Obesity Ties to Cancer, Diabetes Showcased in Vegas Meeting

Marlene Busko

November 04, 2019

LAS VEGAS — In this glitzy city where lady luck lurks, it is a sure bet that attendees at Obesity Week 2019, this year's joint meeting of The Obesity Society and American Society for Metabolic and Bariatric Surgery (ASMBS), will learn new things from the latest scientific evidence in the field.

Medscape Medical News interviewed the ASMBS president and two program planners from The Obesity Society to identify what they deem to be the most important newsworthy presentations.

A major theme at this year's meeting is obesity and diabetes, they note, and other themes include obesity and cancer.  

Pediatric obesity will also be a hot topic at the meeting, which is timely as the American Academy of Pediatrics (AAP) just released a policy statement that calls for greater access to bariatric surgery for adolescents with severe obesity.

"Exciting" Top Papers on Bariatric Surgery

The two ASMBS Top Papers sessions on November 5 are a good place to find the latest science related to metabolic (bariatric) surgery, Eric DeMaria, MD, ASMBS President, told Medscape Medical News.

The top paper "I'm most excited about," he said, is about a risk-prediction model for patients with obesity and diabetes.

The risk calculator predicts 10-year risks for cardiovascular and renal morbidities and all-cause mortality for patients with obesity and diabetes according to whether or not they undergo metabolic surgery, said DeMaria, who is professor and chair of the General and Bariatric Surgery Division at East Carolina University, Greenville, North Carolina.

"It's probably going to be a very useful tool for patients and medical providers" to help them understand long-term risk, with and without bariatric surgery, he explained.

A second top paper is a large case-control study of patients who have had a myocardial infarction (MI), looking at whether bariatric surgery reduces the risk of systolic heart failure or dying from a recurrent MI.  

DeMaria observed that a patient who has had an MI might be deemed too risky for a routine minor procedure (such as a hernia repair), and yet he or she may qualify for more invasive metabolic surgery, "because we are addressing the underlying problem."

A third top paper will present data from a study of sleeve gastrectomy in patients with a body mass index (BMI) less than 35 kg/m2.

"A BMI of 35 kg/m2 has been a traditional indication for considering surgery," DeMaria explained, "but obesity is a continuum. It doesn't start at 1 pound over a certain weight."

Currently, "we have people with significant health problems who don't qualify for insurance coverage for treatment because of this arbitrary BMI of 35 kg/m2," he added, so the new study findings could potentially help inform future insurance criteria.

Obesity in a Pediatric Population

The two meeting planners from The Obesity Society — Matthew R. Hayes, PhD, and Paul MacLean, PhD — outlined their top picks for newsworthy sessions.  

On November 4, a late-breaking research forum, entitled, "Emerging pharmacological anti-obesity therapies," will provide a glimpse into new types of anti-obesity drugs in development, they said. 

Researchers will present findings from a phase 2 trial of bimagrumab, an activin-receptor antagonist, for the treatment of obesity and type 2 diabetes, and from two phase 3 trials of setmelanotide, a melanocortin 4 receptor (MC4R) agonist, in proopiomelanocortin (POMC) deficiency obesity and leptin receptor (LEPR) deficiency obesity.

The meeting will also feature three not-to-be-missed sessions on children and adolescents with obesity.  

First, The Obesity Society's opening session on November 4, entitled, "Hold em or fold em —Treating pediatric obesity in an era of outrage," will set the stage.

Then on November 6, the joint symposium of The Obesity Society and European Association for the Study of Obesity will cover "Policies of marketing unhealthy foods to children — an international perspective." 

And on the following day, in a joint session of The Obesity Society and ASMBS, pediatric experts from around the world will discuss "Pediatric obesity — the global perspective."

Hayes is associate professor of nutritional neuroscience in psychiatry at the University of Pennsylvania, Philadelphia, and MacLean is professor of medicine-endocrinology/metabolism/diabetes, University of Colorado, Denver.

And according to the surgeon, DeMaria, there will also likely be a buzz at the meeting about the just-released policy statement by the AAP about metabolic surgery in adolescents with severe obesity, which "pretty much mirrors" a statement developed by the ASMBS.

"The idea that the pediatricians are coming on board with stronger support" for metabolic surgery for a controversial group, adolescents, is striking, he said.

"I think it'll be a big topic of conversation." 

Diabetes, Obesity and Emerging Links to Cancer Risk

MacLean and Hayes say they look forward to hearing the keynote speech on November 5 by William T. Cefalu, MD, the new director of the Division of Diabetes, Endocrinology and Metabolic Diseases at the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health.

They also point to another key session that day, entitled, "Hitting a triple: Diabetes, obesity, and the emerging links to cancer risk," which touches on the theme of this year's meeting.

And DeMaria picked out two other top surgery papers looking at the relationship between obesity and certain cancers.

"The only cancers that are on the rise are ones that are obesity-associated, and almost any other kind of cancer is on a downward trend," he said, as described in a 2017 report by the Centers for Disease Control and Prevention.

"If we can actually show that successful metabolic surgery to reduce body weight" leads to significant reversal of obesity, not just by a few percentage points, this "would make a huge difference with cancer," he emphasized.

Meanwhile, on November 6, the Blackburn Symposium will provide scientific evidence for intermittent fasting, a popular topic in the lay press, during a session entitled, "Intermittent fasting and circadian rhythms — does it matter when you eat?"

Then on the same day, the Ethan Simms Awards session will present research findings from the novel GRAVITAS trial of "GLP-1 receptor agonist intervention for poor responders after bariatric surgery."

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