Diabetes: Stomach Surgery a Good Idea?

If you’re looking to regain your health and lose weight healthfully, popular stomach surgeries are not the answer. From Eat to Live, here’s what Dr. Fuhrman and the National Institutes of Health have to say about them. Take a look:
Wound problems and complications from blood clots are common aftereffects of gastric bypass and gastroplasty surgery. The National Institutes of Health 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
Seriously, stomach surgeries might be all the rage right now. It seems like every time you turn on the TV another celebrity is singing the praises of stomach-stapling, but come on! You’ve got to consider the risks. Check out this chart:

So, when I say this—I hit the ceiling! Apparently a new study favors stomach surgery to treat obese diabetics. No, it’s not April Fools Day. Denise Grady of The New York Times reports:
Weight-loss surgery works much better than standard medical therapy as a treatment for Type 2 diabetes in obese people, the first study to compare the two approaches has found.

The study, of 60 patients, showed that 73 percent of those who had surgery had complete remissions of diabetes, meaning all signs of the disease went away. By contrast, the remission rate was only 13 percent in those given conventional treatment, which included intensive counseling on diet and exercise for weight loss, and, when needed, diabetes medicines like insulin, metformin and other drugs.

In the study, the surgery worked better because patients who had it lost much more weight than the medically treated group did — 20.7 percent versus 1.7 percent of their body weight, on average. Type 2 diabetes is usually brought on by obesity, and patients can often lessen the severity of the disease, or even get rid of it entirely, by losing about 10 percent of their body weight. Though many people can lose that much weight, few can keep it off without surgery. (Type 1 diabetes, a much less common form of the disease, involves the immune system and is not linked to obesity.)

But the new results probably do not apply to all patients with Type 2 diabetes, because the people in the study had fairly mild cases with a recent onset; all had received the diagnosis within the previous two years. In people who have more severe and longstanding diabetes, the disease may no longer be reversible, no matter how much weight is lost.
I’d be curious to see just what kind of “intensive counseling on diet and exercise for weight loss” these patients were given. Because according to Dr. Fuhrman switching to a vegetable-based nutritarian diet is your best bet against type-2 diabetes. He explains:
How can diabetics safely lower the high glucose levels that are slowly destroying their bodies? How can they lower their lipids and blood pressure, lose weight, and avoid taking dangerous drugs, such as insulin and sulfonylureas? They need to adopt a diet based on nutritional excellence.

When you eat a diet consisting predominantly of nature's perfect foods---green vegetables, beans, eggplant, tomatoes, mushrooms, onions, garlic, raw nuts and seeds, and limited amounts of fresh fruit, it becomes relatively easy to eat as much as you want and still lose your excess weight. In my experience, those who follow my nutritional recommendations find that their diabetes disappears astonishingly fast, even before most of their excess weight melts away.
Now, let’s not forget exercise. Dr. Fuhrman also points out that exercise is an important part of preventing and combating diabetes. Take a look:
The most effective prescription for diabetes is exercise. An essential component of my prescription for diabetes is daily exercise; it is more important than daily medication. Two hundred calories a day of formal exercise on an incline treadmill and an elliptical machine are a great goal to shoot for. It is not an official recommendation of anyone except me.
I’m no health expert and I’m not trying to be overly negative, but, how can researchers and doctors willing endorse elective surgery on someone, especially when there are more effective, proven means of treatment. What do you think?
1. Papakonstantinou, A., P. Alfaras, V. Komessidou, and E. Hadjiyannakis. 1998. Gastrointestinal complications after vertical banded gastroplasty. Obes. Surg. 8 (2): 215–17; Choi, Y., J. Frizzi, A. Foley, and M. Harkabus. 1999. Patient satisfaction and results of vertical banded gastroplasty and gastric bypass. Obes. Surg. 9 (1): 33–35; Guidelines for treatment of adult obesity. 1998. Second edition. Bethesda, Md.: Shape Up America and the American Obesity Association.

2. NIH clinical guidelines, op. cit., p. 81.
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Comments (3) Read through and enter the discussion with the form at the end
Paul - January 24, 2008 7:14 PM

I think the decision is based on your personal circumstances. In my case I go heay carb in the morning and weight lift an hour later to avoid the spike. I know other people that have sciatica,fibromyalgia, degenerative spinal discs,neuropathy etc that cannot use this method. Others cannot tolerate the side effects of oral medications.If medical science offers the lap banding and stapling as an alternative they weigh the consequence against the benefit and come to their own consensus
Presenting a thesis on diet exercise that is inclusive to all diabetics is conceptually medical elitism resolving this thesis anti thesis to objective resolution is a personal decision in my opinion

Sara - January 24, 2008 10:49 PM

I was horrified when I read about this in the paper. Imagine going through risky surgery when healthy diet is so much more effective. People who have the surgery have to restrict their diet afterward anyway. Some of them still regain the weight. With proper diet people have lost more than 20% of body weight. Lots of people like that around following Dr Fuhrman's program.

Gerry Pugliese - January 25, 2008 8:18 AM

Hey Sara-

You weren't the only one. Both Dr. Fuhrman and his wife emailed me the story...while I was blogging about it.

I really don't like how these stomach surgeries are being glamorized lately.


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