Scientific Program

Conference Series Ltd invites all the participants across the globe to attend 2nd International Conference on Metabolic and Bariatric Surgery Rome, Italy.

Day 2 :

Keynote Forum

Claudio Blasi

ASLRMB-1D hospital diabetes center, Italy

Keynote: The vagal system as a mediator of the therapeutic effects of bariatric surgery

Time : 10:35-11:10

Conference Series Bariatric Surgery 2017 International Conference Keynote Speaker Claudio Blasi photo
Biography:

Dr. Claudio Blasi graduated in medicine from Rome “La Sapienza” University at the age of 27 and did a postgraduate specialization in endocrinology at “La Sapienza” School of Medicine. He has been the director of the ASLRMB-1D hospital diabetes center in Rome. He has published more than 30 papers in reputed journals.

Abstract:

Obesity and type 2 diabetes are chronic diseases that respond with difficulty to drug therapies and lifestyle changes. At the origin of this resistance to treatment, an alteration in the functioning of brain sectors in charge of the reward system and of the energy homeostasis, due to a modification of synaptic transmission, has been hypothesized. Overfeeding, presumably beginning as a psychological compulsive search for a rewarding stimulus, turns into food addiction due to the adaptation of synapses in the reward circuit in response to the increased intensity of the inputs (synaptic plasticity). The same would apply to the brain areas responsible for the maintenance of energy homeostasis. The afferent vagal paths transmit to the brain information about ingested food from the digestive tract. Their intermediate station in the brainstem, the vagal nucleus of the solitary tract, has an important role in modulating the metabolic function of the liver and the pancreas. Moreover, they work as a channel for the transmission of information from the periphery to the CNS with regard to both favorable and adverse events. In this way, they influence the synaptic activity of various brain areas through neuroplasticity. The profound anatomical and functional changes in the vagal system caused by bariatric surgery could explain the dramatic improvement in diabetes and the renewed sensitivity to diet by a normalization of synaptic activity. In the future, modulating pharmacologically vagus-vagal synaptic connections or driving brain plasticity via stimulation of the vagus afferents could obtain, “knifelessly”, the same therapeutic effects as surgery.

Keynote Forum

Signe Sørensen Torekov

University of Copenhagen, Denmark

Keynote: Obesity and GLP-1. Obesity pathophysiology and GLP-1 treatment potential

Time : 11:10-11:45

Conference Series Bariatric Surgery 2017 International Conference Keynote Speaker Signe Sørensen Torekov photo
Biography:

Associate Professor Signe Torekov has a strong background in metabolic translational research.

In collaboration with University of California her research has shown that infusion of the natural appetite hormone GLP-1 inhibits appetite and lowers blood glucose (2 first authorships in Diabetes, Obesity and Metabolism (Impact factor (IF) 6.2), 2011 and 2013). During the last three years, her research team has discovered that: 1) obese people have low endogenous GLP-1 response (first author in Diabetes (IF8.4), 2015); 2) weight loss induces a marked increase in GLP-1 response and that this is part of a successful maintenance of weight loss (last author in European Journal of endocrinology (IF4.1), 2016) (major media exposure: front page interview of The Times and live on BBC Today, April 2016 (7 mill listeners), and 3) treatment with GLP-1 analogues facilitate long term weight loss maintenance accompanied by substantial improvement in metabolic health, compared to diet-induced weight loss maintenance (Last author in Journal of Clinical Endocrinology and Metabolism (IF6.4) and International Journal of Obesity (IF5.4), 2015). Furthermore, by synergistically integrating metabolic physiology with novel state of the art mass spectrometry based proteomics and metabolomics, in collaboration with Professor Matthias Mann, Max Planck Institute, they have designed a novel experimental approach for clinical translational metabolism in order to identify new health markers in obesity (2. last author in Molecular Systems Biology, (IF 12.3) and last author in Metabolomics (IF3.7), 2016). In addition, Signe Torekov was awarded Major Discovery 2010-2015 for the her first author paper in Diabetes (IF8.4) 2014 where she, together with the research team, showed that Long QT Syndrome patients with mutations in KCNQ1 besides having prolonged cardiac arrhythmia, also have hyperinsulinemic hypoglycemia. More recently, Signe Torekov has shown that Long QT Syndrome patients with loss of function mutations in hERG display exaggerated incretin and endocrine pancreatic function and thus increased risk of symptomatic reactive hypoglycemia. Pharmacological blockade in rats and inhibition of hERG in β and L- cells had similar effects. Hypoglycemia leads to increased propensity for arrhythmias; hypoglycemia may therefore even further increase the risk of malignant arrhythmia in LQTS patients (published in Circulation (IF17) with Dr. Torekov as last and corresponding author).

