Official Organ of EASO Editorial Representatives ...

Vol. 9, Supplement 1, June 2016

Official Organ of

Editor-in-Chief

Editorial Board

EASO

Hans Hauner, München

Hans-Rudolf Berthoud, Baton Rouge, LA Ellen Blaak, Maastricht Karine Clément, Paris Stefan Engeli, Hannover I. Sadaf Farooqi, Cambridge Gema Frühbeck, Pamplona Susanna Hofmann, Neuherberg Martin Klingenspor, Freising Max Lafontan, Toulouse Julian G. Mercer, Aberdeen Vidya Mohamed-Ali, London Dénes Molnár, Pécs Ruben Nogueiras, Santiago de Compostela Jean-Michel Oppert, Paris Andreas F. Pfeiffer, Potsdam Paul T. Pfluger, Neuherberg Stephan Rössner, Bromma Jacob C. Seidell, Amsterdam Antonio J. Torres, Madrid Christian Vaisse, San Francisco, CA

Editorial Representatives Ellen Blaak, Maastricht Hermann Toplak, Graz DAG

Deutsche Adipositas-Gesellschaft

Editorial Representative Martin Wabitsch, Ulm Affiliated with IFSO-EC

International Federation for the Surgery of Obesity and Metabolic Disorders – European Chapter

Editorial Representative Martin Fried, Prague

Assistant Editor

Nora Klöting, Leipzig Associate Editor

Jennifer Lyn Baker, Frederiksberg Matthias Blüher, Leipzig John E. Blundell, Leeds Ulrich Cuntz, Prien Carl-Erik Flodmark, Malmö Martin Fried, Prague Vojtech Hainer, Prague Berit L. Heitmann, Copenhagen Anja Hilbert, Leipzig Anke Hinney, Essen Christina Holzapfel, Munich Jan Kopecký, Prague John Kral, Brooklyn, NY Bernhard Ludvik, Vienna Dragan Micic, Belgrade Manfred J. Müller, Kiel Annette Schürmann, Potsdam Yves Schutz. Lausanne Pedro Teixeira, Lisbon Hermann Toplak, Graz Matthias Tschöp, Neuherberg Haijun Wang, Beijing Kurt Widhalm, Vienna Tommy Visscher, Zwolle

Founding Editor

Johannes Hebebrand, Essen

S. Karger GmbH P.O. Box D-79095 Freiburg Editorial Office Attn. Dr. Sven Riestenpatt

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European Association for the Study of Obesity

Imprint Obesity Facts 2016;9(suppl 1):II

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Bibliographic Services Index Medicus/MEDLINE Science Citation Index Expanded SciSearch® Current Contents®/ClinicalMedicine Journal Citation Reports/Science Edition Supplement 1/2016 ISBN 978-3-318-05895-6 e-ISBN 978-3-318-05896-3

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ISSN Print Edition: 1662–4025 ISSN Online Edition: 1662–4033

Vol. 9, Supplement 1, June 2016

European Obesity Summit (EOS) – Joint Congress of EASO and IFSO-EC Gothenburg, Sweden, June 1 – 4, 2016

Basel · Freiburg · Paris · London · New York · Chennai · New Delhi · Bangkok · Beijing · Shanghai · Tokyo · Kuala Lumpur · Singapore · Sydney

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ABSTRACTS

Committee Obesity Facts 2016;9(suppl 1):IV

PROGRAMME ORGANISING COMMITTEE (POC) Chair Lauren Lissner (Sweden) Co-Chair Ingvar Bosaeus (Sweden) Co-Chair Carl-Erik Flodmark (Sweden)



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Jennifer Baker (Denmark) Rachel Batterham (UK) Ellen Blaak (Netherlands) Susanne Dickson (Sweden) Nathalie Farpour-Lambert (Switzerland) Alberic Fiennes (UK) Martin Fried (Czech Republic) Gema Frühbeck (Spain) Jason Halford (UK) Charlotte Hardman (UK) Jens-Christian Holm (Denmark) Dragan Micic (Serbia) Paulina Nowicka (Sweden) Torsten Olbers (Sweden) Ralph Peterli (Switzerland) Gabriela Roman (Romania) Harry Rutter (UK) Mikael Rydén (Sweden) Michel Suter (Switzerland) Hermann Toplak (Austria) Mikael Wiren (Sweden) Volkan Yumuk (Turkey)

