The science of obesity is undergoing a revolution, as new research changes the way scientists think about how and why Metabolic and Bariatric Surgery works. Ethicon Endo-Surgery (EES) is helping drive that revolution by supporting clinical and pre-clinical research, including 13 studies being presented at the American Diabetes Association's (ADA) 72nd Scientific Sessions in Philadelphia (June 8-12). The studies investigate a range of cutting-edge approaches to Metabolic and Bariatric Surgery and evolve the current understanding of the mechanisms of action as a key means to finding new, more effective interventions for obesity, diabetes and other metabolic disorders.

(Logo: ) These studies are part of the EES Metabolic Applied Research Strategy (MARS), an ongoing initiative which aims to deconstruct, understand and reinvent metabolic and bariatric surgical procedures in ways that deliver less invasive options. Experts now recognize that surgical manipulation of tissue in the gastrointestinal tract induces physiological responses that can address metabolic abnormalities associated with Type 2 diabetes, obesity, hyperlipidemia and other metabolic disorders.

MARS examines each specific part of the surgical process to understand the complex cascade of biological signals that it triggers and determine the processes which have the greatest impact. Specifically, studies presented at ADA look at the role of gut hormones on therapeutic outcomes after surgery, and the impact of Metabolic and Bariatric Surgery on the incretin system and lipid metabolism. The studies will help inform which patients will receive the most benefit from individual procedures; how steps can be taken to minimize adverse events; and how targeted interventions can preferentially treat metabolic disorders.

"By identifying the key underlying physiological mechanisms that mediate the effects of these bariatric procedures, we will be able to understand better how to use the current procedures and develop new therapeutic strategies that harness these highly effective mechanisms," said  Randy J. Seeley, PhD, Donald C. Harrison Endowed Professor at the University of Cincinnati College of Medicine and Director of the Cincinnati Diabetes and Obesity Center, and 2009 recipient of the ADA's Outstanding Scientific Achievement Award. "The MARS strategy represents a clear commitment to the science that will uncover those mechanisms and provide a unique opportunity to change the course of these diseases." Obesity is a life-threatening condition affecting more than one-third of adults in the United States, and is associated with more than 30 illnesses and medical conditions, including type 2 diabetes, coronary heart disease, stroke, hypertension, sleep apnea, osteoarthritis and cancer.(1),(2) EES is funding research with the aim of changing the conversation about bariatric surgery and weight loss to metabolic surgery and co-morbid condition resolution. This evolution has been reinforced by recent data from the STAMPEDE (Surgical Therapy And Medications Potentially Eradicate Diabetes Efficiently) trial which indicates that overweight, diabetic patients who underwent surgery (gastric bypass and sleeve gastrectomy) achieved significant improvement or remission of their diabetes.(3) The research is being conducted by the Cleveland Clinic.

