Obese? Diabetic? Try surgery!

In 2009, over 220,000 people had bariatric surgery (weight loss surgery) in the U.S. – these procedures are growing in popularity as obesity rates climb.1

On Monday, the International Diabetes Federation announced that they now recommend bariatric surgery as a treatment for diabetics with a body mass index (BMI) of 35 or more; and also as an alternative treatment for diabetics with a BMI of 30-35, either when diabetes is not being adequately controlled with medication or in the presence of major cardiovascular risk factors. As its rationale, the IDF cites effective reversal of diabetes, reduced health costs, reduced risk of all-cause mortality, and reductions in cardiovascular risk factors that occur as a result of the surgery.2

 

Of course, bariatric surgery is effective for reversing diabetes (note however that diabetes remission rates do decrease over time3). Obesity is the primary risk factor for diabetes, and bariatric surgery forces weight loss by physically limiting either intake or absorption of food. But should bariatric surgery be recommended before radical lifestyle changes? The IDF and the American public seem to think so. Yesterday, on Good Morning America, gastric bypass was called a “breakthrough” treatment for reversing diabetes.

According to the physician that discussed bariatric surgery on Good Morning America, “For people who are truly obese and have diabetes, diet and exercise just aren’t really effective.”

Really? Diet and exercise aren’t effective?

Hundreds of formerly obese, formerly diabetic individuals have followed my dietary recommendations and would disagree with that statement.

For example:

  • Charlotte, who lost half her body weight (133 lbs.) and reversed her diabetes
  • Calogero, who lost 100 lbs. in only seven months and reversed his diabetes
  • Richard, who was on insulin for 25 years, and was able to stop taking it after just a few days of a high nutrient diet.

Do you disagree too? Have you reversed your diabetes by changing your lifestyle? If so, let Good Morning America know about it. Comment on the article, or send them your story.

I think that the hundreds of people who have reclaimed their lives by losing over 100 pounds following my high nutrient dietary recommendations would also disagree. Scott, Bill, Sue, Theresa, Anthony, and Julia, to name a few.

It’s not that diet and exercise aren’t enough – it’s just that small changes aren’t enough. A slightly modified version of the standard American diet is not enough. Artificially sweetened sodas and processed foods, excess meat, and a modest increase in vegetable intake cannot do the job of reversing diabetes. With their position statement, the IDF is perpetuating a misguided view, that lifestyle changes are not powerful enough to reverse disease.

Only dramatic changes will produce radical results. Surgery is radical. But there is a safer radical change – a radical lifestyle change, to a natural, high-nutrient plant-based diet-style, plus exercise.
In a recently published study, we investigated the efficacy of a high nutrient density diet for treating diabetes – 62% of the participants reached normal (nondiabetic) HbA1C levels within seven months, and the average number of medications dropped from four to one.4 All participants were able to eliminate or reduce medication, except one, who was already on the lowest dosage of Metformin. A high nutrient density diet has tremendous therapeutic potential for diabetes, and for dramatically reducing health care costs.

To those who are considering bariatric surgery, I ask you to please consider my nutritarian (high-micronutrient) diet-style changes first. We live in an obesity and diabetes-promoting food environment, but we can find freedom from these influences. My discovery that high nutrient eating derails toxic hunger and food addictions enables my overweight clients to achieve dramatic weight loss results that parallels or exceeds the long-term results of gastric bypass, and likewise, when diabetic, it most often resolves or dramatically improves.

Diabetics should be aware that superior nutrition works and it works better than drugs or surgery. Surgery will physically limit your portion sizes, but it will not remove addictive foods from your diet, and it will not give your body the nutrients it needs to protect you against heart disease, cancer, and other chronic diseases. Most often the initial results recede over the years as most of the surgery-treated individuals gain back much of the lost weight.

Once you become a nutritarian nutritional expert, consider the sense of satisfaction, accomplishment, and improved self-esteem that can come from losing the weight and watching diabetes disappear. Consider that you may be stronger than you think you are, and that you capable of reclaiming your health.

Also, surgery does not come without risk.