Contents Obesity Facts 2016;9(suppl 1):V

JOINT PLENARY SESSIONS EASO / IFSO-EC Wednesday, 1 June, 2016 JOPL - Joint Opening Plenary Lecture: Lessons from SOS

1

Thursday, 2 June, 2016 PL 1 – When do you treat Type II Diabetes with Surgery

1

Friday, 3 June, 2016 PL 4 – Effects of obesity and bariatric surgery on pregancy

2

Saturday, 4 June, 2016 PL 9 – Long term effects of bariatric surgery

3

JOINT REVIEW/WORKSHOP SESSIONS EASO / IFSO-EC Thursday, 2 June, 2016 RS 15 – Mechanisms in bariatric surgery RS 28 – Mental health and behavior after bariatric surgery

5 6

EASO PLENARY SESSIONS Thursday, 2 June, 2016 PL 2 – Sustainable Choices

7

Friday, 3 June, 2016 PL 5 – Re-thinking Appetite Regulation: the role of Energy Expenditure and its relationship to Energy Intake

7

Saturday, 4 June, 2016 PL 7 – P ros and cons of the diagnosis Food Addiction for tackling the obesity epidemic

8



Wednesday, 1 June, 2016 RS 1 – Personalised treatment of obesities RS 2 – Browning of WAT RS 3 – Novel drug targets for appetite and obesity RS 4 – Nutrition: from science to practice (with EFAD)

9 9 10 10

Thursday, 2 June, 2016 RS 5 – New aspects on metabolic control RS 6 – Weight maintenance: is it achievable? RS 7 – Childhood obesity across Europe RS 8 – Microbiome RS 11 – Fiscal measures: taxes, subsidies, incentives RS 13 – Interorgan crosstalk RS 14 – Obesity and cancer

11 12 13 14 15 16 16

Friday, 3 June, 2016 RS 16 – Ectopic fat

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EASO REVIEW/WORKSHOP SESSIONS

Contents Obesity Facts 2016;9(suppl 1):VI

RS 17 – Appetite and pleasures RS 18 – How to address social inequalities in childhood obesity RS 19 – How do you manage weight re-gain and comorbidities after surgery? RS 20 – Ethical and Moral Challenges: Obesity as a Socially Defined Disease RS 23 – Immuno metabolism RS 24 – Cognitive sensory control of meal size RS 25 – Metabolically healthy obesity RS 27 – State of the art management in the elderly

18 19 20 20 20 21 22 23

Saturday, 4 June, 2016 RS 29 – Adipogenesis RS 30 – Physical activity and nutritional assessment in children RS 32 – Can we learn anything from Omics?

24 25 27

EASO SYMPOSIA Wednesday, 1 June, 2016 AS 1 – The I.Family cohort: Childhood obesity in relation to genes, families and environments AS 2 – Translating Health-Related Quality Of Life (HRQOL) Research into Clinical Practice for Adults and Youth Thursday, 2 June, 2016 AS 3 – Eating, addiction and behaviour: a psychological perspective AS 4 – Environmental Chemicals and Obesity: Focus on Mechanisms AS 5 – M obile and wireless technology (mHealth) to combat child and youth obesity: Exploring the scope for prevention and treatment Friday, 3 June, 2016 AS 7 – I nteractions of individual and contextual factors related to obesity-related behaviours and obesity in Europe AS 8 – Long term health consequences of childhood obesity AS 9 – E veryBODY Matters: Addressing weight stigma in research, practice, and policy AS 10 – P revention of type-2 diabetes in overweight and obese – first results from the large PREVIEW Project

28 29 30 30 30

31 31 31 32



Wednesday, 1 June, 2016 OS 1 – Prevention and Behaviour OS 2 – Adipose Tissue Metabolism OS 3 – Clinical Management I

33 36 39

Thursday, 2 June, 2016 OS 7 – Growth/Early Life

41

Friday, 3 June, 2016 OS 8 – Inter-organ crosstalk

44

Saturday, 4 June, 2016 OS 11 – Clinical management II OS 12 – Obesity and (cardio)metabolic risk

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EASO ORAL SESSIONS

Contents Obesity Facts 2016;9(suppl 1):VII

EASO POSTER PITCHES Thursday, 2 June, 2016 PP 1 – Basic Science and Experimental Approaches PP 2 – Health, Behaviour and Environment I PP 3 – Clinical Management I

