Should You Have Surgery to Prevent Diabetes?
It's getting to be more than a little ridiculous, folks.
Bariatric surgeons are chomping at the bit to cash-in on a procedure that reduces the size of the human stomach as the solution to our current Type 2 diabetes epidemic. First they labeled it as an instant "cure" for Type 2. Now it's being pushed as way to prevent diabetes.
Here's the "research"…
In April 2012, two studies reported that bariatric surgery was more effective than the standard drug treatment in obese and overweight diabetics. Now, four months later, another study reports that bariatric surgery can prevent or dramatically delay the onset of Type 2 diabetes in obese people.
Folks, there's gold in them thar studies! Considering that the average cost of gastric bypass ranges from $18,000 to $35,000 (and these studies have convinced most health insurance providers to pay), surgeons stand to make a small fortune from this new "treatment." After all, nearly 36% of US adults are obese - and more than 11% of US adults have diabetes, while another 35% have prediabetes. That's a huge market.
But is bariatric surgery really effective in either case? Let's look…
What do these studies really say?
The first two studies compared bariatric surgery to current drug therapy for obesity-related Type 2 diabetes. Type 2 diabetics received either drugs or surgery. In both studies, more of the surgery-recipients had healthy blood sugar after one or two years than did those on drug therapy. (For an in-depth discussion of these studies, see my earlier article.)
The third, more recent study followed 3,429 obese, prediabetic adults for 15 years. These people chose whether to have bariatric surgery or "usual care" (drug therapy). Type 2 diabetes developed in 110 of the surgery patients and in 392 of the drug group members. The researchers concluded, "Bariatric surgery appears to be markedly more efficient than usual care in the prevention of Type 2 diabetes in obese persons."
Sounds impressive, doesn't it? But wait - there's more to the story…
Here's what the studies don't say:
In order to understand these studies, we need to understand a couple of points. For example, what is the "usual care" for obesity and diabetes? And what actually happens to a bariatric surgery patient after surgery? Standard treatment for obesity patients is supposed to primarily consist mainly of diet and lifestyle counseling from healthcare providers. But this rarely occurs.
Doctors readily admit they aren't very good at this job. According to the AMA, 78% of physicians admit they "don't feel qualified" to advise their patients on nutrition.
So why don't they get training - or hire staff members who already have it? Because there's no money in it for them. You see, insurance companies don't reimburse doctors for educating their patients about diet and lifestyle advice. So there's no economic incentive, even though this type of patient education is far more successful with patients.
But it's a different story for drugs
The most common medical treatments for Type 2 diabetes includes blood testing several times daily, plus drugs to control blood sugar, cholesterol, blood pressure, and more. It doesn't matter that research finds that people on these medications do poorly - and have poor outcomes.
So it doesn't surprise me at all that bariatric surgery beat drug treatment in these studies.
What is so unfair is that the researchers didn't include a diet-and-lifestyle program in the test. The reason is all too obvious. Diet and lifestyle would have beaten the pants off of both medical approaches. And that would have put an end to the surgeons' new cash cow.
What surgeons aren't advertising…
You see, what these studies fail to mention is that post-surgical patients must follow a strict low-carb diet. That means no sugar, sodas, bread, chips, cookies, refined-grains products, white potatoes, or pasta. In short, no foods that spike blood sugar and trigger the body's insulin response.
According to the Mayo Clinic, "Gastric bypass surgery can provide long-term, consistent weight loss if you exercise and eat a healthy diet." So gastric bypass is not a shortcut or panacea. You still have to eat right and exercise regularly to manage your weight and your diabetes.
But as Dr. Ripich and I have shown with The 30-Day Diabetes Cure, this approach works without the surgery. And our diabetes-reversing diet plan is far less restrictive than the one post-surgical patients must follow.
Surgery risks vs. benefits
Finally, bariatric surgery is risky. It has a 1% mortality rate, and many patients experience nasty complications. Some need corrective surgeries. Vitamin deficiencies and anemia are common side effects.
In addition, long-term diabetes-reversal and weight loss statistics for bariatric surgery patients are poor. Most patients eventually resume their old eating habits, regaining their weight and diabetes.
While bariatric surgery can prevent or reverse Type 2 diabetes in some people, it doesn't do so for all patients. Dr. Danny Jacobs, chair of the surgery department at Duke University School of Medicine, cautions: "It remains impractical and unjustified to contemplate the performance of bariatric surgery in the millions of eligible obese adults."
Surgery is not the solution for the majority of people
I agree. Bariatric surgery should be reserved for morbidly obese patients who find it impossible to stick with diet-and-lifestyle modification.
For the vast majority of people with Type 2 and prediabetes, the better approach is far simpler: Stop consuming foods and beverages that spike blood sugar and trigger insulin. This will reverse insulin resistance and reduce body fat. This is the real solution to our twin epidemics of obesity and Type 2 diabetes.
We desperately need to find a way to enlist doctors and our health care system in this safe, simple, effective treatment.
Unfortunately, this will be a long time coming. So don't wait for the medical profession to catch up to the science.
I urge you to take control of your blood sugar now - and save yourself a lot of needless misery.
Keep getting better!™
