts diabetes into remission. “Anywhere from 40 to 70 percent of patients can go into complete remission of diabetes after surgery, and there’s no other treatment that we know of that can consistently cause remission of Type 2 diabetes,” Dr. Schauer says.
Another highlight of the conference will be a panel of six patients who had surgery at least 10 years ago, including one patient who is 20 years out from surgery. “We’re going to let them share their experiences and let the audience ask them questions,” says Dr. Schauer. “This is to help doctors understand better how these people are doing, not just a year or two after surgery, but how they are doing with their weight loss and complications long after surgery.”
Dr. Brethauer also will talk about gastric ballooning – a procedure that implants a balloon in the stomach to help a patient reduce caloric intake because of feeling fuller. Dr. Schauer says the procedure is lower risk and lower cost than surgery, but is not a complete solution since balloons need to be removed in six months.
Regardless of whether or not an obese patient has surgery, lifestyle interventions – exercise and diet – are a critical part of obesity management. The Summit will include a live vegetarian cooking demonstration – including samples for the audience.
“We’re also going to focus on some of the new technology that helps motivate patients and track their activity, like Fitbit and Apple Watch,” says Dr. Schauer. “The whole industry has grown dramatically, so there is demand. We’ll have an expert talking about some of the early results of how this can be incorporated into the management of people who are obese.”
New Drugs on the Market
In just the past few years, the FDA has approved four new drugs for the treatment of obesity. Each works in the body in a different way, says Dr. Schauer, including as an appetite suppressant, blocking the absorption or fat, or increasing the amount of sugar flushed out through urination.
“These are essentially first-generation drugs, and they definitely have limitations,” Dr. Schauer explains. “It’s just the fact that doctors now have four drugs to work with that are relatively safe and have some degree of efficacy in terms of weight loss. That is a good thing. In the future, we’ll see more effective drugs become available.”
Other topics of the Summit includes the rapid increase in childhood obesity and possible treatments, as well as treatments for comorbid conditions including diabetes, kidney disease, asthma, cognitive dysfunction, and heart failure.
Finally, the Summit will include two contests: one to guess the BMI of Dr. Schauer with the prize of a Fitbit and the other to guess the average BMI of the entire audience of attendees with the prize of an Apple Watch.
The contests are not only a way to have fun, but they’ve been designed to make an important point about obesity management, says Dr. Schauer.
“Still today, primary care doctors will see patients in their offices who are obese. They will measure their blood pressure; they will check their blood sugar; they will treat them for comorbid conditions; but some overlook the importance of weighing the person or assessing the Body Mass Index to see where the patient is on the obesity continuum,” he says. “Understanding BMI is critical to enact the proper treatment.”
Although the entire Obesity Summit will illustrate the progress made in obesity management, Dr. Schauer says, ideally, he would like to see the field progress even faster.
“The actual epidemic is worse now than it was 10 years ago, but people are waking up to pay attention to it,” he says. “There’s still lots of room for more action. I’m modestly pleased, but we have a long way to go.”
If you’d like to attend the 10th Annual Cleveland Clinic Obesity Summit, register here.
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