Why Weight Loss Surgery is NOT a Sound Treatment Choice for Type 2 Diabetes
November 17, 2012
By Dr. Mercola
The Cleveland Clinic recently published its "Top 10 Medical Inventions for 2013" list1. Doctors and researchers at the Clinic voted for what they thought were the most significant inventions out of 250 submitted ideas.
Noted medical inventions include an implantable neuromodulation device for the treatment of severe cluster headaches, a handheld melanoma detection device, a novel prostate cancer drug, and breast tomosynthesis (a.k.a 3D mammography).
But shockingly, and really almost unbelievably, topping the list at number one is using bariatric surgery for the treatment of type 2 diabetes.
According to the Cleveland Clinic:
"Surgery for obesity, often called bariatric surgery, shrinks the stomach into a small pouch and rearranges the digestive tract so that food enters the small intestine at a later point than usual.
Over the years, many doctors performing weight-loss operations found that the surgical procedure would rid patients of Type 2 diabetes, oftentimes before the patient left the hospital.
To explore this diabetes treatment hypothesis, 150 patients with Type 2 diabetes and obesity were enrolled in a study in 2007. 50 patients had gastric bypass surgery.
This is a procedure that reduces stomach volume from the size of an inflated football to a golf ball size; 50 had a sleeve gastrectomy surgery, which reduces the stomach from the size of a football to that of a banana; and 50 were offered counseling in nutrition and exercise while they continued taking their diabetes medication.
By closing off most of the stomach to food, people who received bariatric surgery ate less and, therefore, lost weight. Patients in the study lost about five times as much weight on average as those only taking bloodsugar-lowering medications.
The study results, published in the New England Journal of Medicine in 2012, astounded the medical world.
Compared with patients taking diabetes medication and receiving lifestyle counseling, those who had bariatric surgery were far more likely to be free of diabetes or to have reduced their dependence on diabetes medications for at least two years. The weight-loss surgery also helped many to lower their blood pressure and cholesterol. Most of the patients went from a dozen or more medications daily to none or just a few."
Dr. Michael Roizen, Cleveland Clinic Chief Wellness Officer, told Reuters2:
"Bariatric surgery has been around for a while. The reason it was chosen as the top innovation is because Medicare has broadened its indication for payment, and Medicaid in many states follows Medicare.
A lot of the other (private) insurance companies started covering it, so it's much more accessible. The criteria that insurers use to cover the surgery has been broadened because of its effectiveness in controlling Type 2 diabetes."
While this will probably sound wonderful to some, there's no doubt in my mind that this is absolutely the wrong treatment and not at all an appropriate solution for the vast majority of people, and that's what this list is all about — one of the primary criteria for making it onto the list was the number of people the product or procedure can potentially help.
Bariatric surgery as a treatment for type 2 diabetes is a prescription for the most invasive and costly (not to mention risky) intervention possible for a problem that is firmly rooted in a faulty diet and lack of exercise... What makes this recommendations particularly troublesome is that virtually 100 percent of type 2 diabetes cases can be successfully treated and reversed through appropriate lifestyle changes!
It's also blatantly clear (they even state it outright) that it topped the list because Medicare (i.e. your tax dollars) will now pay for it, NOT because it's been proven safe and effective.
On the contrary, they appear to base their opinion on the results from a singular study. This is probably ill advised.
Dr. John Ioannidis of the Stanford School of Medicine in California warns against placing too much faith in singular medical studies showing large effects of medical treatment (benefits or harms). His massive analysis, recently published in JAMA,3 tracked the fate of thousands of studies, from the effects demonstrated in the initial study, compared to the effects elucidated in subsequent trials.
Interestingly, in 90 percent of cases where "very large" effects were initially reported, such effects shrank or vanished altogether as subsequent studies were done to confirm the results. Dr. Ioannidis told Reuters4:
"Our analysis suggests it is better to wait to see if these very large effects get replicated or not... Keep some healthy skepticism about claims for silver bullets, perfect cures, and huge effects."
In the case of weight loss surgery, there are already a number of studies showing both bariatric surgery and gastric banding are very risky procedures that produce poor long-term outcomes! But of course, that only means the revenue stream from those suffering with type 2 diabetes will continue to flow, and apparently that's what really matters and drives medical recommendations in the US...
