Saturday, October 24, 2020

Bariatric Surgery for Diabetes


An article in a recent issue of The Journal of the American Medical Association* offered one of the worst solutions ever put forth for diabetics – stomach-banding surgery. According to Australian researchers, three quarters of obese patients with type-2 diabetes were cured. The researchers stated that this was 5 times as many as could be cured with medications and diet and lifestyle changes.

This is simply not true. The comparison was made between stomach banding and traditional weight loss diets, which we all know don’t work. The patients getting the band lost an average of 20.7% of their weight, while those on a medically supervised diet lost only 1.3%. This research represents another example of comparing two terrible alternatives to determine which of the bad ones is better.

In stomach banding, an inflatable silicon band is placed around the stomach to limit its capacity to hold food, which reduces consumption. The problem is that these procedures have a high rate of complications, and leave patients unable to eat enough food to properly nourish the body. Almost all bariatric surgery patients suffer from malnutrition if they continue to consume the tiny amounts of food their stomachs can hold. A significant number of them re-gain their weight as their stomachs stretch out again and can hold more normal amounts of food.

Traditional weight loss diets teaching a moderate approach to dietary change with portion control are notoriously ineffective. Eating small amounts of calorie-dense foods that cannot fill the stomach and hoping that willpower will allow you to remain hungry until you’re thin is a ridiculous plan.

On the other hand, we know that a low-fat vegan diet works both for weight loss and for reversing type-2 diabetes. (there are numerous articles in the Health Briefs series about this topic, some of which cover Dr. Neal Barnard’s research in reversing type-2 diabetes using such a diet)

These facts do not stop the ridiculous and inappropriate comments of medical professionals, which include that the results were “clear and striking” according to Dr. David E. Cummings and Dr. David R. Flum in an editorial in the issue of JAMA that included the article. And, this comment – the findings demonstrate that “Type 2 diabetes is a disease that should aggressively be treated with surgery and not merely controlled with medication,” according to Dr, Mitchell Roslin of Lenox Hill Hospital in New York City. He also said, “The truth is that treatment of diabetes requires a lifestyle modification, and only surgery makes that practical for the majority of obese diabetics.”

I suppose that’s true if you don’t tell them about better alternatives.

*Dixon, John B et al, “Adjustable Gastric Banding and Conventional Therapy for Type 2 Diabetics: A Randomized Controlled Trial,” JAMA;299(3):316-323

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Medically trained in the UK. Writes on the subjects of injuries, healthcare and medicine. Contact me

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