Abstract:

Obesity impairs almost all aspects of health and is a global challenge to our healthcare system as the prevalence reaches 1 billion humans. Therefore, there is an acute need for better prevention and treatment strategies. Glucagon-like-peptide-1 (GLP-1), secreted from endocrine cells in the intestine upon meal intake, reduces food intake. We have previously shown that: 1) obese people have low endogenous GLP-1 response; 2) weight loss induces a marked increase in GLP-1 response, and 3) treatment with GLP-1 analogues facilitates long term weight loss maintenance (12 kg) accompanied by substantial improvement in metabolic health, compared to diet-induced weight loss maintenance. Chronic inflammation is an established part of the pathogenesis of obesity, and activation of macrophages and T cells in the expanded adipose tissue is coupled to the development of a pro-inflammatory state and insulin resistance. Interestingly, emerging evidence identifies GLP-1 as a potentially important immuno-modulator. GLP-1 decreases inflammation-associated gene and protein expression in macrophages and exerts anti-inflammatory actions in adipocytes and endothelial cells as well as potent anti-inflammatory effects in humans.

Keynote Forum

Signe Torekov

Associate Professor

Keynote: Obesity and GLP-1. Obesity pathophysiology and GLP-1 treatment potential

Time : 11:10-11:45

Conference Series Bariatric Surgery 2017 International Conference Keynote Speaker Signe Torekov photo
Biography:

Associate Professor Signe Torekov has a strong background in metabolic translational research.

In collaboration with University of California her research has shown that infusion of the natural appetite hormone GLP-1 inhibits appetite and lowers blood glucose (2 first authorships in Diabetes, Obesity and Metabolism (Impact factor (IF) 6.2), 2011 and 2013). During the last three years, her research team has discovered that: 1) obese people have low endogenous GLP-1 response (first author in Diabetes (IF8.4), 2015); 2) weight loss induces a marked increase in GLP-1 response and that this is part of a successful maintenance of weight loss (last author in European Journal of endocrinology (IF4.1), 2016) (major media exposure: front page interview of The Times and live on BBC Today, April 2016 (7 mill listeners), and 3) treatment with GLP-1 analogues facilitate long term weight loss maintenance accompanied by substantial improvement in metabolic health, compared to diet-induced weight loss maintenance (Last author in Journal of Clinical Endocrinology and Metabolism (IF6.4) and International Journal of Obesity (IF5.4), 2015). Furthermore, by synergistically integrating metabolic physiology with novel state of the art mass spectrometry based proteomics and metabolomics, in collaboration with Professor Matthias Mann, Max Planck Institute, they have designed a novel experimental approach for clinical translational metabolism in order to identify new health markers in obesity (2. last author in Molecular Systems Biology, (IF 12.3) and last author in Metabolomics (IF3.7), 2016). In addition, Signe Torekov was awarded Major Discovery 2010-2015 for the her first author paper in Diabetes (IF8.4) 2014 where she, together with the research team, showed that Long QT Syndrome patients with mutations in KCNQ1 besides having prolonged cardiac arrhythmia, also have hyperinsulinemic hypoglycemia. More recently, Signe Torekov has shown that Long QT Syndrome patients with loss of function mutations in hERG display exaggerated incretin and endocrine pancreatic function and thus increased risk of symptomatic reactive hypoglycemia. Pharmacological blockade in rats and inhibition of hERG in β and L- cells had similar effects. Hypoglycemia leads to increased propensity for arrhythmias; hypoglycemia may therefore even further increase the risk of malignant arrhythmia in LQTS patients (published in Circulation (IF17) with Dr. Torekov as last and corresponding author).

