Day 2 :
- Track 4: Surgical Weightloss: Bariatric Surgery and Liposuction, Track 5: Dietary Approaches for Weight Management, Track 6: Current Clinical Research and Interventions in Treatment Approches
Chair
Farid Saad
Bayer Pharma, Germany
Co-Chair
Mohamed Saleh Ismail
University of Dammam, KSA
Session Introduction
Muneera Q Al-Mssallem
King Faisal University, KSA
Title: Traditional food and weight loss
Time : 11:20-11:50
Biography:
Muneera Q Al-Mssallem is a faculty member at King Faisal University, Saudi Arabia. She has got her PhD in dietetics from Surrey University, Guildford, UK. She has been working as an Assistant Professor at King Faisal University since 2011. She has published some of her works in some journals such as European Journal of Clinical Nutrition, Saudi Medical Journal, Journal of Diabetes & Metabolism, Annals of Nutritional Disorders & Therapy, Proceedings of Nutrition Society, and Arab Gulf Journal of Scientific Research.
Abstract:
Obesity is a chronic condition that has been found to be associated with habitual eating patterns and lifestyle. The recent dramatic modification in Saudi diet in particular, modifying the type of carbohydrates content of the diet, was behind the most health problems. This study investigates both, the relationship between consumption of traditional Saudi foods and prevalence of obesity, and the effect of consumption traditional Saudi foods on losing weight. The results have revealed that 28% of subjects were overweight or obese, and 70% of subjects usually consume the traditional Saudi foods. There was a significant inverse correlation between the BMI and the consumption of these traditional Saudi foods (p=0.003). The second part of the study on obese and overweight participants has shown that 4% of weight reduction has been achieved within 6 weeks on low glycaemic index traditional foods. In conclusion, dietary advice should be givento consume the healthy traditional food in order to overcome and diminish the occurrence of health problem escalation.
Farid Saad
Bayer Pharma AG, Germany
Title: Hypogonadism, Obesity and Testosterone Therapy (oral)
Time : 11:50-12:20
Biography:
Farid Saad worked for various pharmaceutical companies as specialist for reproductive endocrinology, pediatric endocrinology, andrology, endocrinology of male ageing, and hormonal male contraception in clinical development andrology, scientific and medical affairs. He currently works for Bayer Pharma in Berlin, Germany. He has authored and co-authored more than 100 peer-reviewed papers and more than 500 scientific abstracts. He received honorary Professorships in clinical research and endocrinology at Gulf Medical University, Ajman, U.A.E., and at Men’s Health Reproduction Study Center, Hang Tuah University, Surabaya, Indonesia.
Abstract:
Adipose tissue produces substances that suppress testosterone production. Low testosterone leads to further accumulation of fat mass. This situation represents a vicious circle. In an ongoing registry study of 347 hypogonadal men (total testosterone ≤12.1 nmol/L and presence of hypogonadal symptoms) being treated with testosterone in a urology office in Germany, only 7.5% had normal weight (BMI <25 kg/m2) at baseline, 22.8% were overweight (BMI 25-29.9 kg/m2) and 69.8% obese (BMI ≥30 kg/m2). The same applies to waist circumference (WC): 4.3% with WC<94, 30.8% 94-101.9, and 64.8% ≥102 cm at baseline. This distribution seems representative for hypogonadal populations. Only when long-term studies (5 years) with injectable testosterone undecanoate (TU) appeared in 2013 and 2014, substantial and sustained weight loss became apparent. In a controlled study, 5-year treatment with TU in men with metabolic syndrome resulted in progressive weight loss of 15.4 kg and decrease in WC of 9.6 cm. In registry studies, patients lost weight in the same magnitude. In none of these studies, patients regained weight during the observation time. In a meta-analysis on TU, the magnitude of effects depends on baseline BMI, duration of treatment, and age. It can be hypothesised that increase in lean mass and behavioural changes are factors in achieving weight loss by testosterone treatment. In conclusion, testosterone may have the potential to decrease obesity in hypogonadal men in a meaningful and sustainable manner.
