I have posted a number of previous notes about the association of obesity with various chronic diseases including diabetes, hypertension, and hyperlipidemia. It is well documented that obesity reduces one's lifespan by up to twenty years. I have also posted notes about bariatric surgery as a means to achieve weight loss. For morbidly obese people, there is now a general consensus that such surgery, despite the risks, decreases both morbidity and mortality. A recent article on bariatric surgery (see: To Heal Diabetes, Doctors Push Weight-Loss Surgery) indicates that one of the achievable goals for such surgery is "curing" diabetes. Below is an excerpt from the article (boldface emphasis mine):
A growing amount of research suggests that bariatric surgery, which shrinks the stomach and sometimes reroutes the intestines, has a lasting effect on the most common form of diabetes, and not just because patients lose weight. Studies have found that more than 75% of patients with this type of diabetes who undergo the surgery see their disease disappear. They can go on to live diabetes-free without insulin or other medicines....Bariatric surgery can lead to serious complications such as nutritional deficiency. The death rate from the procedure is estimated to be between one in 100 and one in 1,000....Studies into bariatric surgery's impact on diabetes are shedding light on little-understood hormones that reside in the small intestine and help keep the body's sugar levels in balance. Researchers theorize that in diabetic patients, food causes these hormones to go awry, but when surgery alters the intestinal tract and diverts food away from them, the disease can quickly recede....Bariatric surgery usually costs about $25,000 and is a big profit center for some hospitals. If even a small percentage of diabetics chose to undergo surgery, it would bring a gusher of new business for the profession....Daniel B. Jones, director of bariatric surgery at Beth Israel Deaconess Hospital in Boston, is among doctors who think diabetics with moderate obesity may benefit from surgery. "If you have type 2 diabetes and your BMI is 35, we absolutely intervene," says Dr. Jones, referring to the more common type of diabetes that typically strikes adults.....Last year, 177,600 patients underwent bariatric surgery, according to the American Society of Bariatric Surgery, nearly four times the figure five years earlier.
I can't help but comment on the fact that many clinicians looked askance at bariatric surgery when it first began to be performed, and not without reason. It was often undertaken by inadequately trained surgeons working in specialized hospitals. The morbidity and mortality rates for the procedures were also enormous. Keep in mind, however, that the morbidly obese patients were very poor candidates for complex surgery. We now learn that these bariatric "experiments" have yielded new insights into the pathophysiology of type 2 diabetes that we might not otherwise have gained.
There have also been significant improvements in the surgery over time, including the development of LAP-BAND device, an adjustable gastric banding system that can be is inserted using a laparascope and can be subsequently removed. Here is a link to an article (see: Laparoscopic Adjustable Gastric Banding In 2000 Consecutive Obese Patients: 12-Year Results) reporting a " mortality rate of 0 in 1,791 consecutive LAP-BAND patients."
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