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Posted 3/5/2020

March 2020 Edition

1. Presidential Messages

ASMBS Presidential Message

Putting our patients first. Capturing what matters most to our patients.

One of the best things about being a bariatric surgeon is the one-year postop visit. You are probably saying "Clinic is the best part of being a surgeon? Really??" But I am being serious. I always ask my patients "What has been the biggest change in your life"? and then I listen. I listen to how they can play with their kids, how they can go on a plane, how they can sit cross-legged, or how they have all this newfound energy. When they reflect, there are often tears of joy and gratitude. And the most common comment is "I wish I had done this sooner."

As Metabolic and Bariatric Surgeons, we have proven that our operations are remarkably safe by preventing complications like leaks, bleeds and readmissions, and we continuously work to make these procedures better. But until now, our data collection has not focused on what matters most to patients… their quality of life.

Patient Reported Outcomes or PROs can capture the patient’s voice about how they feel about what matters most to them – their general health and their obesity and weight-loss related quality of life before and after bariatric surgery. PROs can now be collected as part of the Metabolic and Bariatric Surgery Accreditation Quality Improvement Program (MBSAQIP). The program was launched in November and is now available to all participating accredited centers. Signing up is easy – you just opt-in – and there is no additional cost for the program. Participating centers register preoperative patients using an online portal. Patient name, email, and surgery details are entered. The system then takes over and automatic emails are sent inviting patients to take the survey before surgery and annually on their surgical anniversary. No additional work is required by your staff. In addition to the three validated surveys selected for the program, postoperative patients are asked about their satisfaction with the decision to have surgery and about their status with the five most common obesity-related comorbidities; hypertension, hyperlipidemia, diabetes, GERD, and sleep apnea. We will assess if this is an accurate way to capture long-term data. Upon completion of the survey online, the patient receives a report detailing their scores on the three surveys. This report updates each year allowing patients to track their changes over time. Specific reports for the surgeons and their center can be viewed to assess their patients’ progress and compare their results to the rest of the nation.

The Patient Reported Outcomes Program from the MBSAQIP is an exciting opportunity to engage your bariatric patients about their quality of life and general health before and after surgery. Now, at the one-year postop visit with my patients, I go over changes in their quality of life from the PROs. Then, when I ask, "what has been the biggest change in your life?", they are even more ready to reflect on what matters most to them, and their stories are that much richer. I encourage you to opt-in for the PROs Program.

Any accredited center interested in learning more or joining the PROs Program should reach out to the team at the MBSAQIP by an email to mbsaqipquality@facs.org.

Sincerely,

Matthew Hutter, MD, MPH, FASMBS
President, ASMBS

ASMBS Integrated Health Presidential Message

Greetings! Your ASMBS Executive Council has just returned home from the annual strategic planning retreat full of energy and appreciation for our position as the leading authority in the field of obesity treatment around the world. Our IH President-Elect, Nate Sann, and I enjoy our role on the surgeon Executive Council and are honored to serve as the voice of IH in leadership of the ASMBS. During the retreat this year, a great deal of time was spent discussing our organizational priorities. ASMBS work in 2020 will focus on an issue of extreme importance to our patients and members – access to care. We will also be working on recommendations to help our clinicians address hot topics, including cannabis use by individuals pursuing bariatric surgery.

Committee Spotlight

This month we are featuring our hard working Support Group Committee. Chair Dr. Francine Broder, PsyD, Co-Chair Lauren Carey, RDN, and IHEC Liaison, Dr. Paul Davidson, PhD, are doing a fantastic job for our members and their programs. Feel free to contact them with suggestions or if you are interested in joining this or any other committee. The IH Support Group Committee’s mission is to promote the development of support groups in the care of the bariatric surgical patient. A key to this involves providing for the needs of support group leaders by developing and distributing educational resources and strategies to meet those needs. We further encourage the exchange of ideas and networking amoung support group leaders both online and in-person. To this end, the IH Support Group Committee wrote an online support group manual for the ASMBS website, populates toolkit resources for ASMBS members, contributes columns to bariatric publications, offers support group trainings and networking at ASMBS conferences, actively reviews the support group literature and expects to publish on this, and is working to create a support group facilitator certificate training program.

We are all looking forward to the ASMBS Weekend to be held in conjunction with the IFSO World Congress in Miami, July 28th – August 1st. In the meantime, those of us in colder climates are thinking Spring…

With kindest regards,

Lisa West-Smith, PhD, LISW-S
President, Integrated Health Section of ASMBS


2. ASMBS Support Obesity Care Week 2020!

Obesity Care Week 2020 (OCW2020) is here and ASMBS is a proud founding Champion of this important awareness week. Today is Access to Care Day, and we encourage you to use your voice to support the Treat and Reduce Obesity Care Act. Everyone should have access to healthcare that is not limited by their size, weight, or economic status. Learn more at ObesityCareWeek.org.