Greta Krešić
University of Rijeka, Croatia
Title: Postpartum weight retention as a risk factor for the development of midlife obesity
Time : 12:20-12:50
Biography:
Greta Krešić received her BA (1997), MA (2001) and PhD (2005) in Food Technology and Nutrition from the University of Zagreb, Faculty of Food Technology and Biotechnology. The fields of her scientific interest is human nutrition (dietary intake, dietary habits, maternal and child nutrition). As an author and co-author, she has generated 30 peer-reviewed publications. She has held 15 poster and oral presentations and lectures on international congresses. She is a member of the editorial board of Croatian Journal for Food Technology, Biotechnology and Nutrition and also serving as a reviewer for 14 international scientific journals.
Abstract:
The childbearing years are an important life stage for women that may result in substantial weight gain leading to the development of obesity. In the light of early prevention of obesity, special concern should be taken in counselling women in the period after parturition since they are a very vulnerable population, considering the changes in metabolism and in lifestyle which have occurred. Weight gain before, during and after pregnancy not only affects the pregnancy but may also be a primary contributor to the future development of obesity in women during midlife and beyond. Women are often told that breastfeeding will help them lose weight, but they may have concerns about diet and substantial weight loss and its effect either on their breast milk quality or supply or on the growth of their babies. Evidence is limited and conflicting about whether women who breastfeed their infant lose more weight than women who do not breastfeed. From an evolutionary point of view, it appears reasonable to assume that the adipose tissue deposition during pregnancy would serve during breast-feeding as a nutritional reserve to ensure an adequate energy supply for the newborn. Weight change during postpartum and its major determinants such as pre-pregnancy BMI, gestational weight gain and diet will be discussed as a risk factor for obesity development.
Rohit Kumar
International Modern Hospital, Dubai
Title: Intraoperative, Early and Late complications of Laparoscopic Sleeve Gastrectomy
Time : 12:50-13:20
Biography:
Dr. Rohit Kumar has a vast experience in the fields of bariatric, gastrointestinal and general surgery. He has undergone training in laparoscopic bariatric surgery at Sir Ganga Ram Hospital, advanced laparoscopic training in Greece, and has done a fellowship in hepatobiliary and pancreatic surgery in Japan. He has, amongst his patients, a host of dignitaries, leaders, and foreign nationals. His areas of clinical interests include; Laparoscopic adjustable gastric banding, laparoscopic sleeve gastrectomy and laparoscopic Roux en Y gastric bypass, lap cholecystectomy, laparoscopic appendix, laparoscopic hiatus hernia, laparoscopic splenectomy, laparoscopic nephrectomy, laparoscopic colectomy, laparoscopic low anterior resection, laparoscopic gastrectomy, hepato-biliary and pancreatic surgery, laparoscopic inguinal hernia
Abstract:
Laparoscopic sleeve gastrectomy (LSG) is gaining acceptance among bariatric surgeons as a viable option for treating morbidly obese patients. We describe results of a single surgeon’s experience with LSG, its intra-operative, early and late complications and their management. We retrospectively reviewed the data of patients who underwent LSG from 2006 to 2015. Patients underwent LSG as a primary procedure or as revisional bariatric surgery. The short-term morbidity and mortality were examined. All patients entering our practice, requesting bariatric surgery, were offered three procedure options: laparoscopic gastric bypass, adjustable gastric banding, and LSG. After a one-on-one consultation with the surgeon, the patients made an informed decision to undergo LSG, and an informed consent was obtained. All patients were required to undergo a psychological screening, routine labs, electrocardiogram, upper gastrointestinal X-rays, pulmonary function studies, and a medical evaluation. All patients were scheduled for LSG as a primary definitive procedure. All patients received intravenous antibiotics, subcutaneous unfractionated heparin and sequential compression devices preoperatively. One-stage LSG was performed. The major complications were late leakage after 4 weeks, with hemorrhaging. Two patients required reoperation & one patient was treated conservatively. Furthermore, one patient had complete Dysphagia, and was treated conservatively. Moreover, one patient who had an injury to the lower esophagus was re-operated, intra-operatively. One patient had mesenteric injury; another patient had an NG tube stapled, while a third patient’s GE junction blew up because the balloon was inflated while doing the leak test. In addition, the serosal layer of ten patients came off while firing the first stapler. However, in spite of the presence of many such complications, only one case was aborted. In conclusion, LSG is a relatively safe surgical option for weight loss as a primary procedure.
