European Summit Marries All Approaches to Obesity

Liam Davenport

May 25, 2016

GOTHENBURG, SWEDEN — The surgical, medical, and public-health aspects of managing obesity will be united for the first time at a major international conference, when experts gather to discuss the latest research and most important issues from across the field.

The European Obesity Summit (EOS) 2016, which will take place from June 1 to June 4 in Gothenburg, Sweden, is the result of a merger of the congresses of the European Association for the Study of Obesity — usually called the European Congress on Obesity (ECO) — and the European Chapter of the International Federation for the Surgery of Obesity and Metabolic Disorders.

The Twitter hashtag for the meeting will retain the ECO nomenclature, though: #ECO2016.

The meeting will feature parallel programs and joint sessions that will offer a balance between surgical and nonsurgical presentations, covering medicine and basic science, as well as the social, public-health, and political aspects of obesity.

Lauren Lissner, PhD, professor at the section for epidemiology and social medicine at the University of Gothenburg, Sweden, is chair of the EOS 2016 program organizing committee.

She told Medscape Medical News that being in Gothenburg for the inaugural European Obesity Summit will be "special," not only because it will be the first time that the two organizations have brought their meetings to the city, but also because one of the original and most influential investigations of bariatric surgery, the Swedish Obese Subjects study (SOS), originated at the University of Gothenburg.

SOS: Surgery Is Tip of Iceberg

SOS initially examined how surgery affected patients' weight and weight trajectories and then later how it affected their subsequent health after they lost weight as well as their longevity. Its influence continues to be felt today, as will be shown in the plenary session "Lessons from SOS" on the first day of the conference.

For Dr Lissner, it was "very natural" to bring together the surgical and nonsurgical aspects of obesity management and care together into one meeting. In obesity, surgery is the "tip of the iceberg of the problem," as it treats people at a very advanced state, she stressed.

If, however, one thinks of obesity in terms of a normal distribution, surgery is focused on treating the tail of that distribution, while public health is about the "prevention of people ever getting to that end."

In other words, while surgery can have a big impact on peoples' individual weight, Dr Lissner pointed out that the public-health argument is that "if you treat the middle of the distribution, where most of the people are, even preventing small weight gains can have a great population impact."

To bring together all the different elements of the summit, Dr Lissner has worked closely with her cochairs Ingvar Bosaeus, professor in clinical nutrition at the Sahlgrenska Academy, the University of Gothenburg, and Carl-Erik Flodmark, from the childhood obesity unit at University Hospital, Malmö.

Dr Lissner singled out several sessions that underline the breadth of the program, one of which is a session on Wednesday June 1 entitled "Nutrition: from Science to Practice," which will be held jointly with the European Federation of the Associations of Dietitians and will discuss energy metabolism and body composition.

She noted that the session will "raise some interesting questions" about body composition and aging, including whether overweight per se has the same negative effect at old ages compared with midlife and earlier.

Childhood Obesity Taking Center Stage

Another key session on Wednesday will feature data from the IDEFICS I.Family cohort, a study of 16,000 children from eight countries across Europe, who have been followed in detail since early childhood, with many now reaching adolescence.

Dr Lissner, who is involved in the Swedish part of the study, explained that it offers "a really interesting European perspective on how children's lifestyles and diets differ in different parts of Europe and how this may relate to big differences in obesity rates across the eight countries."

The symposium will cover, among other topics, gene expression and diet, including the role of sugar.

Dr Lissner pointed out that, while sugar has got "bad press" in terms of its role in childhood obesity in particular, it is difficult to quantify the true impact, and several studies have not found any association.

To those ends, one of the presentations will be a study of a urinary biomarker for sugar to determine whether that offers a more reliable method for quantifying the contribution of the sweet stuff to childhood obesity.

Dr Lissner said that the other "big news" on the pediatric side will be the results from the PRIMROSE study, showing lack of effectiveness of primary-prevention strategies for childhood obesity.

This adds to earlier data from IDEFICS showing that better prevention programs are needed in children, she noted.

Surgery and Public Health Will Overlap

On the surgical program, which was developed with Torsten Olbers, a researcher in the department of gastrosurgical research and education at the University of Gothenburg, a highlight will be a session on Thursday morning discussing when to treat type 2 diabetes with surgery.

Another controversial topic will be that of whether to perform bariatric surgery in adolescents, which will be discussed in a dedicated session on Friday morning.

Dr Lissner noted that some see surgery in this population as a "last resort," while others highlight the difficulties of compliance in young patients. However, others view this as a way of dealing with obesity early in patients in whom other measures may not ever be successful.

There will also be sessions on the long-term effects of bariatric surgery, as well as a plenary session on plastic surgery after massive weight loss, which Dr Lissner observed is also "a big issue in treating adolescents who don't always have realistic perceptions of what life will be like after the surgery."

Overall, Dr Lissner believes that the summit will be a success because "I, as a public-health person, will be going to surgical sessions," adding: "I hope my colleagues in surgery will be interested in coming to the public- health and nutrition sessions and the childhood obesity sessions. That is our vision."

Dr Lissner reports no relevant financial relationships.

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