54 60 64

Friday, 3 June, 2016 PP4 – Health, Behaviour and Environment II PP5 – Clinical Management II

71 75

EASO POSTERS Wednesday, 1 / Thursday, 2 June, 2016 PO 1 – Basic Science and Experimental Approaches I PO 1 – Health, Behaviour and Environment I PO 1– Clinical Management I PO 2 – Basic Science and Experimental Approaches II

82 109 151 179

IFSO-EC PLENARY SESSIONS Thursday, 2 June, 2016 PL 3 – Internal hernias after laparoscopic gastric bypass

271

Friday, 3 June, 2016 PL 6 – Which operation for T2DM?

272

Saturday, 4 June, 2016 PL 8 – Plastic Surgery after massive weight loss

272

IFSO-EC REVIEW/WORKSHOP SESSIONS Thursday, 2 June, 2016 RS 9 – Young IFSO Session: Long-term side effects of bariatric surgery RS 10 – Complications RS 12 – Value of registries

274 276 279

Friday, 3 June, 2016 RS 21 – How different national health care systems influence quality the management of the bariatric patient RS 22 – Innovation vs evidence RS 26 – Video Session – How do I do it

281 282 284

Saturday, 4 June, 2016 RS 31 – Long term side effects of bariatric surgery

285

IFSO ORAL SESSIONS



287 290 292

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Thursday, 2 June, 2016 OS 4 – Effect of surgery on T2DM / Managing poor weight loss OS 5 – Miscelaneous OS 6 – Video session – Revisional surgery

Contents Obesity Facts 2016;9(suppl 1):VIII

IFSO-EC SYMPOSIA Friday, 3 June, 2016 AS 6 – Bariatric Surgery in adolescents OS 9 – Mechanisms of metabolic surgery / Effect of surgery on commorbidities other than T2DM OS 10 – Multidisciplinary approach / Bariatric and metabolic surgery in extremes of age Saturday, 4 June, 2016 OS 13 – Abstract Prize (voting session)

IFSO-EC POSTERS

PO 3 – Bariatric and metabolic treatment approaches

295 296 276 303

307



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Author Index 349 ImprintII

Abstracts Obesity Facts 2016;9(suppl 1):1-368 DOI:10.1159/000 446744

JOINT PLENARY LECTURES Wednesdy, 1 June, 2016

Thursday, 2 June, 2016

JOPL - Joint Opening Plenary Lecture: Lessons from SOS

PL1 – When do you treat Type II Diabetes with Surgery

Carlsson L

Background and aims The Swedish Obese Subjects (SOS) study is a prospective, controlled intervention trial examining effects of bariatric surgery on mortality and other hard endpoints. The surgery group (n=2010) underwent gastric banding (n=376), vertical banded gastroplasty (n=1369), or gastric bypass (n=265). Controls (n=2037) received customary obesity treatment. The study is ongoing and has a mean follow-up of over 20 years. Inclusion criteria were age 37–60 years and BMI >34 in men and >38 in women. Anthropometry, blood pressure, biochemical variables and electrocardiography were measured at regular intervals and participants complete questionnaires capturing lifestyle factors. Drug use, inpatient and outpatient care, cancer and mortality are traced by searching Swedish National Health Registers. Results from the SOS study have shown that bariatric surgery reduces premature mortality,1 incidence of cancer,2 myocardial infarction and stroke,3 prevents diabetes,4 and induces diabetes remission and prevents diabetes complications.5 For health-care costs6,7 we observe drug cost savings after surgery in patients with diabetes and prediabetes, and cost-neutrality for overall healthcare costs for surgery versus usual care for patients with diabetes7. My lecture will summarize published results and recent unpublished data from the SOS study. References 1. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med 2007;357:741-52. 2. Effects of bariatric surgery on cancer incidence in obese patients in Sweden (Swedish Obese Subjects Study): a prospective, controlled intervention trial. The Lancet Oncology 2009;10:653-62. 3. Cardiovascular events after bariatric surgery in obese subjects with type 2 diabetes. Diabetes Care 2012;35:2613-7. 4. Bariatric surgery and prevention of type 2 diabetes in Swedish obese subjects. N Engl J Med 2012;367:695-704 5. Association of bariatric surgery with long-term remission of type 2 diabetes and with microvascular and macrovascular complications. JAMA 2014;311:2297-304. 6. Health care use during 20 years following bariatric surgery. JAMA 2012;308:1132-41. 7. Health-care costs over 15 years after bariatric surgery for patients with different baseline glucose status: results from the SOS study. Lancet Diabetes Endocrinol 2015;3:855-65. Disclosure: L Carlsson has obtained lecture fees from AstraZeneca, Johnson&Johnson and MSD.

