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.
- 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.
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:
- Hardening of the connection of the stomach to the small intestine
- 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.
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.