MRC Integrative Epidemiology Unit (IEU) Seminar Series

Title: The evidence base for obesity surgery in the context of diabetes will be presented introducing the concept of surgery for the metabolic syndrome. 

Abstract: The shift from treating morbid obesity to treating obese morbidity will be discussed.Data on long-term outcomes after weight loss surgery will be presented demonstrating that recurrence of type 2 diabetes following initial remission is an issue. The need for aggressive treatment of type 2 diabetes postoperatively with reduction in cardiovascular risk will be highlighted. The paradigm of cancer treatment with combination treatment, surgical and medical will be discussed. Comparative data of best medical therapy compared to best medical therapy combined with weight loss surgery will be described. The need to focus on hard endpoints such as micro-vascular complications as an outcome measure after weight loss surgery will be suggested, as with all other treatment modalities used for type 2 diabetes. The shift of the focus from weight loss maintenance to obesity associated disease control will be highlighted.

Finally, the mechanism of action of gastrointestinal surgery will be examined. The effect of these manipulations of the gastrointestinal tract on appetite and glucose homeostasis will be reported focusing on gut hormones and bile acids. The changes in physiology in the context of anatomical alterations will be discussed demonstrating that the gut represents an important target for understanding and treating the disease of obesity.

Biography: Dimitri Pournaras is currently a Consultant in Upper Gastrointestinal and Bariatric Surgery at the North Bristol NHS Trust, UK. He graduated from the Aristotle University of Thessaloniki, Greece and undertook all his postgraduate training in the UK. He was awarded a Royal College of Surgeons of England Research Fellowship to conduct research on obesity, diabetes and metabolic surgery. Mr Pournaras completed his PhD in the Department of Investigative Medicine, Hammersmith Hospital, Imperial College London and then trained in oesophagogastric surgery in Cambridge and Norwich, UK. Following a Bariatric and Metabolic Surgery Fellowship approved by the Royal College of Surgeons of England in Musgrove Park Hospital, Taunton, he was appointed to his current position where he currently works as part of the multidisciplinary team.

Dr Pournaras serves on the Editorial Board for the journals Obesity Surgery and Clinical Obesity and has authored 48 peer-reviewed publications, including articles in The Lancet, the Annals of Surgery (the world’s most highly referenced surgery journal), the British Journal of Surgery and the British Medical Journal. He delivers more than 10 invited international lectures every year.

All welcome

It would be great to see as many people attend as possible and if you would like to speak to Dimitri separately, please get in touch with laura.corbin@bristol.ac.uk