Endocrine Abstracts

Bariatric surgery has had to change its name because as a ‘weight loss treatment’ it was far less successful than as a ‘health gain treatment’. The focus now is on metabolic surgery and no longer on just reducing kilograms but rather on improving organ function. The organs that appear to benefit most are those damaged by the combination of type 2 diabetes and excess adipocytes. At the heart of success of surgery is the significant gut adaptation which then drives multiple visceral signals. At the same time there has been improvements in nutrition, medicines and medical devices interventions for metabolic control. The question now arise whether we can do ‘knifeless surgery’ and still get all the benefits we have become accustomed to? We know that metabolic surgery can acutely improve health and maintain the health benefits for decades. At the same time we have seen improvements in nutritional science, medication, and medical devices, but maybe we have been asking the wrong question. Maybe we shouldn’t try to achieve knifeless surgery, but instead combine all our efforts, using the knife plus nutrition plus medication plus medical devices. What we now need is to find a more personalised medicine approach in getting the right treatment or treatment combination to the right patient at the right time. The options are endless, but we still need to define what it is we really want to achieve.