Healthy Together Spring 2016

Weight Loss Surgery Improves Diabetes

Steward_weight loss article-Healthy Together Nov17.jpgLosing weight is key in controlling type 2 diabetes – and now there is evidence that suggests weight loss surgery (also called bariatric surgery) may help reverse type 2 diabetes. A 2014 study published in The New England Journal of Medicine compared the blood glucose levels of obese people with uncontrolled type 2 diabetes in three treatment groups:

  1. Patients who had gastric bypass (a type of weight loss surgery) and medical therapy (including lifestyle counseling, weight management, blood glucose monitoring and medication).
  2. Patients who had sleeve gastrectomy (a type of weight loss surgery) and medical therapy.
  3. Patients who received medical therapy alone (lifestyle management, medications, carbohydrate controlled meal planning and exercise).

After one year, patients in the weight loss surgery groups were far more successful in controlling blood sugar and reducing or eliminating the need for insulin than patients who had medical therapy alone. Some patients experienced a return to normal blood sugar levels shortly after surgery – before any significant weight loss occurred. This suggests that stomach-reducing surgery could play a role in helping the body control blood sugar on its own.

Similarly, an earlier study published in the Journal of the American Medical Association concluded that participants in a randomized controlled study who had laparoscopic gastric banding were more likely to achieve remission of type 2 diabetes through greater weight loss.

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How Losing Weight Helps Fight Diabetes

Losing weight and exercising more may help control blood sugar levels and reduce the amount of diabetes medication you take. Here’s how it works: excess weight makes it harder for your body to process the sugars in your system. After losing weight, your body may be able to use its own insulin to control blood sugar levels more effectively.

Losing any amount of weight can help, even just five percent of one’s body weight. Some people achieve dramatic weight loss through diet and exercise, but others need more help to reach their weight loss goals.

People with diabetes in particular may struggle to lose weight because some diabetes medications may contribute to weight gain

Surgical Options for Weight Loss

If a patient with diabetes has not achieved a healthy weight with dieting, then weight loss surgery may be the next step.

Weight loss surgery involves reducing the size of the stomach or redirecting part of the lower intestine, or both. The surgery requires a lifelong change in diet and exercise habits in order to lose weight and keep it off. Types of weight loss surgery include:

  • Gastric bypass – the upper portion of the stomach is surgically stapled to separate it from the rest of the stomach, changing the path food takes so it bypasses much of the stomach and part of the small intestine.
  • Sleeve gastrectomy – part of the stomach is removed to create a smaller stomach in the shape of a long tube.
  • Laparoscopic gastric banding (for example, LAP-BAND®) – a band is placed around the upper stomach to reduce food intake and facilitate weight loss.

There are risks involved with weight loss surgery, so you should consider all of your options for controlling diabetes and reducing the risk of complications. Talk to your doctor about your diabetes management plan and whether weight loss surgery may be right for you.

To find a Steward Center for Weight Control doctor, visit Steward DoctorFinder™ or call 1-800-488-5959.