That’s News

By Katy Mena-Berkley
Tuesday, September 8, 2020

The Role of Microbes in Addressing Obesity

More than 40% of the population in the United States is obese, according to the CDC, accounting for a host of comorbid conditions, including high blood pressure and stroke. When diet and exercise do not help address obesity, many patients may be candidates for bariatric surgery. However, the community of bacteria known as the microbiome may provide a surgery-free solution for obesity and its comorbid conditions.

Inspired by studies indicating that obese people tend to have a limited diversity of gut microbes, researchers at Arizona State University examined how and at what point a patient’s microbiome is altered following Roux-en-Y gastric bypass surgery. A hallmark of this particular form of bariatric surgery is that it alters the composition of a patient’s gut bacteria. The researchers discovered that after surgery, changes in mucosal and fecal microbiomes were associated with enhanced metabolism. This information could lead to the development of probiotic therapy as an alternative to surgery.

Racial Disparities Following Bariatric Surgery

When it comes to weight-loss surgery, one study finds that African American patients may not respond as well as to the procedure. Titled, “Outcomes of Bariatric Surgery in African Americans: An Analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) Data Registry,” the study was published in Obesity Surgery and completed by researchers at Carolinas Medical Center, Atrium Health in Charlotte, N.C.

The research team analyzed the MBSAQIP database to review details about 429,714 patients who had Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy, 75,409 of whom were African American. Key takeaways indicated that African American patients who undergo bariatric surgery tend to be heavier and younger than other patients and have different comorbidities. African American patients also have less-favorable outcomes following surgery, such as higher mortality rates among sleeve gastrectomy patients.

Weight-Loss Solutions Underutilized to Manage Obesity

Obesity is an increasingly prevalent medical concern in the U.S. However, recent research finds that weight-loss surgery, specifically sleeve gastrectomy — one of the most commonly performed bariatric procedures in the U.S. — and postoperative antiobesity pharmacotherapy are not proportionately used in treating these patients.

The retrospective study, led by Raj Shah, MD, at University Hospitals Cleveland Medical Center, looked at nearly 3 million obese adults and found less than 0.94% had undergone sleeve gastrectomy. Of the patients who had the surgery, 5.6% received weight-loss medications after discharge. Study findings underscore a need for primary care providers to connect obese patients with weight-loss treatments. Authors also note that familiarizing clinicians with bariatric surgery criteria may help bridge the utilization gap. Educational programs addressing pharmacotherapy may also make an impact for patients.