Abstract:

Obesity impairs almost all aspects of health and is a global challenge to our healthcare system as the prevalence reaches 1 billion humans. Therefore, there is an acute need for better prevention and treatment strategies. Glucagon-like-peptide-1 (GLP-1), secreted from endocrine cells in the intestine upon meal intake, reduces food intake. We have previously shown that: 1) obese people have low endogenous GLP-1 response; 2) weight loss induces a marked increase in GLP-1 response, and 3) treatment with GLP-1 analogues facilitates long term weight loss maintenance (12 kg) accompanied by substantial improvement in metabolic health, compared to diet-induced weight loss maintenance. Chronic inflammation is an established part of the pathogenesis of obesity, and activation of macrophages and T cells in the expanded adipose tissue is coupled to the development of a pro-inflammatory state and insulin resistance. Interestingly, emerging evidence identifies GLP-1 as a potentially important immuno-modulator. GLP-1 decreases inflammation-associated gene and protein expression in macrophages and exerts anti-inflammatory actions in adipocytes and endothelial cells as well as potent anti-inflammatory effects in humans.

Keynote Forum

Signe Torekov

Associate Professor

Keynote: Obesity and GLP-1. Obesity pathophysiology and GLP-1 treatment potential

Time : 11:10-11:45

Conference Series Bariatric Surgery 2017 International Conference Keynote Speaker Signe Torekov photo
Biography:

Associate Professor Signe Torekov has a strong background in metabolic translational research.

In collaboration with University of California her research has shown that infusion of the natural appetite hormone GLP-1 inhibits appetite and lowers blood glucose (2 first authorships in Diabetes, Obesity and Metabolism (Impact factor (IF) 6.2), 2011 and 2013). During the last three years, her research team has discovered that: 1) obese people have low endogenous GLP-1 response (first author in Diabetes (IF8.4), 2015); 2) weight loss induces a marked increase in GLP-1 response and that this is part of a successful maintenance of weight loss (last author in European Journal of endocrinology (IF4.1), 2016) (major media exposure: front page interview of The Times and live on BBC Today, April 2016 (7 mill listeners), and 3) treatment with GLP-1 analogues facilitate long term weight loss maintenance accompanied by substantial improvement in metabolic health, compared to diet-induced weight loss maintenance (Last author in Journal of Clinical Endocrinology and Metabolism (IF6.4) and International Journal of Obesity (IF5.4), 2015). Furthermore, by synergistically integrating metabolic physiology with novel state of the art mass spectrometry based proteomics and metabolomics, in collaboration with Professor Matthias Mann, Max Planck Institute, they have designed a novel experimental approach for clinical translational metabolism in order to identify new health markers in obesity (2. last author in Molecular Systems Biology, (IF 12.3) and last author in Metabolomics (IF3.7), 2016). In addition, Signe Torekov was awarded Major Discovery 2010-2015 for the her first author paper in Diabetes (IF8.4) 2014 where she, together with the research team, showed that Long QT Syndrome patients with mutations in KCNQ1 besides having prolonged cardiac arrhythmia, also have hyperinsulinemic hypoglycemia. More recently, Signe Torekov has shown that Long QT Syndrome patients with loss of function mutations in hERG display exaggerated incretin and endocrine pancreatic function and thus increased risk of symptomatic reactive hypoglycemia. Pharmacological blockade in rats and inhibition of hERG in β and L- cells had similar effects. Hypoglycemia leads to increased propensity for arrhythmias; hypoglycemia may therefore even further increase the risk of malignant arrhythmia in LQTS patients (published in Circulation (IF17) with Dr. Torekov as last and corresponding author).

