I don’t talk about surgery as a viable weight loss solution very often. Why would I when there are so many effective strategies out there that don’t require going under the knife?
But to be truthful, there have been a few patients for whom I have recommended it. Of course, I didn’t make these recommendations lightly. These are patients that I saw month after month and year after year, who were still unable (or perhaps unwilling) to make the changes necessary to get healthy.
And as a doctor, it reached a point where I felt I must do something to save their lives.
I know it may shock you to hear me say that there’s ever a time when weight loss surgery might be appropriate. But ultimately, my job is to make my patients healthier. And sometimes, that means offering an option that’s right for one particular patient…even if it’s something that I consider completely unnecessary for others.
And despite my own reservations, there are some very good studies out there showing that gastric bypass surgery does indeed work. Including the one I want to discuss with you today…
This study showed that, over the course of a year, gastric bypass surgery was more effective at reversing type 2 diabetes than an intensive diet and exercise program. Of course, that result hinges upon the fact that when you have this kind of surgery, dramatic weight loss is pretty much the only possible outcome. Compliance isn’t really “optional” the way it is for diet and exercise.
So I can’t say I’m particularly surprised by these findings. But let’s take a look at them anyway.
The study featured 23 obese adults with type 2 diabetes. Researchers gathered data on a long list of metabolic factors, including fasting blood sugar, insulin levels and sensitivity, body weight and composition, waist circumference, blood pressure and cholesterol, cardiovascular fitness, medication usage, and quality of life.
They assessed the participants before the study, after six months, and again after a year.
By the end of the study, 60 percent of the bypass patients had blood sugar levels back in the non-diabetic range — as opposed to just six percent of patients relying on diet and exercise alone. Fewer than 30 percent of the patients who had surgery were insulin-dependent at this point — compared to 41 percent in the lifestyle intervention group. Bypass patients were also using fewer blood pressure drugs after one year.
On the other hand, cardiorespiratory fitness improved in the lifestyle group, but not in the surgery group. (A point I think is absolutely worth noting.)
But body weight and fat mass, waist size, and waist-to-hip ratio went down in both groups. The bypass patients simply lost more over the course of the year.
Taking all of this into account, it’s obvious that there is a place for gastric bypass surgery among a certain subset of patients. The study authors demonstrated that pretty clearly. But here’s where they lose me…
The lead author went on to wonder “might we begin to see surgery as a way to treat diabetes primarily?”
Let me stop him right there. Might we? Sure. Nothing shocks me anymore. But should we? ABSOLUTELY NOT.
Relying on surgery as a first-line diabetes treatment is like killing a fly with a sledgehammer. Which, sadly, is typical mainstream medicine thinking here in the U.S.
But how about… oh, I don’t know… preventing diabetes before it starts?! I know, I know. It’s kind of an old-fashioned idea! But I guess that’s just the kind of doctor I am. And for very good reason.
The changes this study reported are a testament to the incredible benefits of weight loss. They’re also changes that I see routinely in my patients — the vast majority of whom haven’t had gastric bypass surgery.
Unfortunately, there still aren’t a lot of doctors out there who have the first clue how to prescribe this kind of “medicine.” Despite being perfectly skilled with a scalpel.
This is exactly why I developed my Metabolic Repair Protocol — to “re-program” my patients’ bodies to work the way they’re supposed to naturally. And more importantly, without assuming the serious risks of surgically altering your body just to get blood sugar back under control.