Is bariatric surgery an option for curing diabetes?
You know, bariatric surgery has been getting a lot of traction in recent months and in the last two years. And it has very good press. In the reality, what we have seen is that some people, especially if they have diabetes in a very early stage and they are significantly overweight and obese, when they loose weight by bariatric surgery, especially gastric bypass surgery, they may get partial or complete remission. But this doesn’t mean cure. There is not cure. And even that remission is a temporary remission because if there is no change in the lifestyle, you will gain the weight back. If they get the weight back, they will get the diabetes even if they have remission. The second thing people have to consider is that this is still a surgery and has a lot of consequences short-term and long term, especially nutritional deficiencies. We will end up with a lot of nutrition deficiencies—protein, malnutrition, osteoporosis, folic acid deficiency, vitamin B-12 deficiency, iron deficiency—and they will live with these deficiencies for the rest of their lives and they will have to take supplements all the time.
What’s the long-term success of bariatric surgery?
Again, this is debated. Most of the clinical trials that have been published are for a very short duration…they are two years, maximum three years. The only study that has a very long duration was done in Sweden, but it is mostly about surgery that is not commonly used these days. So this data cannot reflect on other types of surgery.
So the truth is, it is not a silver bullet.
Personally, I think it is a last option. It is not the first. In the “Why Wait” program, for example, we have people maintain the weight loss for five years. More than 50% maintained around 10% weight loss for five years—and this is without surgery. And the most important—that you change your behavior. When you do the surgery, you are not changing anything. And then any reason that made that person initially gain weight will still exist and cause weight regain again.
