Metabolic syndrome is associated with obesity and an important trigger for bariatric care, including weight-loss surgery. As the obesity epidemic has spread worldwide, better insight into this syndrome is an important piece of clinical care for patients with obesity, within and beyond bariatric surgery.
This afternoon, from 2:30 to 3:30 pm, Walter J. Pories, MD, FACS, will tackle the issue in the 2025 Metabolic and Bariatric Surgery Lecture (NL08), “Unraveling the Metabolic Syndrome.”
Dr. Pories is an emeritus professor, Founding Chair of the Department of Surgery at East Carolina University in Greenville, North Carolina, and a retired US Marine Corps colonel. His remarkable career has included numerous achievements in research, as well as a unique status as one of the founders of bariatric surgery.
“There’s quite a battle about the metabolic syndrome,” Dr. Pories said. He explained that a long-running debate has focused on whether high blood glucose levels, high low-density lipoprotein cholesterol levels, low high-density lipoprotein cholesterol levels, central obesity, and hypertension are effects of obesity or common health conditions that incidentally accompany obesity.
Dr. Pories will attempt to answer this question during his lecture in part by presenting his own research, which has included the Longitudinal Assessment of Bariatric Surgery, which was supported by the National Institute of Diabetes and Digestive and Kidney Diseases. It engaged an early cohort of gastric bypass patients who he and his team tracked for 16 years, starting in 1980, with a remarkable 95% follow-up.
This study helped establish that gastric bypass surgery can lower blood glucose levels from diabetic to normal levels within 6–8 days of surgery, which suggests that eliminating a dysmetabolic signal, rather than postoperative weight loss, is responsible for the shift. Given that multiple benefits (ranging from elimination of sleep apnea to improved cardiovascular health) also can result from the single procedure “means that not only that there is a metabolic syndrome, but it is broader than high blood pressure, obesity, and diabetes,” Dr. Pories said.
In addition to further explaining the research that led to this conclusion, Dr. Pories will discuss the questions this finding raises: “If that is true, how do you explain it? The only intervention is to keep food out of the stomach, but it suggests that there is a signal from the stomach that leads to this.”
With close colleagues, particularly G. Lynis Dohm, PhD, of the East Carolina University Department of Physiology, Dr. Pories has worked on clarifying what that signal might be. The results he will discuss include insights into underlying molecular biology, with particular attention to fat storage, energy production, and lactic acid levels.
Although formally called the Metabolic and Bariatric Surgery Lecture, Dr. Pories’s lecture will not probe into the specifics of bariatric surgical techniques. Rather, he will focus on how research into bariatric surgery has led to data-driven clarifications of the pathophysiology of obesity and related conditions.
Obesity now affects 42% of US adults and is predicted to soon affect roughly half of all adults, and one in every four US adults has diabetes at present. As a result, the implications of this finding are immense. Indeed, Dr. Pories noted the association of obesity with nearly three in every four deaths in the US.
As a result, surgeons in nearly every surgical discipline are encountering the affected population in the clinic and may want to attend this lecture.
“It applies to so many patients,” Dr. Pories said.
The Metabolic and Bariatric Surgery Named Lecture is sponsored by the American Society for Metabolic and Bariatric Surgery (ASMBS). The ASMBS is the largest scientific organization dedicated to metabolic and bariatric surgery and has collaborated with the ACS on the development of the ACS Metabolic and Bariatric Surgical Quality Improvement Program.
Ann M. Rogers, MD, FACS, a professor of surgery at Penn State Health in Hershey, Pennsylvania, and ASMBS past president, will serve as the presiding officer, and Marina Kurian, MD, FACS, who is a clinical professor of surgery at New York University (NYU) Langone Health and NYU Grossman School of Medicine in New York City, will introduce Dr. Pories.