3. Register for ASMBS Weekend at IFSO 2020

Registration for ASMBS Weekend at IFSO 2020 is open! This year’s ASMBS Weekend will take place at the 25th IFSO World Congress in Miami, Florida. Join us, Juy 29th – August 1st, for our specialized surgical track. Attendees must register through IFSO to attend the ASMBS sessions. Visit ASMBSWeekend.com for more information.


4. Celebrate Certified Nurses Day with CBN!

Certified Nurses Day is an annual day of recognition for and by healthcare leaders dedicated to nursing professionalism, excellence, recognition, and service.

Every March 19th, employers, certification boards, education facilities, and healthcare providers celebrate and publicly acknowledge nurses who earn and maintain the highest credentials in their specialty.

Certified Nurses Day honors nurses worldwide who contribute to better patient outcomes through national board certification in their specialty.

Every year, the Certified Bariatric Nurse (CBN) Certification Program of the ASMBS joins in this celebration by providing congratulations and CBN informational brochures for celebration events for CBNs accross the country to spread the word about Bariatric Nursing, Nursing Certification, and the Certified Bariatric Nurse Certification. This year, we filled over 50 requests.

On March 19th, 2020, we at the CBN would like to ask all ASMBS members (Bariatric Surgeons, Obesity Medicine Physicians, and Integrated Health Professionals) to take a few minutes to recognize and thank the CBNs in your facility, practice, or program, for the extra step they have taken to become certified and thus provide the highest quality nursing patient care for your patients.

Thank you,

William Gourash, PhD, CRNP, RN
Certified Bariatric Nurse Certification Program Chair

Jessie Moore, MSN, APRN
Certified Bariatric Nurse Certification Program Co-Chair


5. AAP Statement Endorsed by ASMBS

The ASMBS Pediatric Surgery Committee – Dr. Janey S.A. Pratt, Chair, and Dr. Brad Linden, Co-Chair – is excited to share several meaningful advances in the care of children and adolescents with obesity.

On October 27, 2019, the American Academy of Pediatrics (AAP) issued a new policy statement, "Pediatric Metabolic and Bariatric Surgery: Evidence, Barriers, and Best Practices." The Obesity Committee of the American Pediatric Surgical Association (APSA), together with the Pediatric Sugery Committee of the American Society for Metabolic and Bariatric Surgery (ASMBS), supports the October 2019 AAP policy statement in a letter of endorsement to be published on our websites.

Thank you to ASMBS Pediatric Surgery Committee members, Kirk Reichard and Marc Michalsky, for their hard work as contributing authors to the AAP statement. The AAP statement calls for improved access to care for children suffering from obesity, early referral for Metabolic and Bariatric Surgery, transitioning to using growth chart definitions of obesity (i.e. 120% of the 95th percentile = class 2 obesity) and no longer using age as a barrier to surgery.

This week is Obesity Care Week 2020, of which ASMBS is a founding Champion. On March 3rd, a landmark publication calling for the end of weight bias was published in Nature Medicine. A coalition of over 40 organizations contributed to this valuable evidence-based statement providing advice, support, and direction for an international audience to eliminate weight bias and its harmful effects on our patients. How weight bias affects children and adolescents was also addressed supporting the 2018 ASMBS Pediatric MBS Guidelines. Children are frequently victims of weight bias and bullying in school, at home, and unfortunately at medical appointments. Our committee is excited that Obesity Care Week is helping raise awareness that obesity is a disease and that obesity bias needs to be addressed at every level.

During Obesity Care Week 2020, many groups have connected to educate, advocate, and support obesity care throughout the world. Weight bias, along with advocacy for access and treatment were highlighted at the beginning of the week. On Friday, March 6, the focus is on childhood obesity. The Pediatric Surgery Committee encourages all ASMBS members to advocate for access to effective treatment for children and adolescents. Our knowledge about pediatric obesity physiology and phenotypes along with effective treatment including intensive lifestyle support, medication use, device therapy, and MBS is growing daily. This knowledge requires advocacy and support for pediatric obesity teams along with related child advocacy efforts. Please join the Pediatric Surgery Committee every day, but especially March 6th, in advocating for effective treatment for this vulnerable population.

Think about opening a center for pediatric obesity in your hospital. Think about doing an educational program in your child’s school. Think about giving pediatric Grand Rounds in your hospital and improve access to care by providing Metabolic and Bariatric surgery to children and adolescents in an appropriate setting. Thank you to our entire committee for trying to advance the science, care, and understanding of pediatric obesity and a special thanks to Nancy and Allen Browne, who always say: Do it for the kids!

Janey Pratt, MD, FACS
Chair, Pediatric Surgery Committee

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