Nearly Half of Weight Loss Surgeries Result in Major Complications
All surgeries have inherent risks, but bariatric surgeries seem to have a much higher ratio of complications. Complications occur for both types of weight loss surgery, gastric banding and the more invasive gastric bypass.
For example, a study from 20045 reported that the risk of dying within 30 days of gastric bypass surgery was 1 in 50. And, within the surgeon's first 19 procedures, the odds of death within 30 days were 4.7 times higher, due to inexperience.
Gastric banding consists of surgically inserting a band around the top section of your stomach, and cinching it into a small pouch. This is often touted as a simpler, less invasive procedure to gastric bypass, and whereas gastric banding is at least reversible, while gastric bypass is not, the complications are often so debilitating that patients opt to have the bands removed completely. According to research6 published last year, nearly 40 percent of patients who undergo gastric banding experience major complications, including:
||Bowel and gallbladder problems
||Increased risk of death
||Abnormal band expansion
Furthermore, the study found that:
- Nearly 50 percent of patients required removal of their bands
- Nearly 1 out of 3 patients experienced band erosion
- 60 percent needed to undergo additional surgery
The researchers concluded that:
"LAGB [laparoscopic adjustable gastric banding] appears to result in relatively poor long-term outcomes."
Even according to LapBand.com, one American clinical study that included a 3-year follow-up reported a staggering 88 percent of gastric banding patients experienced one or more adverse events, ranging from mild to severe. Common complications, from gastric banding included the following -- and keep in mind that excess weight increases your risks even further, which means everyone who undergoes weight loss surgery is at even greater risk:
||Band slippage and/or pouch dilation
||Reduced esophageal function
|Leaking or twisted access port into the stomach
||Band eroding into the stomach
Gastric Bypass Will Wreak Havoc on Your Digestive Processes and Ability to Absorb Nutrients
Gastric bypass involves stapling your stomach into a pouch that's only a half-ounce in size, so it literally cannot hold much. The idea is that you'll feel full faster, since your stomach will be unnaturally tiny, but this also means you'll often be eating meals that are sorely lacking in nutritional requirements.
A small opening is also created to allow food to empty slowly from the pouch. Because the opening is so small (made this way deliberately to keep the small amount of food you've eaten in your stomach longer, making you feel "full"), food must be chewed very thoroughly or it won't be able to fit through the opening, leading to vomiting.
You'll also be instructed to eat the protein portion of your meal first, because you very well may get too full to fit in a vegetable or anything else. Even liquids must be restricted for up to 45 minutes before and after a meal, lest they take up what little space you have to consume actual food. As you might suspect, because bariatric surgery patients can consume very little roughage, constipation is often a problem. It is even described as "normal" to have a bowel movement only once every two or three days!
Snacking is also expressly forbidden after gastric bypass, as you're only allowed three small meals a day, and you may have to write off certain foods entirely because your body just can't digest them anymore. This includes red meats, skins of fruits and vegetables (where the bulk of the antioxidants are) and fibrous vegetables. This is simply NOT a healthy way of eating, and the long-term implications are just as severe as the short-term risks. Hair loss and muscle loss are common after the surgery -- both signs that your body is not receiving proper nutrition.
Proper Diet — The Most Important Strategy to Reverse Type 2 Diabetes
What makes this so frustratingly ironic, if not downright tragic, is that your diet is not only the most effective way to reversetype 2 diabetes, it's the ONLY way! Yet the medical community keeps coming up with one bad diabetes treatment after the other, and I think they've really hit it out of the park with this one — all because Medicare and insurance companies will pay for it...
Seven years ago, Dr. Ron Rosedale wrote the article Doctors Cause Diabetics to D.I.E., and if you have type 2 diabetes, or know someone who does, you'd be well advised to read what he has to say on this matter.
"I have been incensed about the traditional medical treatment of diabetes for decades," Dr. Rosedale writes. "Diabetics have been told that they can eat meals multiple times daily that turn into sugar and even sugar itself, as long as they take enough insulin to lower their blood sugar.