Mohamed Saleh Ismail
University of Dammam, Kingdom of Saudi Arabia.
Title: Association between Dietary Calcium Intakes and Weight Loss
Time : 14:20-14:50
Biography:
Mohamed Saleh Ismail has completed his PhD at the age of 36 years from Minufiya University, Egypt. He has supervised 14 PhD and 26 Master theses in the field of human and clinical nutrition; also he published more than 20 papers in reputed journals and has been serving as a reviewer in several reputed journals e.g. Nutrition and Dietetics, Journal of Public Health etc. In addition, he translated three books from English to Arabic (Principles of Nutritional Assessment, Nutrition and Immunity in Human, and Simplified Diet Manual).
Abstract:
In recent years, several studies have reported a positive relationship between calcium intakes and weight loss, the highest the calcium intakes, the highest the weight loss. This association has shown in children, men, and younger and older women. Researchers calculated that a 300-mg increase in daily calcium intake was associated with a 3-kg difference in body weight (BW). The effect of higher calcium intake on BW is stronger in subjects with a larger fat mass. Two possible physiological mechanisms explained this relation. First: in cell cultures of human adipocytes, increasing 1,25(OH)2D levels can increase lipogenesis and decrease lipolysis. The concentration of 1,25(OH)2D increases when calcium intake is decreased. Second mechanism is fat binding in the gut, increasing dietary calcium intake increases the calcium concentration in the intestine, which in turn induces formation of insoluble fatty acid and bile acid soaps that are excreted through the feces, thus decreasing the amount of dietary fat available for oxidation and/or storage. In clinical trials, increasing dietary calcium intake by 905–4,000/ day increased fecal fat excretion by up to 8.2 g per day. Moreover, diets containing high amounts of proteins and calcium have shown to decrease BW. Nevertheless, studies reported a greater reduction in BMI when calcium is derived from dairy products rather than from supplements. Finally, there may be a threshold for calcium intake (800 mg/day) above which no additive beneficial effect exists. Some researchers believe that suboptimal calcium intake may increase the risk of developing obesity.
Vinod Kumar Singhal
Prime Hospital and Healthcare Group, UAE
Title: Sleeve Gastrectomy for Weight Reduction in Personal Perspective, Results of Surgery done in 5 Years
Time : 14:50-15:20
Biography:
Dr Vinod Kumar Singhal is extensively trained in GI Surgery (2001-2004) from one of the premier institute in India. Subsequently he obtained further education and training in advanced laparoscopic procedures for morbid obesity, from stalwarts in the field. Now working as GI, Bariatric and Advanced Laparoscopic Surgeon (Chair & Head- Department of General, Metabolic and Bariatric Surgery, Prime Healthcare, Dubai), practice is dedicated to the field. He is recognized with fellowship, by Royal College of Surgeons in England, Glasgow, Ireland, America. Serving proudly as member of foundation committee for European board (Metabolic and Bariatric Surgery).
