Patients, Society and Cultural Issues of Managing Obesity

Reset Diabesity

We will get Dr. Mattar’s thoughts on ongoing obesity patient issues, socio-cultural issues, economic and environmental issues, and ideas to help Primary Care Providers refer and manage obese patients.

Host

Rob Johnston, PhD

Chief Scientist, Johnston Analytics

Houston, TX

Guest

Samer Gamil Mattar, MD, FACS

Professor and Chief, Division of Metabolic and Bariatric Surgery

Baylor College of Medicine

Houston, TX

Useful resources

ASMBS

https://asmbs.org/search/

The Obesity Society

https://www.obesity.org/

American College of Surgeons

https://www.facs.org/

Obesity Medicine Association

https://obesitymedicine.org/

American Board of Obesity Medicine

https://www.abom.org/

Learn more about Reset Diabesity:

https://cine-med.com/diabesity-education

About Rob Johnston

Dr. Rob Johnston is a computational social scientist and applied ethnographer specializing in technology and political-national security. Rob is the Chief Scientist at Johnston Analytics, Inc., a data science, machine learning, and national security consultancy. He is a Distinguished Visiting Scholar in the School for Public and International Affairs at North Carolina State University. Rob is also a Research Scholar at the Laboratory for Analytic Sciences (a National Security Agency partner Laboratory) at North Carolina State University focused on the intersection of Artificial Intelligence, Machine Learning, and Social Science.

Prior to this Rob was the Deputy Chief of Globalization and Workforce Modernization at the Central Intelligence Agency supervising over hundreds of staff and contractors, he served as Program Manager for Business and Workforce Modernization, he was the founder and first Chief of the Lessons Learned Program at CIA, was the Director of the Lessons Learned Program at the Office of the Director of National Intelligence, and was a research scientist in the Center for the Study of Intelligence and the Office of the Chief Scientist at CIA.

Rob is a former Associate of the National Intelligence Council for both Warning and Transnational Threats. He served as a team lead and member of several global crisis task forces that monitored, prepared, and responded to emerging threats, forced migration, ethnic violence, and political crises. Rob is a former Visiting Scholar at the Sherman Kent Center, a CIA Postdoctoral Research Fellow, the author of “Analytic Culture in the US Intelligence Community: An Ethnographic Study” published by CIA and producer of the award-winning Intelligence Community 2011 Best Documentary “Extraordinary Fidelity.”

Rob was a research analyst at the Institute for Defense Analyses where he conducted research for the White House Office of Science and Technology Policy, the Department of Defense, and the Intelligence Community. He has worked on science and technology policy with the JASONS, the Intelligence Science Board, and the Defense Science Board. Rob served at NASA during graduate school where he conducted research for the Virtual Environment Research Institute at the Johnson Space Center to support the Space Flight Training Division for manned missions: STS-82 Hubble Space Telescope Servicing, STS-88 International Space Station Assembly, STS-96 International Space Station Supply, and STS-103 Hubble Space Telescope Servicing.

Rob is a former Fellow of the Royal Anthropological Institute, the Society for Applied Anthropology, and the Inter-University Seminar on Armed Forces and Society. He has been a Lecturer at Yale University, an adjunct instructor at the University of California San Francisco, and the Baylor College of Medicine. Rob has conducted fieldwork in North and Central America, China, Europe, Eurasia, the Caucasus, East and South Asia, Africa, and the Middle East. He has published over 50 articles, book chapters, and books, and has been a guest speaker at over 200 national and international conferences and events.

About Dr. Mattar

Samer Mattar, MD was introduced to modern bariatric surgery in the clinical year of my Advanced Laparoscopy Fellowship at Emory University. As a resident, Dr. Mattar did assist in bariatric cases and managed bariatric patients, but that was in the open era, and most patients were not treated in the multi-disciplinary manner that is now practiced. Outcomes were less than favorable and both mortality and morbidity rates were unacceptably high.

The advent of laparoscopy ushered in a new approach that afforded markedly reduced pain and accelerated recovery. With accrued experience, the complication rates dramatically dropped and patients presented in large numbers for these life-saving operations, resulting in a renaissance of gastric surgery and a worldwide explosion in research efforts to understand the underlying mechanisms of these life-transforming operations. As a result, bariatric and metabolic surgery now occupies a pole position in disciplines that provide the multi-disciplinary, comprehensive, holistic continuum of care that has now become commonplace in many surgical fields.

