Read for yourself, but in a nutshell, surgeons are trying to lower the requirements for bariatric
surgery to "reverse" diabetes in T2's while acknowledging they don't
know why bariatric surgery has reduced diabetic symptoms in obese patients.
I have a number of issues with this from a general standpoint. For one, I
haven't seen a lot of long term success stories for folks that have had this
type of surgery. I'm not saying it doesn't have benefits, so please don't start
a flame campaign for those who have had such procedures. I'm just saying I
don't know anyone personally who has such a procedure and cases for those in
the public spotlight seem to be short term successes.
Secondly, my personal opinion is that high risk surgery, with known short term risks
and unknown long term complications, should be a last resort so I am always concerned
when the medical community looks to expand procedures and lower the qualifications
for such procedures. In this case, it seems like surgeons are looking at the
potential increase in cases and minimizing the risks to increase their bottom
line. For those with T2 who do have weight issues, and where lowing weight
would result in better control of their diabetes, I don’t think surgery, or the
requirements to qualify for surgery, are dealing with other issues that may be
contributing to the core of the weight issue (lack of exercise, depression or
other emotional issues).
There are many reasons people struggle with weight, and for some I do believe surgery can be
the best, or only choice. But it seems that in America, we are looking at a
quick fix here without knowing what the long term outcome will be and without
addressing any of the actual issues commonly associated with the diabetes, and
overall good health (eating well, exercising, insulin resistance, etc… etc… etc)
I work with a formerly T2 girl who dropped from 350 to about 225 in about 14 or 15 months. She has kept it off, fluctuating +/- 10 lbs for 4 years. Her blood pressure went down, her asthma improved, and her diabetes went away. She, however, eats much less than she used to, and exercizes regurlary with a personal trainer who she wants to kill sometimes. Who knows if it will come back? I work wth a guy who lost weight the healthy way, because he was prediabetic and lost about 50 lbs, now about 3 years later, with exercize and healthy diet and maintaining a healthy weight, is on meds for his T2.
I am guessing that extra pressure on the organs from being overfat causes them to not work properly. Also, unless there is a medical reason someone is overfat, the person is probably eating so much it isn’t healthy to eat that much.
Also, if you are an emotional eater, I knew someone who got the surgery, then ate more than she was supposed to. Eventually, what was left of her stomach burst. She almost died from the toxicity. It is an extreme measure, but the first person I mentioned definitely benefited.
You first example on the surface sounds like a viable candidate for surgery regardless of the D. i am curious, and not sure if you have the answer, but what was it about hitting 225 that weight loss stopped?
You second example is similar to my situation, although i am just at my target weight and now have to put in the effort for the maintenance But i lost 50 pounds and have reduced my medication requirements through low carb and exercise.
Your friend whose stomach burst is, at least from experience, what we see the most in the media. A person has surgery, loses a great amount of weight up front, then gains it back on the back end when other factors come back into play (emotional eater).
I appreciate the feedback. While i am sorry for your one friend, it’s nice to also hear of success stories.
This information has been in debate for a long time in the bariatric surgery support groups. My wife is a bariatric patient (130 lbs lost thus far) but was not and is not diabetic. She is noticing changes in her blood pressure and going to have medications that she was on reworked. In my opinion (I am NOT a doctor or scientist) the effects on the diabetes is the result of a smaller stomach to consume food into. This means that portion control is of the utmost importance. The patient is given strict orders to limit carbs and avoid natural sugar completely. The new stomach (called pouch) is about the size of an egg so it’s important to follow instructions very carefully. Weight loss surgery (WLS) should not be considered as a treatment for diabetes but rather for clinical/morbid obesity. The research may be beneficial in the treatment of diabetes but not a replacement for. According to my wife’s support group there are stories of the surgery curing the diabetes in some cases, but as with any person’s body, not in ALL. To promise success, to me, would be giving false hope. These opinions are my own.
Umm. I do know a handful of folks who have had the surgery…sometimes twice! I agree surgery is a risky way to approach weight loss. At least two of the people I know who’ve had the surgery have had bowel problems that were caused by the food “dumping” action that sometimes follows the surgery. All of them have to continue taking suppliments as they are no longer able to get all of the vitamins and minerals they need from their meals.
I do think that in some cases, surgery may be the best approach. I guess what got me about this approach is that its using surgery for people who don’t really need it. In other words, if you are extremely overweight, have physical limitations due to weight, other diseases, or something that prevents you from losing weight using traditional methods, then this type of surgery may make sense. but in mildly overweight people? it just seem to push the “easy way out” solution.
I am a firm believer that surgery has its proper place in our medical system. i guess i just see this as pushing the boundaries and opens our society up to long term risks that we cant even foresee.
I know two folks who have had the surgery, for other reasons than D, and its been 5 or more years now and they have not gained the weight back. I know one person who has started gaining weight backafter 2 years.
I agree that it is my last resort, if I cannot do it with diet and exercise. Because the risks associated with the surgery about balance with the risks associated with D.
So far I have been able to lose a pound a week or a little more. I am down 18 lbs from June 2 when I was diagnosed. My goal is 100 lbs in two years. If successful, I will need to go in for a tummy tuck, which is infinitely preferable to bypass.