Abstract:
An introduction to history and physiological basis, ideal patient selection and present role of sleeve gastrectomy in management of obese patients will be discussed. Technical details, alternative surgical approaches and intra-operative difficulties during sleeve gastrectomy like size of bougie, size of antrum, handling of hiatus and instrument failure will be discussed. Associated complications and best way to identify prevent and management will also be discussed. Surgical outcome of sleeve gastrectomy on resolution of obesity and associated comorbidities will be reviewed. Video presentation highlighting important steps will also be shown.
Biography:
Wojciech Konrad Karcz was born in August 7th 1970 Groß Sthrelitz. Currently he working as Head of Metabolic and Obesity Surgery, University of Lubeck, Germany.He graduated from Silesian Medical University in 1989-1995 and completed his Scholarship for doctor’s degree in Surgery on Silesian School of Medicine (for 4 years) in 1995-1999, After Medical Doctor Degree in 1999 where he awarded surgeon’s National Board First Degree in Poland. After that he studied Management of Health Care Economy Academy in Katowitz 1999-2000 and he got his manager degree in 1999, he is the Manager of Medical Center for Esthetic, Vascular and Dermatological Surgery in 2000-2002. And Surgeon National Board Degree from Germany 2004. He worked as consultant and senior consultant at various Bariatric & Visceral Surgeries. He worked at University Clinic of General and Vascular Surgery (S.S.M.), Medical Center for Esthetic, Vascular and Dermatological Surgery & Clinic of General and Visceral Surgery. He is member of various international associations.
Abstract:
Obesity is a primary disease in which no obvious cause exists, except for the imbalance of energy intake and expenditure. Gastric bypass surgery is called the gold standard in the United States for surgical weight loss procedures. Longitudinal studies indicate weight loss surgery is effective as a long-term, even life-long solution. Almost the same therapeutic results could be reached with the Isolated Sleeve Resection. The number of LSG operation per year in Germany is nowadays even bigger than bypass procedures. There are also many other new procedures which are performed in numerous clinics. Let us see what surgical therapy for weight loss do we really have what results we are able to achieve, when and which surgical techniques should be used and maybe we will find out which procedure could be called the “Gold Standard†in 2015.
Mujahid Saeed
University Hospital Birmingham NHS Foundation Trust, United Kingdom
Title: Weight loss: Non-surgical strategies through newer drug therapies
Biography:
Mujahid Saeed is a Consultant Physician and Diabetologist at University Hospital Birmingham and Honorary Senior Lecturer at the University of Birmingham, UK. He was the top academic student at medical school and was awarded 5 gold medals. He undertook his Specialist Training in General (Internal) Medicine & Endocrinology and Diabetes at the prestigious Oxford Centre for Diabetes, Endocrinology and Diabetes. His day-to-day activities include managing patients with obesity. He has an active interest in research and has run studies on newer diabetes therapies including those resulting in weight loss. He has several publications in peer-reviewed journals.
Abstract:
There has been a flurry of anti-diabetic medications since 2005 and the list is ever-expanding. These newer therapies include, glucagon-like peptide-1 (GLP-1) analogues, dipeptidyl peptidase-4 (DDP-4) inhibitors and sodium glucose co-transporter 2 (SGLT-2) inhibitors. Prior to their introduction, diabetes management was plagued by the invariable notorious side-effect of weight gain with the use of sulfonyl ureas (~2-3 kg), thiazolidinediones (~2–3 kg) and in particular with insulin (~4-10 kg). The latter group of medications remain a massive deterrent to both healthcare professionals in terms of prescribing and patients in respects to adherence as weight gain is undesirable and results in poor body image, depression, hypertension, hyperlipidaemia and an increased rate of micro- and macro-vascular diabetic complications. The newer therapies, apart from their anti-diabetic properties offer the desired effect of weight reduction (~2-3 kg) or at least weight neutrality (DDP-4 inhibitors). More recently, a GLP-1 analogue has been approved for management of obesity with promising efficacy (mean weight reduction of ~4-5 kg) in both non-diabetic and diabetic subjects. These newer therapies add to the armamentarium of therapies in addressing the global pandemic of diabetes and or obesity. Some of these offer other health benefits including a reduction in systolic and diastolic blood pressure (~4/2 mm of Hg) and improvement in some markers of hyperlipidaemia. The mechanisms through which weight loss is targeted, the data from the trials and the use of these newer agents in medically managing the ever-increasing tide of diabetes and obesity will be examined.