Dr. Mattar was fortunate to be “in the right place at the right time” and rode this wave of exciting innovation and scientific progress. The dramatic improvements in overall health and wellbeing that he witnessed in patients had a captivating effect on him. Over the first few years of his career, Dr. Mattar’s case distribution became progressively bariatric in nature until it entirely dominated his practice. Dr. Mattar truly believes there is no surgical specialty that so much embodies compassionate care, technical prowess, intellectual curiosity, principled advocacy, and career satisfaction as that derived from bariatric and metabolic surgery.

Dr. Mattar has had the good fortune to develop, or expand, several bariatric programs at different institutions with gratifying results in volume growth, improvement of quality outcomes and increased patient satisfaction. His style of leadership is one that promotes building bridges and achieving consensus. Because of the high burden of comorbidities that bariatric patients carry, bariatric surgery is an ideal example of the benefits that can be achieved through multi-specialty collaborative efforts in clinical care and research opportunities. These collaborative efforts at local, regional and national levels have significantly advanced this field to the benefit to patients, their families and fellow practitioners. As president of ASMBS, the world’s largest association of bariatric and metabolic surgeons, Dr. Mattar has both participated and witnessed, from a front seat position, the remarkable advancements that have been made in the fields of patient care and pertinent patient advocacy and health policy.

Dr. Mattar has devoted his career to patient care, student, resident and fellow education, and towards raising the global awareness of the art and science of metabolic and bariatric surgery. He is confident that the most appropriate and effective approach to reversing the ravages of metabolic dysfunction can only be achieved through a holistic multi-disciplinary approach. To achieve this ideal, there must be an entity that brings together a group of experts from various specialties whose common and unifying goal is to treat the patient with metabolic syndrome; all within a unified and shared location. This patient-centric approach would best serve patients and their families, and provide consistency and longevity of therapies, and provide ample opportunities for research and innovation.

Dr. Mattar’s ambition is to develop such a program, while exerting an emphasis towards supporting and guiding the ascending generations of motivated and hard-working surgeons and physicians who are committed to answering this most noble of callings.

Hardware / Software Requirements

•An internet connection speed of at least 4Mbps and a modern browser

•Modern browsers have a built in PDF reader which would be necessary for you to view your completion certificates.

Release Date: 4/12/24

Expiration Date: 4/12/27

Target Audience

This activity is designed for internal medicine physicians and supporting staff who treat patients with obesity and associated co-morbid conditions.

Learning Objectives

At the completion of this activity, learners should be able to:

• Recognize patient risk factors for negative outcomes associated with obesity
• Identify treatment options for obesity, including but not limited to medications,
• dietary changes, exercise and surgery
• Describe the team approach to managing patients with obesity
• Discuss dietary and exercise changes that can be beneficial to patients with obesity
• Identify indications and contraindications for bariatric surgery for the treatment of
• obesity

Activity Goal

This activity is designed to address the following core and team competencies:

Patient Care, Medical Knowledge, Professionalism, Employ evidence-based practice, Value

& Ethics, Team & Teamwork, Interprofessional Collaboration, and Interprofessional Communication.

Non-Endorsement

The accredited provider verifies that sound education principles have been demonstrated in the development of this educational offering as evidenced by the review of its objectives, teaching plan, faculty, and activity evaluation process. The accredited provider does not endorse or support the actual opinions or material content as presented by the speaker(s) and/or sponsoring organization.

Disclosures

The accredited provider adheres to accreditation requirements regarding industry

support of continuing medical education. Disclosure of the planning committee and faculty's commercial relationships will be made known at the activity. Speakers are required to openly disclose any limitations of data and/or any discussion of any off-label, experimental, or investigational uses of drugs or devices in their presentations. - All employees in control of content have no relevant financial relationships to disclose. All relevant financial relationships have been mitigated.

Relevant Financial Relationships

Samer Mattar, MD - B2M - Consultant, Stock options

Samer Mattar, MD - Intuitive - Consultant, received honorarium

Accreditation

In support of improving patient care, Cine-Med is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcareteam.

Physicians

Cine-Med designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurses / Physician Assistants

All other healthcare professionals will receive a Certificate of Participation. For information on the applicability and acceptance of Certificates of Participation for activities designated for AMA PRA Category 1 Credits™, consult your professional licensing board(s).