Abstracts

PL1.01

What is the evidence of BMI? Schauer, P. USA

The observation that bariatric or metabolic surgery can lead to full diabetes remission or substantial improvement was evident in the 1990’s; yet it was not until 2009 that major diabetes organizations such as the American Diabetes Association included metabolic surgery as a treatment modality for type 2 diabetes (T2DM). Due to limited randomized controlled trials comparing surgery to medical treatment of T2DM and limited longterm results, such guidelines were relatively weak in supporting surgical treatment. Since 2009, 11 RCT’s comparing surgery to medical treatment of T2DM have been published in high impact journals including NEJM and JAMA. These studies with follow-up duration of 1–5 years involve nearly 1000 patients without surgical mortality, and major complication rates of less than 5% and reoperation rate of 8%. All 11 RCT’s have shown superiority of surgery over medical management at achieving remission or glycemic improvement. In addition, the Swedish Obesity Subject study (non-randomzied) and 9 other comparative studies (non randomized) have shown either reduction in all cause mortality, and/or reduction in CV morbidity/mortality and microvascular complications associated with surgery vs. medical management of T2DM. At the 2015 London Diabetes Surgery Summit new guidelines for surgery based on current evidence have been proposed. Based on such evidence, metabolic surgery is recommended to treat T2DM in patients with Class III obesity (BMI≥40 kg/ m2) and in those with Class II obesity (BMI 35.0-¬39.9 kg/m2) when hyperglycemia is inadequately controlled by lifestyle and optimal medical therapy. Surgery should also be considered for patients with T2DM and BMI 30.0-¬34.9 kg/m2 if hyperglycemia is inadequately controlled despite optimal treatment with either oral or injectable medications. These BMI thresholds should be reduced by 2.5 kg/m2 for Asian patients.

PL1.02

Metabolic surgery in the treatment algorithm for type 2 diabetes: A Joint Statement by International Diabetes Organizations Francesco Rubino,* David M. Nathan, Robert H. Eckel, Philip R. Schauer, K. George Alberti, Paul Z. Zimmet, Stefano Del Prato, Linong Ji, Shaukat M. Sadikot, William H. Herman, Stephanie A. Amiel, Lee M. Kaplan, Gaspar Taroncher-Oldenburg, David E. Cummings* Writing on Behalf of the Delegates of the 2nd Diabetes Surgery Summit * FR and DEC chaired the writing committee for this report. Background. Despite growing evidence that bariatric/metabolic surgery powerfully improves type 2 diabetes (T2DM), existing diabetes treatment algorithms do not include surgical options. Aim. The second Diabetes Surgery Summit (DSS-II), an international consensus conference, was convened in collaboration with leading dia-

Obesity Facts 2016;9(suppl 1):1–368

1

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Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

PL1.04

Critical evaluation of metabolic surgery in obese diabetic patients Schernthaner G Department of Medicine I, Medical University of Vienna, Vienna, Austria

According to the early meta-analysis of Buchwald (1) a high remission (80%) of type 2 diabetes (T2DM) was assumed after bariatric surgery (BS), but more than 50% of the patients were lost in the short follow-up of only two years. In a recent review (2) only 6 diabetes studies out of 7.877 BS reports could be identified with a follow up of 80% of the entire study cohort for at least 2 years. More recent studies (3-5) show much lower remission “ rates of only 7-42% after BS in T2DM patients. Since several studies have demonstrated that patients with more severe and less well-controlled T2DM, as determined by insulin use, high HbA1c and/ or fasting glucose level and/or longer duration of disease are less likely to experience remission of T2DM after BS, the use of the recently described diabetes remission score might be helpful (6) to select T2DM patients who have the best outcome. Remarkably, longer observation studies indicate also a re-occurence of T2DM associated with regain of body weight. A recent prospective UK study (7) of 826 obese T2DM patients showed a remission (HbA1c