Louise Langman
Flourish Psychology Ltd., United Kingdom
Title: Mindful eating, an ancient solution to modern day difficulties: Shifting the focus from weight to well-being
Biography:
Louise Langman is a Consultant Clinical Psychologist, Mindfulness Practitioner and recovered Yo-Yo Dieter. She has more than twenty years experience of providing professional, evidence-based individual and group therapy to individuals of all ages across the spectrum of psychological distress and relational difficulties. Since completing her Professional Doctorate in Clinical Psychology in 2010, she has been working with the National Health Service and in private practice specializing in eating distress and Bariatric Psychology. She is committed to reducing weight stigma and to helping individuals reach their potential and experience well-being and resilience in all facets of life. She is currently South West Chair Elect of the British Psychological Society and Clinical Director at Flourish Psychology Ltd., UK.
Abstract:
Louise Langman is a Consultant Clinical Psychologist, Mindfulness Practitioner and recovered Yo-Yo Dieter. She has more than twenty years experience of providing professional, evidence-based individual and group therapy to individuals of all ages across the spectrum of psychological distress and relational difficulties. Since completing her Professional Doctorate in Clinical Psychology in 2010, she has been working with the National Health Service and in private practice specializing in eating distress and Bariatric Psychology. She is committed to reducing weight stigma and to helping individuals reach their potential and experience well-being and resilience in all facets of life. She is currently South West Chair Elect of the British Psychological Society and Clinical Director at Flourish Psychology Ltd., UK.
Jos Runhaar
Erasmus MC University Medical Center Rotterdam, The Netherlands
Title: Weight loss and knee osteoarthritis prevention in overweight and obese women
Biography:
Jos Runhaar has completed his PhD at Erasmus MC University Medical Center Rotterdam (2013). Currently he works as Post-doctoral researcher at the Department of General Practice of Erasmus MC. His works focusses on the effects and treatment of obesity and on physical exercise as treatment/preventionof knee osteoarthritis. He also is a full member of the European D-BOARD consortium. His work has been recognized by the OARSI by means of a Collaborative Scholarship in 2013. This allowed him to become a fellow at the University of Pittsburgh to study the biomechanics of obese women using the advanced imaging techniques.
Abstract:
Overweight is one of the major risk factors for knee osteoarthritis (OA) development. Despite this knowledge, the first ever preventive randomized controlled trial in OA research was recently completed. This study aimed to evaluate the effect of weight loss, through apragmatic tailor-made lifestyle intervention, on the incidence of knee OA after 30 months in a high-risk group of 407 middle-aged overweight and obese women. The lifestyle intervention was effective in reducing body weight at short follow-up (12 months), but not at long-term (30 months). Subgroup analysis, using Latent Class Growth Analysis, showed weight loss in mainly achieved by women with greater weight gain in recent years. The lack of a significant reduction in body weight after 30 months probably led to a non-significant effect on the incidence of knee OA. In total, 17% of all women achieved the predefined target of 5 kg/5% weight loss after 30 months. Incidence of knee OA was significantly reduced in women achieving the weight loss target (OR 0.5 [0.3-0.9] for combined clinical and radiographic knee OA and OR 0.3 [0.1-0.9] for radiographic knee OA). Moreover, blood glucose levels (HbA1c), fat percentage, waist circumference and blood pressure were significantly reduced among women achieving 5 kg/5% weight loss. Using the results of the first ever preventive trial in OA research, we now aim to design a more effective lifestyle intervention that achieves greater weight loss after long-term follow-up. Potentially, this will effectively increase health and reduce the incidence of knee OA among middle-aged women.