"We are committed to helping address the obesity epidemic, which is why we have made a multi-year, multi-million dollar investment in this research, which is built on strategic collaborations with leading investigators," said Chuck Austin, Company Group Chairman, Ethicon Endo-Surgery. "We are encouraged that these collaborations are contributing to the evolving scientific understanding of bariatric and metabolic surgery." Studies supported by EES being presented at ADA: -- Electrical and Mechanical Stimulation of the Duodenum Increases GLP-1 Levels D. Sandoval; Presentation # 1864-P; embargoed until 9-June, 10:00 AM Investigates how stimulation of the duodenum (the beginning portion of the small intestine) increases the levels of a peptide hormone (GLP-1) -- The Role of GLP-1 Receptor Signaling in Metabolic Changes after Roux-en-Y Gastric Bypass in Diet Induced Obese Rats Z. An; Presentation # 209-OR; embargoed until 10-June, 9:30 AM Investigates how the elevated secretion of a peptide hormone (GLP-1) following Roux-en-Y Gastric Bypass effects glucose homeostasis, food intake and weight loss -- Molecular Insights of Improved Cholesterol Metabolism Following Vertical Sleeve Gastrectomy in Diet Induced Obese Rats Z. An; Presentation # 1947-P; embargoed until 9-June, 10:00 AM Investigates the effect of sleeve gastrectomy on lipid metabolism -- Potential Role of the Intestinal Lipid Messenger OEA in the Effects of Sleeve Gastrectomy on Food Intake and Preference H. Wilson-Perez; Presentation # 1948-P; embargoed until 9-June, 10:00 AM Investigates how OEA (a diet-derived intestinal lipid messenger that promotes satiety) affects food intake and preference after sleeve gastrectomy -- Gastric Bypass Surgery Modifies Ethanol Consumption J. Davis; Presentation # 1980-P; embargoed until 9-June, 10:00 AM Examines the hypothesis that that Roux en Y gastric bypass surgery affects alcohol intake and reward in individuals that frequently consume alcohol -- Effect of Vertical Sleeve Gastrectomy in Melanocortin Receptor 4-Deficient Rats J. Mul; Presentation # 108-LB; embargoed until 9-June, 10:00 AM In humans, partial loss of melanocortin receptor 4 (MC4R) activity is the most common monogenic (gene-based) cause of obesity regardless of lifestyle; this study investigates how genetic alteration of MC4R signaling affects the beneficial effects of vertical sleeve gastrectomy -- The Bile Acid Receptor FXR is Necessary for Metabolic Improvements Associated with Bariatric Surgery K. Ryan; Presentation # 1897-P; embargoed until 9-June, 10:00 AM Investigates the role of bile acids in the regulation of metabolism -- Effects of Bariatric Surgery on the Intestinal and Plasma Levels of Endogenous Cannabinoids S. Obici; Presentation # 1898-P; embargoed until 9-June, 10:00 AM Investigates how the weight reducing efficacy of gastric bypass and sleeve gastrectomy is linked to the reduction of  endocannabinoid levels (known to play a role in numerous physiological processes including appetite, memory, and pain) -- Sleeve Gastrectomy is Effective in Mice Lacking the Glucagon-Like Peptide-1 Receptor H. Wilson-Perez; Presentation # 1899-P; embargoed until 9-June, 10:00 AM Investigates the role of a peptide hormone (GLP-1) in the metabolic improvements induced by sleeve gastrectomy -- Changes in Cholesterol Absorption and Synthesis and Intestinal and Hepatic Gene Expression after Roux-en-Y Gastric Bypass in Obese Rats Z. An; Presentation # 1900-P; embargoed until 9-June, 10:00 AM Investigates how gastric bypass affects cholesterol absorption and synthesis -- Cognitive Improvements Following Bariatric Surgery B. Grayson; Presentation # 1901-P; embargoed until 9-June, 10:00 AM Investigates whether surgically-induced weight-loss restores or improves cognitive function to levels observed when calories are restricted -- Glucagon-Like Peptide-1 Receptor Agonism Predicts Roux-en-Y Gastric Bypass Metabolic Benefits in Rats K. Habegger; Presentation # 1903-P; embargoed until 9-June, 10:00 AM Investigates how response to glucagon-like peptide 1 (GLP-1) may be predictive of outcome after gastric bypass -- Glucagon-Like Peptide-1 Receptor Agonism, but not Cannabanoid Receptor-Type 1 Antagonism, Improves Adjustable Gastric Banding in Rats K. Habegger; Presentation # 1904-P; embargoed until 9-June, 10:00 AM Investigates whether the outcome gap between gastric bypass and less invasive treatments can be closed through combination therapy with glucagon-like peptide (GLP-1) receptor agonists About Ethicon Endo-Surgery Ethicon Endo-Surgery develops and markets advanced medical devices for minimally invasive and open surgical procedures, focusing on procedure-enabling devices for the interventional diagnosis and treatment of conditions in general and bariatric surgery, as well as gastrointestinal health, gynecology and surgical oncology. For more information, visit

MEDIA CONTACT: David Shaffer Office: (513) 337-8281 Mobile: (513) 446-0887 References 1. Centers for Disease Control and Prevention (CDC)/National Center for Health Statistics. Prevalence of Overweight, Obesity, and Extreme Obesity Among Adults: United States, Trends 1976-1980 Through 2007-2008.

2. American Society for Metabolic & Bariatric Surgery. Obesity in America Fact Sheet.  June 2010.

3. Schauer PR, et al. Bariatric Surgery versus Intensive Medical Therapy in Obese Patients with Diabetes. NEJM. Published online on March 26, 2012, at

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