This headline has been splashed all over the Internet and media. But does this preliminary study take into account health risks associated with weight loss surgery or the percentage of patients who regain weight?
Weight Loss Surgery vs. Healthy Lifestyle Change
The results of an Australian study conducted by Dr John B Dixon and colleagues, of Monash University, Melbourne have been published in the January 23rd issue of the Journal of the American Medical Association (JAMA).
Over 2 years, a small test group of 60 patients, (55 of whom completed the study), gastric banding was compared to conventional diabetes treatment in people with type 2 diabetes.
Apparently, weight loss in the surgical group was responsible for a remission rate 5 times higher and a drop in blood sugar that was 4 times that found in the control group.
But What About The Long Term?
While researchers acknowledge that a larger, more diverse population and longer followups will be needed to confirm these results, they believe this study shows that "intensive weight loss" rather than "simple lifestyle change" is more effective when combating type 2 diabetes.
Will such a strategy really work in the long term? Some people regain a significant amount of weight after a success gastric surgery, which would put them at risk for type 2 diabetes again. In addition, a good portion of obese patients who undergo surgery develop gallstones, nutritional deficiencies, have more serious complications due to the operation itself or will require a secondary surgery.
"After 10 years, only 1 out of 5 people have kept the weight off. A review of studies on stomach stapling (vertical banded gastroplasty) notes that 60% of excess weight (the weight above what is considered healthy) was lost, although a large portion of people regained the lost weight after 3 to 5 years.
About one-third of all people having surgery for obesity develop gallstones or a nutritional deficiency condition such as anemia or osteoporosis. And about 1 out of 5 people may need a second operation because the connection between the stomach and the intestines narrows (stomal stenosis), leading to nausea and vomiting, or because of an increase of gastroesophageal reflux after eating." (WebMD)
While surgical weight loss for obese patients with type 2 diabetes may be greater than healthy lifestyle changes in the short term, so are the risks. Traditionally, surgery has been recommended for the morbidly obese only after conservative measures such as diet, exercise, and medication have failed. With America’s growing obesity problem, I hope this and other similar studies won’t pressure patients into ‘bypassing’ careful consideration before undergoing weight loss surgery.