I met a guy when I did HBO that was not diabetic and did it strictly for weight loss - he did lose weight but then gained it all back.
This summer, some people in my development decided to raise money to build a playground for the kids and I was drafted to be on the committee. There is a T2 woman that is going to have the surgery to, as she puts it, cure her diabetes. One of the first times that I talked to her, she did not even know that there are different kinds of diabetes. She keeps saying that her diabetes is good - I guess I am bad because I am T1 and take insulin. I did ask her the one day what her A1c was. Our maintenance guy was standing there and laughed and said she probably did not even know what an A1c was. She said she knew but had no idea what her number was or what was even considered good.
She told me that she wants to lose 100 pounds. I have been around her because of helping with the playground stuff and have seen her eat. I think it is one thing to have a piece of cake when you are having meals with other people, but totally another when you live alone and take half of the leftover cake home. Like was mentioned, if you aren’t going to fix what caused the overeating problems in the first place, you aren’t going to fix anything.
I know that the guy that I did HBO with was not allowed to eat salads and other foods because of the gastric bypass. When I mentioned that to my neighbor, she said she did not know what she would be allowed to eat. I would think that would be something that you should know before deciding to go thru with surgery.
Her PCP is a doctor that I saw for a short period of time. She was definitely a pill pusher. My neighbor said that she was supposed to have 3 visits with her PCP as part of the requirements for surgery. She went in once and the PCP told her not to worry about the 3 visits, she would take care of it. Knowing what I know about the PCP, there is no doubt in my mind that the PCP would do that.
My feeling is that this surgery was dangled in front of her as some easy fix and someone wanted to make some money. She is in her 60s and does not have a computer to read any horror stories or learn all the actual pluses and minuses of having the surgery.
One person who has had it three times! And she is fatter than ever before, now.
One is the thinnest, but still overweight, and always having to have follow up surgeries to deal with complications, including complications from having to take away his excess leftover skin (because losing the weight is never the end of the story, either).
Another who DIED on the operating table… leaving her 13 kids behind, many of them adopted kids.
Gastric Bypass should NEVER be touted as a solution for regular overweight people to go and “cure” their Diabetes. Simply put, the stomach just can’t absorb any food any more, and that’s how most of these people’s blood sugars don’t spike. I don’t care how easy and awesome it seems… It’s not worth it. DYING on your family is not worth it. Living like you are more handicapped now, than you ever were, with Diabetes because of horrible, uncontrollable dumping and accompanying hypoglycemia, and never being able to drive again anymore… is NOT worth it. Especially when one can’t even do the most basic things like portion control, and the psychology of why we are overweight to begin with… If you don’t fix those things first, you will NEVER succeed with some shortcut surgery… And a few weeks of psychobabble so that you can have the surgery (and doctor’s can play at that they care about how you will do) is NOT going to make it doable, either.
I can see a reason for it, if you are very much overweight, say +400 lbs. But the psychological that these people have to go through is not, is NOT strong enough to prove to me or many that they will stick w ith it, have a very real understanding of what the ramifications are to their bodies. My friend who had hers done in May, is not progressing, but regressing back to old habits, and still saying “I have to get back on the wagon”. Her latest was to buy into a protein diet that cost a fortune (much like her surgery) and has done little or nothing to teach her how to eat healthy, or to help her get back on the wagon.
We are a society of “instant or fast” everything. So if there is a treatment that will give you weight loss in days or hours or weeks, we’ll buy it, and then wonder why we are going no where. No thank you, I’ll take my time, eat healthy, exercise, drink water, and watch the pounds come off slowly — and most likely stay that way!
Oh yeah… I know a 4th one, who is always dumping… Always… And is always having terrible hypoglycemia, to the point where she shouldn’t be driving anymore. She now is also an alcoholic, because she has replaced one addiction with another.
I guess the truth is that if you can exercise control over what you eat, you won’t need the bypass, and if you are not able to exercise control the bypass won’t be a permenant solution.
I don’t know. When I look at how much I have to lose, I get very discouraged and the thought of the surgery to “take this all away” is attractive. It feels like a mountain I have to climb.
Well so far so good. I can’t lose an elephant all at once, but I might be able to lose an elephant a pound a week at a time.
Hey… I’ve never been my ideal weight in my adult life, so… we can climb the mountain together. You’re not alone. I’m fighting hard, and learning new things every day, and retraining myself all the time… and I won’t give up. I’ll keep on going on.
“It’s kinda like a person who has a triple bypass they where never going to
do the right thing until they woke up in the recovery room hugging that pillow
and seeing their chest laced up with stainless steel wire, and after
that their Mr perfect. ----JMHO”
I will disagree with that statement. My cousin was also a T1 and pretty much ate French fries for every meal plus smoked. He had bypass surgery and his first meal home from the hospital was French fries. He continued to smoke. He is now dead because of heart issues. Yes, waking up hugging that pillow should have been a warning but it wasn’t. I am watching my brother go thru the same thing. His attitude is he is doomed anyway so why bother.
But i lost 50 pounds and have reduced my medication requirements through low carb and exercise.
I’ll keep on going on.