Abstract:

Obesity impairs almost all aspects of health and is a global challenge to our healthcare system as the prevalence reaches 1 billion humans. Therefore, there is an acute need for better prevention and treatment strategies. Glucagon-like-peptide-1 (GLP-1), secreted from endocrine cells in the intestine upon meal intake, reduces food intake. We have previously shown that: 1) obese people have low endogenous GLP-1 response; 2) weight loss induces a marked increase in GLP-1 response, and 3) treatment with GLP-1 analogues facilitates long term weight loss maintenance (12 kg) accompanied by substantial improvement in metabolic health, compared to diet-induced weight loss maintenance. Chronic inflammation is an established part of the pathogenesis of obesity, and activation of macrophages and T cells in the expanded adipose tissue is coupled to the development of a pro-inflammatory state and insulin resistance. Interestingly, emerging evidence identifies GLP-1 as a potentially important immuno-modulator. GLP-1 decreases inflammation-associated gene and protein expression in macrophages and exerts anti-inflammatory actions in adipocytes and endothelial cells as well as potent anti-inflammatory effects in humans.

Keynote Forum

Lenwood W. Hayman

University of Michigan, USA

Keynote: Keynote: Development and Validation of the Children’s Emotional Eating Scale (ChEES)

Time : 09:05-09:40

Conference Series Bariatric Surgery 2017 International Conference Keynote Speaker Lenwood W. Hayman photo
Biography:

Lenwood Hayman, Assistant Professor of Public Health at the University of Michigan – Flint, focuses on the psychosocial determinants of eating behaviors in under-privileged communities. Specifically, Lenwood’s research focuses on the assessment of emotional eating (including stressed and bored eating) in preschool-aged children from low-income families. Lenwood has also worked with community-based organizations to demonstrate how increased participation in local food systems correlates with eating a healthier diet. Recently, Lenwood established the Mindful Promotion of Healthy Eating & Learning (Mind-PHEL) research team in which he studies the influence of mindfulness-based activities on healthy eating and positive student learning outcomes. Lenwood is in the process of developing a mindfulness-based intervention to encourage healthy eating behaviors in low-income communities.

Abstract:

Associations between the propensity to eat foods high in sugar and fat in response to negative emotions has been linked to a higher risk of obesity in multiple prior studies in adults. Emotional eating, however, has not been extensively studied in children, particularly among very young children from low-income families. Research suggests that low-income mothers of preschool-aged children believe that children in this age range can eat in response to their emotions, however, they tend to underreport the occurrence of emotional eating for their own children. Such findings could be due, in part, to the fact that the two most commonly-used questionnaires were developed in White, European populations. Due to contradicting evidence regarding the utility of current questionnaires to reliably assess emotional eating in very young children from low-income families in the United States, the focus of the current study was to develop such a scale. Specifically, we used a 2-aim, mixed-methods, cross-sectional design to develop a valid tool for assessing emotional eating at a population level in very young children from low-income families. In our previous work, we qualitatively assessed how mothers from US-based low-income populations conceptualized the construct of emotional-eating in preschool-aged children. We then used that data to develop an inventory of items to capture the salient aspects of emotional eating. These items were assessed by a sample of mothers from the target population for clarity and relatability. Those items demonstrating face- and content-validity, along with the child version of the Dutch Eating Behavior Questionnaire, were then used to collect data from a sample of 200 participants from the target population. Results and conclusions will be discussed in detail during conference session.

  • Young Researchers Forum
Speaker
Biography:

M Pishsaraeian has completed her MS degree in Exercise Physiology from University of Mazandaran, Babolsar. Iran. She is a teacher of Sport Science in High School of Tehran city and her field of interest is the evaluation of effects of sport and exercise on psychological and physiological factors.