Seham Alsaif
University of Liverpool, UK
Title: The effect of visfatin and dyslipidemia on uterine contractility
Biography:
Seham Alsaif has completed his Honor’s MRes Degree from University of Liverpool. She is pursuing her PhD at the University of Liverpool with recent distinction award. She is a Clinician Sponsored by University of Dammam, KSA. She has published two papers.
Abstract:
Adipose tissue secretes adipokines which have been linked to the pathophysiology of pregnancy-related complications. Visfatin is a recently discovered adipokine whose levels were reported to be increased during obesity and pregnancy. The aim of this study is to examine the effect of visfatin on mouse myometrial contractility, both wild type and APOE knockouts (hyperlipidemia model). Myometrial strips from term non pregnant and pregnant Wild Type (WT) and APOE Knock-Out (KO) mice were dissected, super fused with physiological saline and the effects of visfatin (10 nM–150 nM), on spontaneous and oxytocin-induced contractions (0.5-1 nM) were studied. After regular contractions were established, contractility was examined for control of 100% and test response at 37°C for 10 min. Visfatin had a relaxant effect on pregnant mouse myometrium. This effect was small in pregnant tissue contracting spontaneously. For example, in the pregnant WT myometrium, 10-150 nM visfatin produced a reduction in the 5 min area under the curve (AUC) of 95±3%, (n=8), However under more physiological conditions, oxytocin-induced contractions, a larger decrease was found (AUC=76±9%, n=4), mean±SEM. In the dyslipidemia APOE KO, the stimulation by oxytocin was reduced the AUC by (97±6%, n=4) compared to spontaneous contractions (104±4%, n=5). Together these data suggest that increased output of visfatin and dyslipidemia in obese pregnant women may impair uterine contractility resulting in labor related complications.
Ahmad Alkhatib
Qatar University, Qatar
Title: Natural Herbs for Weight Loss: Recent Findings of Exercise-dependent Augmented Effects
Biography:
Ahmad Alkhatib is an accredited nutritionist (RNutr) and a certified sport Nutritionist (CISSN), and an Associate Professor in Clinical Physiology and Exercise Metabolism. He has held several leading academic positions over the past twenty years at several UK universities including Sheffield Hallam, Lincoln, Greenwich, Essex and Middlesex, before recently heading and developing the Sport Science department at Qatar University. His recent research focuses on optimizing health and exercise performance and preventing cardiovascular disease through novel nutritional and physical activity interventions. He has over sixty research publications and has won several excellence research and academic awards.
Abstract:
Natural herbs have been in use for weight loss purposes since the history began. However, the global obesity epidemic and the rise in obesity-related chronic diseases, including type-II diabetes and cancer, have highlighted the need for novel and effective approaches for herbal remedies. Whilst the popularity of several prescribed and non-prescribed slimming aids and herbal plant supplements have been marketed for their weight loss efficacy, single and multi-ingredient herbal supplements are still being investigated for their single or combined weight loss benefits. Limited research have highlighted an interesting efficacy for several popular herbal plant supplements including caffeine and capsaicin, Ayurvedic preparations and herbal teas, resulting in various degrees of effectiveness including thermogenic, appetite control and psychological benefits such as mood state. Recent research has suggested acute augmented weight-loss effects of combining herbal ingestion with exercise. For example, ingesting green tea, yerba mate and/or caffeine have been shown to increase metabolic rate, and augmented fatty acid metabolism and increase energy expenditure from fatty acid sources during exercise with various intensities, particularly low and moderate intensities. Other promising weight-loss effects have also been also reported for multi-ingredient herbal supplements, particularly those that are rich in phytochemicals and caffeoyl derivatives. Combining herbal ingestions with exercise still require further research in order to establish the supplement’s most effective protocols in terms of dosage and timing, and the long-term benefits, particularly those related to exercise protocols and exercise adherence.