On the one hand you have bariatric surgery that can take a morbidly obese person and dramatically reduce their weight and their risks for serious health issues (or if those issues are already present, modify them). On the other hand, you have a surgery that has the negative associations of a death rate (right after surgery or down the road), vitamin deficiencies, gastro-intestinal complaints and a recently identified "post prandial hypoglycemia (low blood sugar) associated with possible seizures." We further know that when it comes to type 2 diabetes - the diabetes associated with poor lifestyle choices- bariatric surgery can help to modify the disease and even put it into a remission state - so you no longer need medications to control your blood sugars.
Currently the parameters that make a person eligible for bariatric surgery are:
BMI greater than 40
BMI of 35 or greater if co-existing conditions like diabetes, heart disease, or other serious illnesses.
So the question is - if someone has a BMI in the 30s and diabetes, is this a really good treatment option, when weighing the inherent risks??
The Obesity Society endorsed this treatment but would like to see more long term studies on its efficacy.
The American Association of Clinical Endocrinologists also endorses the use of this surgery to treat obesity/diabetes.
The American Diabetes Association was hesitant to support the surgery since they felt that tight control of diabetes, which was supposed to show a decrease in heart risks, has its own inherent problems. So to put a patient at risk with a somewhat dangerous surgery could not be supported at this time. They would support further research.
Other top experts weighed in with differing opinions as well.
One specific opinion and recommendation was that the patients need to be followed closely for 10-15 years, since in year 2 and 3, negative outcomes like bone problems, anemia, nutritional abnormalities and the hypoglycemia problem clearly show up in many patients. Notwithstanding those complications, many experts would recommend the surgery to patients who are overweight and have diabetes type 2 and who have tried unsuccessfully to lose weight. It should be pointed out that all bariatric surgery candidates need close pre and post surgery therapy to help them work on their food issues. Simply having the surgery is not a miracle cure. Unless you are able to keep vigorous exercise in place, most days of the week, and stay on a regular eating plan - you will ultimately re-gain the weight and the diabetes.
Published On: December 04, 2008