Abstract:

Obesity is a major problem in many societies. One of the proposed solutions for the treatment of obesity is exercise. Exercise has complex effects on immune system. One of most important immunoglobulins in mucus is IgA that protect the body against microorganisms. The aim of this study was to evaluate the effect of aerobic exercise on the levels of IgA and total protein in salivary of female teenager students. 20 female healthy volunteer students (age 12-13) without any infection, using drug, cardiovascular diseases and with healthy diet randomly divided into control (n=10) and aerobic activity (n=10) groups. Before the exercise saliva samples were taken from each student and kept in suitable condition. Aerobic activity group performs the Shuttle Run Test for exercise and control group has no activity. After finishing the exercise the samples were collected and sent to laboratory for analysis. For detection of IgA the ELISA kit essay was used and the Bradford protein essay was used for the detection of total protein. Our results have indicated that in comparison with pre-test and post-test of aerobic activity group, the level of IgA concentration was significantly (P≤0/05) decreased but the total protein was increased (P≤0/05) significantly. There has been no significant change in the level of IgA between two groups. It is recommended that duration, type and intensity of physical activity be considered for prevention of infection.

  • Bariatric surgery for obesity and metabolic disorder
Location: Olimpica 4

Session Introduction

Sukaina Jaffar

Nepean Hospital, Australia

Title: Correlation between Laparoscopic Sleeve Gastrectomy outcomes and Mental Health

Time : 15:50-16:15

Speaker
Biography:

Sukaina Jaffar is working as a Surgeon in Nepean Hospital, Australia. Sukaina Jaffar has participated in National and International conferences in the field of
bariatric surgery and she has published many research articles in various International and National journals.

Abstract:

Background: High incidence of depression in obese populations is well-reported. While several studies examined the impact of weight loss outcomes after bariatric surgery on post-operative psychological well-being and vice-versa, fewer have analyzed influence of preoperative depression on post-operative weight loss outcomes. Furthermore, this question has been limitedly applied to Laparoscopic Sleeve Gastrectomy (LSG) versus other bariatric procedures.
 
Aim: Given the increasing utilization of LSG, we aim to evaluate the relationship between pre-operative Beck’s Depression Index (BDI) scores and post-operative weight outcomes.
 
Method: 117 patients underwent LSG. BDI, a validated tool for assessing psychometric properties was completed pre-operatively. Additional psychological history and medications were obtained during patient interview. Pre and post-operative BMI, percent Total Weight Loss (%TWL) and percent Excess Weight Loss (%EWL) were recorded.
 
Results: Among the 88 females and 29 males, the mean pre-operative weight and BMI is 123 kg and 42.7 kg/m2, respectively. Mean reduction in BMI post operatively at one year is 14 kg/m2. This equates to a median %TWL of 32%. The median BDI score is 14 (Range 0-52), correlating to ‘mild’ depression. Females reported a higher average BDI score. 39.6% and 33.3% of patients reported minimal and mild depression, respectively. Patients classified with severe BDI score, were less likely to lose more than the median TWL of 35.4 kg found in our cohort (OR: 0.32 95% CI 0.06-1.66).
 
Conclusion: In our cohort, an important association was found between pre-operative BDI scores and weight loss post LSG.
This highlights the significance of pre-operative assessment for depression and makes implications for the involvement of early
psychological services to improve both bariatric-specific and psychosocial outcomes.

Speaker
Biography:

Sukaina Jaffar is working as a Surgeon in Nepean Hospital, Australia. Sukaina Jaffar has participated in National and International conferences in the field of
bariatric surgery and she has published many research articles in various International and National journals.