Potential complications of bariatric surgery:
Gastric bypass is the most common bariatric surgery, and carries the following risks5:

  • Infection
  • Hardening of the connection of the stomach to the small intestine
  • Bleeding
  • Obstruction of the small intestine
  • Gastrogastric fistulae (leaks between the “pouch” and the rest of the stomach), requiring additional surgery
  • Internal hernia, a potentially life-threatening complication that requires additional surgery6
  • Venous thromboembolism (blood clots)
  • Nutrient deficiencies7
  • Neurologic complications are said to be often disabling and irreversible, and many do not produce symptoms until over ten years after the surgery8
  • Bone loss

Diabetes and severe obesity both put the patient at greater risk of complications.5 Diabetes is associated with poor weight loss following gastric bypass.9

Laparoscopic gastric banding (lap-band) surgery is also not without complications – a recent study reported a long-term complication rate of over 40% (including leakages and band infections, and esophageal dilatation), a re-operation rate of 20.4%. The failure rate of the procedure after 10 years was 31.6%.10

Addiction and emotional attachment to food is so prevalent and so powerful in our culture that these surgical procedures seem more reasonable than diet change. But it is not – weight loss surgery is extreme and risky; my dietary approach is safe and in most cases, the results are even more effective compared to gastric-bypass surgery. It could save your life.

 

References:
1. American Society for Metabolic & Bariatric Surgery [http://www.asmbs.org]
2. Surgical and Procedural Interventions in the Treatment of Obese Patients with Type 2 Diabetes: A position statement from the International Diabetes Federation Taskforce on Epidemiology and Prevention.
3. Sjostrom L, Lindroos AK, Peltonen M, et al: Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. The New England journal of medicine 2004, 351:2683-2693.
4. Dunaief D, Gui-shuang Y, Fuhrman J, et al. Glycemic and cardiovascular parameters improved in type 2 diabetes with the high nutrient density diet. Presented at the 5th IANA (International Academy on Nutrition and Aging) meeting July 26 & 27, 2010 Hyatt Regency Tamaya Resort & Spa 1300 Tuyuna Trail Santa Ana Pueblo, NM, USA J Nutr Health Aging 2010;14:500.
5. Campos GM, Ciovica R, Rogers SJ, et al: Spectrum and risk factors of complications after gastric bypass. Arch Surg 2007, 142:969-975; discussion 976.
6. Schneider C, Cobb W, Scott J, et al: Rapid excess weight loss following laparoscopic gastric bypass leads to increased risk of internal hernia. Surg Endosc 2010.
7. Bell BJ, Bour ES, Scott JD, et al: Management of complications after laparoscopic Roux-en-Y gastric bypass. Minerva Chir 2009, 64:265-276.
8. Juhasz-Pocsine K, Rudnicki SA, Archer RL, et al: Neurologic complications of gastric bypass surgery for morbid obesity. Neurology 2007, 68:1843-1850.
9. Campos GM, Rabl C, Mulligan K, et al: Factors associated with weight loss after gastric bypass. Arch Surg 2008, 143:877-883; discussion 884.
10. Naef M, Mouton WG, Naef U, et al: Graft survival and complications after laparoscopic gastric banding for morbid obesity--lessons learned from a 12-year experience. Obes Surg 2010, 20:1206-1214.

 

 

Q & A: Doctors Choose Pills for Heart Disease

Unless you have a broken arm or an exploding appendix, a doctor likely is to jam a bunch of pills down your throat, especially if you have heart trouble, despite the evidence showing a healthy diet reverses heart disease. From Dr. Fuhrman’s member center, here's a quick discussion about doctors’ pill obsession:

Question: My doctors want me to start on cholesterol meds. When I told my primary doctor that I did not want to try the drugs and wanted to try something else, she said cholesterol meds do more than lower cholesterol and that you can reduce cholesterol with diet but not the inflammation in the arteries.

Will lowering my cholesterol with diet not take care of the inflammation? All my heart test, stress, Doppler, leg test came by normal. Do you have any advice? The heart doctor wants me to have a gastric by-pass and my primary doctor wants me to have the lap-band. I don’t want either one!

Dr. Fuhrman: Doctors see drugs and surgery as the only answer, but the truth is that nutritional excellence is more effective at reducing inflammation than drugs and it is more protective against heart disease than drugs, is more effective than gastric bypass and lap band—both have no long-term studies that show that those undergoing those procedures have normal lifespan.

Doctors grant all their interventions with beneficial qualities no matter how poorly studied, then hold to natural methods and nutritional interventions as not having enough proof. Dermatologists claim acne has nothing to do with food, studies show this is false. Cardiologists claim heart disease is predominantly genetic, also false—and so on and so on.

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Bone Fracture Risk Doubles After Obesity Surgery

Speaking at this year’s The Endocrine Society's annual meeting, scientists say bone fracture rate is higher among people who have underwent bariatric surgery. Researchers studied 90 people who had either vertical banded gastroplasty or biliopancreatic diversion. Seven years following their operation, 21 participants endured a total of 31 fractures. The risk for hand and foot fractures was the most elevated; Reuters explains.

