Journal watch - review of the latest clinical papers 01/09/2021

Welcome to our weekly round-up of the latest bariatric and obesity-related papers published in the medical literature. As ever, we have looked far and wide to give you an overview of papers including the outcomes from the SCOTS study looking at access to bariatric surgery, the effect of increasing BMI on health-related quality of life, better survival following RYGB and LSG compared to non-surgery controls, updated T2DM recommendations from the USPSTF for screening adults between ages 35 to 70 years old with overweight or obesity for prediabetes and diabetes, and a paper from the UAE assessing four anthropometric measurements and indices of weight status and their associations with cardiometabolic risks (please note, log-in maybe required to access the full paper).

SurgiCal Obesity Treatment Study (SCOTS): a prospective, observational cohort study on health and socioeconomic burden in treatment-seeking individuals with severe obesity in Scotland, UK


Published in BMJ Open, investigators from Scotland report the characteristics of patients recruited in the SCOTS study, and the relationship between health and socioeconomic status with BMI and age.

In total, 249 completed health-related preoperative PROMS and regression models were used to estimate the effect of a ten-unit increase in age or BMI, adjusting for sex, smoking and socioeconomic status.


They reported that a higher BMI combined with older age was associated with poor physical functioning and QoL in people seeking bariatric surgery treatment.

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Long-term cost-effectiveness of interventions for obesity: A mendelian randomisation study


A study led by researchers from the University of Bristol, Bristol, UK, used mendelian randomisation to estimate the cost-effectiveness of interventions that target BMI. Using data from the UK Biobank, they estimated health-related QALYs and both primary and secondary healthcare costs for more than 310,000 individuals.


They reported in PLOS Medicine that a unit increase in BMI decreased QALYs by 0.65% of a QALY per year and increased annual total healthcare costs by £42.23 per person. They estimated that both laparoscopic bariatric surgery and restricting volume promotions for high fat, salt, and sugar products, would increase QALYs and decrease total healthcare costs, with net monetary benefits of £13,936 per person over 20 years and £546 million in total per year, respectively.


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Reduction in Long-term Mortality after Sleeve Gastrectomy and Gastric Bypass Compared to Non-surgical Patients with Severe Obesity


Researchers from the US compared the long-term risk of mortality among bariatric surgical patients undergoing either RYGB or SG to large, matched, population-based cohorts of patients with severe obesity who did not undergo surgery.


Reporting in the Annals of Surgery, they found that RYGB and SG were both associated with a significantly lower risk of all-cause mortality compared to nonsurgical patients at five-years. RYGB was associated with a significantly lower five-year risk of cardiovascular, cancer and diabetes-related mortality.


The authors hope these findings will help to inform the trade-offs between long-term benefits and risks of bariatric surgery.


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Screening for Prediabetes and Type 2 Diabetes US Preventive Services Task Force Recommendation Statement


The US Preventive Services Task Force (Task Force) has published a final B grade recommendation statement on screening for prediabetes and type 2 diabetes in JAMA Network. The Task Force recommends screening adults between ages 35 to 70 years old with overweight or obesity for prediabetes and diabetes.


For these latest recommendations - an update from its 2015 recommendations - the USPSTF commissioned a systematic review to evaluate screening for prediabetes and type 2 diabetes in asymptomatic, nonpregnant adults and preventive interventions for those with prediabetes. The review also looked at the evidence on the effectiveness of interventions for prediabetes to delay or prevent progression to type 2 diabetes.


After reviewing the evidence, the USPSTF concluded with ‘moderate certainty’ that screening for prediabetes and type 2 diabetes and offering or referring patients with prediabetes to effective preventive interventions has a moderate net benefit. Therefore, the USPSTF recommends screening for prediabetes and type 2 diabetes in adults aged 35 to 70 years who have overweight or obesity.


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Significance and agreement between obesity anthropometric measurements and indices in adults: a population-based study from the United Arab Emirates


Researchers from the United Arab Emirates assessed four anthropometric measurements and indices of weight status and investigated their associations with cardiometabolic risks.


Their study included 3,531 subjects and looked at the relationship between body mass index (BMI), waist circumference (WC), waist–hip ratio (WHR) and neck circumference (NC). They found that overweight and obesity based on BMI, WC and WHR were significantly associated with cardiometabolic risks.


Specifically, NC was not significantly associated with BMI, WC and WHR. BMI and WC showed better performance for identifying cardiometabolic risks than WHR and NC.


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