Expansion of Obesity Surgery

iStock_000065162681_MediumBariatric surgery, or obesity surgery, is now being recommended for many people with type 2 diabetes (T2D), and thus should undergo a name change: metabolic surgery, as Rick and I report on PodMed this week.  That's according to a rather large consensus of 48 professional organizations, including the American Diabetes Association, and published in Diabetes Care.

There are 11 studies published in this issue of the journal and reviewed in the development of the guidelines that address various aspects of metabolic surgery, including the several types of operations available, people in whom they are indicated, and the role of diet and exercise. The authors assert that they are not advocating that surgery should be a first step in managing diabetes, but rather that some procedure is indicated in those with a BMI greater than 40 or those with a BMI of 35 or more and whose diabetes isn't managed well with other methods.

Of note to Rick and me is the cost-effectiveness aspect of metabolic surgery in managing T2D and therefore avoiding many of the complications of the condition.  This is especially interesting given that such an expansion of metabolic surgery as proposed in these guidelines would present a huge up front cost to the health care system.

Other topics this week include two from JAMA: management of hypertension in the elderly and sodium in those with chronic kidney disease, and in the Journal of Clinical Oncology, a look at what people with advanced cancer hear from physicians about their condition. Until next week, y'all live well.

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