Other Healthcare Professionals

All other healthcare professionals will receive a Certificate of Participation. For information on the applicability and acceptance of Certificates of Participation for activities designated for AMA PRA Category 1 Credits™, consult your professional licensing board.

Certificates: To claim your CME/CE credits, complete the online Credit and Evaluation form using the following URL: https://cine-med.com/certificate.php?id=495

This is a one-time credit submission. Credits should be tracked at the completion of the activity. Participants will be able to download or print a certificate once the form has been submitted.

American Board of Surgery (ABS) Reporting: Successful completion of this CME activity enables the learner to earn credit toward the CME requirement(s) of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit. Claimed credits will be reported to the ABS one-time, in December of the calendar year.

Support

This activity is being supported by an educational grant from Medtronic.

Background References

1. Bendewald, F.P., Choi, J.N., Blythe, L.S., Selzer, D.J., Ditslear, J.H. and Mattar, S.G., 2011. Comparison of hand-sewn, linear-stapled, and circular-stapled gastrojejunostomy in laparoscopic Roux-en-Y gastric bypass. Obesity surgery, 21, pp.1671-1675.

2. Burchett, M.A., McKenna, D.T., Selzer, D.J., Choi, J.H. and Mattar, S.G., 2015. Laparoscopic sleeve gastrectomy is safe and effective in elderly patients: a comparative analysis. Obesity surgery, 25, pp.222-228.

3. Collins, J., Mattar, S., Qureshi, F., Warman, J., Ramanathan, R., Schauer, P. and Eid, G., 2007. Initial outcomes of laparoscopic Roux-en-Y gastric bypass in morbidly obese adolescents. Surgery for Obesity and Related Diseases, 3(2), pp.147-152.

4. Cottam, D.R., Mattar, S.G., Barinas-Mitchell, E., Eid, G., Kuller, L., Kelley, D.E. and Schauer, P.R., 2004. The chronic inflammatory hypothesis for the morbidity associated with morbid obesity: implications and effects of weight loss. Obesity surgery, 14(5), pp.589-600.

5. Cottam, D.R., Mattar, S.G. and Schauer, P.R., 2003. Laparoscopic era of operations for morbid obesity. Archives of Surgery, 138(4), pp.367-375.

6. Dallal, R.M., Mattar, S.G., Lord, J.L., Watson, A.R., Cottam, D.R., Eid, G.M., Hamad, G., Rabinovitz, M. and Schauer, P.R., 2004. Results of laparoscopic gastric bypass in patients with cirrhosis. Obesity surgery, 14(1), pp.47-53.

7. Eid, G.M., Cottam, D.R., Velcu, L.M., Mattar, S.G., Korytkowski, M.T., Gosman, G., Hindi, P. and Schauer, P.R., 2005. Effective treatment of polycystic ovarian syndrome with Roux-en-Y gastric bypass. Surgery for Obesity and Related Diseases, 1(2), pp.77-80.

8. Eid, G.M., Brethauer, S., Mattar, S.G., Titchner, R.L., Gourash, W. and Schauer, P.R., 2012. Laparoscopic sleeve gastrectomy for super obese patients: forty-eight percent excess weight loss after 6 to 8 years with 93% follow-up. Annals of surgery, 256(2), pp.262-265.

9. English, W.J., DeMaria, E.J., Hutter, M.M., Kothari, S.N., Mattar, S.G., Brethauer, S.A. and Morton, J.M., 2020. American Society for Metabolic and Bariatric Surgery 2018 estimate of metabolic and bariatric procedures performed in the United States. Surgery for obesity and related diseases, 16(4), pp.457-463.

10. Filip, J.E., Mattar, S.G., Bowers, S.P. and Smith, C.D., 2002. Internal hernia formation after laparoscopic Roux-en-Y gastric bypass for morbid obesity. The American surgeon, 68(7), pp.640-643.

11. Husain, F., Jeong, I.H., Spight, D., Wolfe, B. and Mattar, S.G., 2018. Risk factors for early postoperative complications after bariatric surgery. Annals of surgical treatment and research, 95(2), pp.100-110.

12. Ibele, A.R. and Mattar, S.G., 2011. Adolescent bariatric surgery. Surgical Clinics, 91(6), pp.1339-1351.