The importance of limiting the intake of sugar and foods that turn into sugar has been almost totally ignored. There has been virtually no recognition that high levels of insulin are at least as much of an insult to a person's health as high levels of sugar (see Insulin and its Metabolic Effects).
With blinders on, drugs have been and are still being given to lower blood sugar, even though they essentially whip the islet cells of the pancreas to produce more insulin. These unfortunate, overstressed islet cells have been producing excess insulin for years and often decades to try to compensate for the insensitivity, the resistance of the body's cells to insulin's signal.
This is much like whipping a horse to run faster at the end of a race; it runs faster for a little while, but if you keep doing it, it collapses and dies.
So too do the islet cells that manufacture insulin in the pancreas die when drugs, nay doctors, whip them to keep producing more insulin when they are tired and sick. At this point, a diabetic, who originally had plenty of insulin being produced, and whose problem was merely one of insulin resistance that is easily remedied via proper treatment and diet, now starts losing the ability to produce insulin and becomes, in addition to insulin resistant, insulin deficient; a much more serious and problematic disorder caused by Doctor Induced Exacerbation (DIE)."
Reversing Type 2 Diabetes Sans Surgery or Drugs
Amazingly, one in four Americans has some form of diabetes or pre-diabetes. If this is not a clear sign that conventional health recommendations are flawed, I don't know what is.
I too have personal experience with this disease. I developed it myself at one time, and most of my paternal relatives (my dad included), have, or have died from, diabetes. My personal experience with diabetes and subsequent review of the literature made it VERY clear to me that virtually every case of type 2 diabetes is reversible... And the cure for type 2 diabetes has NOTHING to do with giving insulin or taking drugs to control your blood sugar. In fact, giving insulin to someone with type 2 diabetes is one of the worst things that can be done. Any physician still doing this suffers from profound ignorance of insulin physiology.
It's important to understand that many of the conventional recommendations for treating diabetes are not only flawed but dead wrong. If you need a refresher, please review my previous article, Deaths Halt Diabetes Study. Once you understand that type 2 diabetes is a fully preventable condition that arises from faulty leptin signaling and insulin resistance, the remedy will become clear.
To reverse the disease, you need to recover your body's insulin and leptin sensitivities!
How do you do that? As mentioned earlier, the ONLY way to accomplish this is through proper diet and exercise, as detailed in my free Nutrition Plan. Surgery will not do the trick, and there is NO drug that can correct leptin signaling and insulin resistance... Adhering to the following guidelines can help you do at least three things that are essential for successfully treating diabetes: recover your insulin/leptin sensitivity; normalize your weight; and normalize your blood pressure:
- Severely limit or eliminate sugar and grains in your diet, especially fructose which is far more detrimental than any other type of sugar. Following my Nutrition Plan will help you do this without too much fuss.
- Exercise regularly. Exercise is an absolutely essential factor, and without it, you're unlikely to get this devastating disease under control. It is one of the fastest and most powerful ways to lower your insulin and leptin resistance. If you're unsure of how to get started, I recommend reviewing my Peak Fitness program for tips and guidelines.
- Avoid trans fats.
- Get plenty of omega-3 fats from a high quality, animal-based source, such as krill oil.
- Optimize your vitamin D levels. Recent studies have revealed that getting enough vitamin D can have a powerful effect on normalizing your blood pressure and that low vitamin D levels may increase your risk of heart disease.
- Optimize your gut flora. Your gut is a living ecosystem, full of both good bacteria and bad. Multiple studies have shown that obese people have different intestinal bacteria than lean people. The more good bacteria you have, the stronger your immune system will be and the better your body will function overall. Fortunately, optimizing your gut flora is relatively easy. You can reseed your body with good bacteria by eating fermented foods (such as fermented vegetables, natto, raw organic cheese, or raw milk kefir) or by taking a high quality probiotic supplement.
- Address any underlying emotional issues and/or stress. Non-invasive tools like the Emotional Freedom Technique can be helpful and effective.
- Get enough high-quality sleep every night.
- Monitor your fasting insulin level. This is every bit as important as your fasting blood sugar. You'll want your fasting insulin level to be between 2 and 4. The higher your level, the worse your insulin sensitivity is.