Abstract:

Background: High incidence of depression in obese populations is well-reported. While several studies examined the impact of weight
loss outcomes after bariatric surgery on post-operative psychological well-being and vice-versa, fewer have analyzed influence of preoperative
depression on post-operative weight loss outcomes. Furthermore, this question has been limitedly applied to Laparoscopic
Sleeve Gastrectomy (LSG) versus other bariatric procedures.
Aim: Given the increasing utilization of LSG, we aim to evaluate the relationship between pre-operative Beck’s Depression Index
(BDI) scores and post-operative weight outcomes.
Method: 117 patients underwent LSG. BDI, a validated tool for assessing psychometric properties was completed pre-operatively.
Additional psychological history and medications were obtained during patient interview. Pre and post-operative BMI, percent Total
Weight Loss (%TWL) and percent Excess Weight Loss (%EWL) were recorded.
Results: Among the 88 females and 29 males, the mean pre-operative weight and BMI is 123 kg and 42.7 kg/m2, respectively. Mean
reduction in BMI post operatively at one year is 14 kg/m2. This equates to a median %TWL of 32%. The median BDI score is 14
(Range 0-52), correlating to ‘mild’ depression. Females reported a higher average BDI score. 39.6% and 33.3% of patients reported
minimal and mild depression, respectively. Patients classified with severe BDI score, were less likely to lose more than the median
TWL of 35.4 kg found in our cohort (OR: 0.32 95% CI 0.06-1.66).
Conclusion: In our cohort, an important association was found between pre-operative BDI scores and weight loss post LSG.
This highlights the significance of pre-operative assessment for depression and makes implications for the involvement of early
psychological services to improve both bariatric-specific and psychosocial outcomes.

  • Obesity
Location: Olimpica 4
Speaker
Biography:

Sandra is a health psychologist with research interests in chronic disease management and smoking cessation. She recently completed her doctorate in health psychology at the University of the West of England in Bristol, UK. She previously worked in the National Health Service (NHS) as a primary care and mental health researcher, an assistant psychologist and in research governance. She has also delivered consultancy work developing tailored stress management interventions within organisations and group settings. Alongside her research work, Sandra also works as a general advisor for the London Research Design Service team based at Queen Mary University, which involves supporting health professionals and research teams within the North East London area to develop their research ideas into full funding applications to the NIHR and other peer reviewed funders

Abstract:

Statement of the problem: The superiority of bariatric surgery for improving medical outcomes in severely obese individuals when compared to other weight loss interventions remains undisputed. However, knowledge about the psychological impact of the procedure on people’s lives is limited. Recent systematic reviews have shown persisting disordered psychosocial wellbeing after surgery when compared to control groups, especially after long-term monitoring, suggesting need for psychological support and longer term postoperative research on psychological outcomes. Research literature infers limited understanding regarding the postoperative lived experience from the patient perspective. This may form a barrier in health professionals’ understanding of this patient group’s postoperative ongoing needs. This study aimed to capture patients and health professionals’ accounts of the postoperative bariatric surgery experience, exploring concordance between the two groups to gauge awareness of patients’ subsequent health needs.
 
Methodology and theoretical orientation: Ten individuals who had bariatric surgery two or more years ago and eight bariatric surgery practitioners were recruited within UK public hospital settings and individually interviewed by the researcher. The audio recorded interviews were transcribed and examined using thematic analysis.
 
Findings: Thematic analysis of the interviews elicited a key finding around ‘postsurgical cliffs in patient care’ within a heavily structured service. This permeated through three themes; (1) navigating health changes (2) contrasting perspectives and (3) perceived prejudice. Participants reported some unmet needs; namely psychological aftercare to facilitate adjustment following physical and psychological changes. Issues with excess skin, acceptance of non-obese self and perceived prejudice were prominent. Impact of differing views of success between patients and professionals on postoperative care within the service context was highlighted.
 
Conclusion & Significance: Bariatric surgery is a great catalyst for weight loss in severe obesity. However, lack of psychological aftercare may threaten weight loss outcomes over the longer term. Findings infer postoperative psychological support as a potential facilitator for optimising results. Recommendations from a health psychology perspective are given.