Recently, I attended a convention of the American Diabetes Association in New York City where the main booth heralded a breakthrough "cure" for diabetes. Excited to think I might learn something new, I hustled right over. Imagine my dismay when all the information at the booth was about weight loss surgery!
Do we need a cure? Absolutely!
Is surgery a one-size-fits-all solution for diabetes? No way.
I understand the desire to find a solution. After all, Type 2 diabetes is looming as the biggest epidemic and public health issue in human history. Close to 300 million people are affected worldwide and another 150 million forecast to be diagnosed by 2030. The reason? Obesity.
Yes, obesity is a tenacious problem, but surgery is only a Band-Aid solution, albeit one that is growing in popularity. In the last decade alone, the rate of weight loss surgeries performed each year in the U.S. has increased from 10,000 to 230,000. But how many of the 1.7 billion overweight citizens of the world can afford gastric bypass? And how many of those will regain the weight?
I have seen many patients go under the knife for these procedures only to gain back the weight they lost, plus some. Weight loss surgery may seem like a panacea, but it won't solve the underlying hormonal and metabolic imbalances that are driving the diabetes and obesity.
My patient Alan is a prime example. Alan has been overweight since he was 6 years old and never experienced a day without ravenous hunger. At age 40, he had gastric bypass surgery and shrunk from 450 pounds to 250 pounds. The size of his stomach changed, but his overall lifestyle did not. Eventually, he gained back 100 pounds. Even with a stomach the size of a walnut, he managed to gain weight one tiny, fattening bite at a time. By the time he landed in my office, he was 60 years old and tired of juggling all the complications of weight loss surgery.
The Reality of Gastric Bypass: What Doctors Don't Tell You
Alan is hardly an anomaly. A report on the effectiveness of weight loss surgery published by the Agency for Healthcare Research and Quality found that within 3 to 5 years after laparoscopic gastric banding, as many as one-third of patients are not able to maintain weight loss due to noncompliance with a prescribed diet and other issues. Plus, the complications stemming from lap band surgery were as high as 30 percent.
We also know that weight loss surgery is not without risks. Altering the gastrointestinal tract can lead to nutritional deficiencies that require lifelong monitoring and supplementation of calcium, vitamin B12, folate, multivitamins, iron, and thiamine. And the psychological risks of these surgeries are often underplayed. In 2010, a study published in the American Journal of Medicine showed a dramatic increase in suicide among patients who had bariatric surgery, most occurring within three years following the surgery (1).
Even more disturbing is the rise in overweight teens choosing weight loss surgery. Since the late '90s, the number of weight loss procedures performed on teenagers has skyrocketed (2). Some studies show the mean age of these young patients is just 16 years old, with some as young as 12! (3) Very few studies have looked at the long-term ramifications of these surgeries. What kind of problems are we passing on to our youth?
A Better Solution
Instead of glorifying the ability of weight loss surgery to stem the tide of Type 2 diabetes in this country, we need to remember that Type 2 diabetes is an entirely preventable and reversible lifestyle disease. Let me repeat: There is clear evidence from the scientific literature that diabetes is reversible, especially if it is caught early and treated aggressively through lifestyle intervention and nutritional support, and occasionally with medications (4). In many cases even later stage diabetes can be reversed with very intensive lifestyle changes, medications and supplements.
A groundbreaking new study from England showed unequivocally that people with advanced Type 2 diabetes, when the pancreas has lost its oomph and the insulin-producing (beta) cells are damaged, can reverse the course of the disease in just one week by optimizing dietary strategies, such as eating low-glycemic foods and staying on a low-calorie diet (5). One week!
The best news is that dietary changes alone can help your body heal. Studies of patients who have weight loss surgery show that even a dramatic change in diet in a short period of time creates beneficial metabolic changes (6). All the metrics we thought were related to obesity, such as high blood sugar, high cholesterol, high blood pressure, inflammation, and clotting, are drastically reduced even without significant weight loss due to the rapid effects of dietary changes on the body. (For more information on how to reverse diabetes with diet, see The Blood Sugar Solution.)
Let me be clear: Maintaining a healthy weight is ideal for optimal health. But we shouldn't be signing up for surgery without exhausting every other avenue. Curing diabetes with surgery relies on outdated ideas about the origins of disease and overlooks the complex web of biology as well as the social, political, and economic conditions at the root of our current epidemic.
We can do better.
To learn more please see The Blood Sugar Solution. Get one book or get two and give one to someone you love -- you might be saving their life. When you purchase the book from this link you will automatically receive access to the following special bonuses:
Now I'd like to hear from you...
Have you considered bypass surgery?
Do you experience nutritional deficiencies due to bypass surgery?
Have you battled with weight loss?
Please leave your thoughts by adding a comment below.
To your good health,
Mark Hyman, MD
(1) Tindle HA, Omalu B, Courcoulas A, Marcus M, Hammers J, Kuller LH. Risk of suicide after long-term follow-up from bariatric surgery, Am J Med. 2010 Nov;123(11):1036-42
(2) Nguyen NT, Karipineni F, Masoomi H, Laugenour K, Reavis K, Hohmann S, Varela E. Increasing utilization of laparoscopic gastric banding in the adolescent: data from academic medical centers, 2002-2009. Am Surg. 2011 Nov;77(11):1510-4.
(3)Schilling PL, Davis MM, Albanese CT, Dutta S, Morton J. National trends in adolescent bariatric surgical procedures and implications for surgical centers of excellence. J AM Coll Surg. 2008 Sep;207(3):458
(4) Diabetes Prevention Program Research Group, Knowler WC, et al. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet. 2009 Nov 14;374(9702):1677-86.
(5) Lim EL, Hollingsworth KG, Aribisala BS, Chen MJ, Mathers JC, Taylor R. Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol. Diabetologia. 2011 Jun 9.
(6) Saliba J, Wattacheril J, Abumrad NN. Endocrine and metabolic response to gastric bypass. Curr Opin Clin Nutr Metab Care. 2009 Sep;12(5):515-21. Review.
Mark Hyman, M.D. is a practicing physician, founder of The UltraWellness Center, a four-time New York Times bestselling author, and an international leader in the field of Functional Medicine. You can follow him on Twitter, connect with him on LinkedIn, watch his videos on YouTube, become a fan on Facebook, and subscribe to his newsletter.
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