Interestingly enough, in 2008 experts determined gastric bypass surgery caused bone loss, citing vitamin D and calcium deficiencies in individuals undergoing the procedure. Dr. Fuhrman lists depression and malnutrition as other harmful side-effects of weight-loss surgery.

Another report found people who underwent gastric surgery have a higher rate of suicide than the general population, but experts argue the surgery is not the reason why.

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Gastric Bypass Linked to Bone Loss

Weight-loss surgery is risky! A previous report showed an INCREASED risk of depression and suicide with weight-loss surgery. And now, new research by Columbia University reveals a connection between gastric bypass and deficiencies of calcium and bone loss.

The study appears in the Journal of Clinical Endocrinology & Metabolism. More from ScienceDaily:

"Our research shows that deficiencies of calcium and vitamin D absorption occur following gastric bypass surgery," said Dr. Shonni J. Silverberg, professor of medicine at Columbia University College of Physicians & Surgeons in New York, N.Y., and coauthor of the study. "When analyzing hip bone density, we found that those who lost the most weight also lost the most bone."

In this study, researchers evaluated 23 morbidly obese men and women who underwent gastric bypass surgery. Dr. Silverberg and her colleagues measured serum calcium, vitamin D, and parathyroid hormone levels before surgery and at three, six, and twelve months after surgery. Researchers also measured bone mineral density before and after surgery using dual-energy x-ray absorptiometry (DXA). One year after weight loss surgery, patients had lost an average of 99 pounds and had significant declines in hip bone mineral density (both total hip and femoral neck measurements).

"The calcium and vitamin D deficiencies may be due to the alterations in the gastrointestinal tract that take place during these procedures," said Dr. Silverberg. "These deficiencies may be restored if the amount of calcium and vitamin D supplementation is increased appropriately."

Now, this only a FRACTION of the potential complications! Dr. Fuhrman also lists gastritis, dilated pouch, incisional hernia and vitamin B12 deficiency as other possible consequences of weight-loss stomach surgery. Seems like A LOT of risks to me!

There’s a simpler. You know it already—diet and exercise! Exercise keeps us moving, but a diet change is REALLY crucial. Some foods, like green vegetables, actually allow you to eat MORE and still lose weight. No scalpels needed!

Weight-Loss Surgery, Bad News

Dr. Fuhrman will never give weight-loss surgery his endorsement. Why? It’s risky and full of complications. He talks about it in Eat to Live. Here’s a snippet:

According to the National Institutes of Health (NIH), wound problems and complications from blood clots are common aftereffects of gastric bypass and gastroplasty surgery. The NIH has also reported that those undergoing surgical treatment for obesity have had substantial nutritional and metabolic complications, gastritis, esophagitis, outlet stenosis, and abdominal hernias. More than 10 percent required another operation to fix problems resulting from the first surgery.1

And some new research confirms Dr. Fuhrman’s concerns. According to Reuters death-risks increase after weight-loss surgery. Michael Conlon reports:

Patients who undergo weight-loss stomach surgery have a higher death rate than is true for the general population, including more suicides, perhaps linked to depression, researchers said on Monday.


The higher risk of death generally is due not to the surgery itself but to the health problems that accompany obesity, and the damage that the condition does to the body before and after surgery, the researchers said.

Dr. Bennet Omalu and colleagues at the University of Pittsburgh said a review of more than 16,000 bariatric operations done in Pennsylvania over a nine-year period found a "substantial excess of deaths owing to suicide and coronary artery disease" compared to normal death rates found in the population at large.

Why not just eat healthfully and exercise?

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Surgery for Weight Reduction and Its Risks

According to the National Institutes of Health (NIH), wound problems and complications from blood clots are common aftereffects of gastric bypass and gastroplasty surgery. The NIH has also reported that those undergoing surgical treatment for obesity have had substantial nutritional and metabolic complications, gastritis, esophagitis, outlet stenosis, and abdominal hernias. More than 10 percent required another operation to fix problems resulting from the first surgery.1


Another tempting solution is liposuction. Studies show that liposuction begets a plethora of side effects, the main one being death! A recent survey of all 1,200 actively practicing North American board-certified plastic surgeons confirmed that there are about 20 deaths for every 100,000 liposuctions, whereas the generally acceptable mortality rate for elective surgery is 1 in 100,000.3 Compared with the 16.4 per 100,000 mortality rate of U.S. motor vehicle accidents, liposuction is not a benign procedure. Liposuction is dangerous.

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