Benefits and Risks Of Weight-Loss Surgery For Diabetes

A growing number of persistently overweight, or obese individuals are undergoing weight-loss surgery to shed pounds, and better manage their diabetes.

According to the American Society for Metabolic and Bariatric Surgery (ASMBS), weight-loss surgery improves type 2 diabetes in almost 90 percent of patients by lowering blood sugar levels, reducing the dosage and types of medication needed, and alleviating diabetes-related health problems.

Not An Easy Choice

Despite the amazing potential health benefits, weight-loss surgery is an option that must be carefully considered, and here are three reasons why:

• It’s Not Easy Weight Loss. Weight-loss surgery is an effective, permanent weight solution, but only if necessary lifestyle changes - such as making daily wise food choices - are maintained.
• Because making the most of weight-loss surgery demands a certain level of commitment and diligence, patients typically undergo psychological assessments, nutritional, and lifestyle counseling prior to their procedures. Success requires the hard work of changing long-held attitudes and behaviors related to food.
• It’s Not Considered A Type 2 Cure. Though many patients experience significant improvements in blood sugar levels following weight-loss surgery, and may eventually have their glucose levels return to normal, it seems that endocrinologists do not consider the surgery a type 2 diabetes cure. They instead consider it a remission of symptoms that will return if healthy lifestyle guidelines are disregarded, and may return even if guidelines are followed.
• All Surgery Carries Risk. The ASMBS points out the risks involved with weight-loss surgery are significantly less than the long term risks of continued high blood sugar. However, surgical risk needs to be carefully considered, especially for individuals with severe, preexisting health conditions including hypertension, and uncontrolled diabetes.
• Generally, risk factors for weight-loss surgery performed at larger medical centers - or at clinics with an Accredited Bariatric Centers of Excellence designation - are about the same as for gall bladder removal. While that may be reassuring, all patients should discuss the potential benefits and risks of weight-loss procedures with their physician.

Because it is not a diabetes cure, the American Diabetes Association recommends that individuals who have weight loss surgery continue with regular diabetes screenings, even if glucose levels normalize. There is always a chance hyperglycemia will return.

Consider Carefully

Though generally treatable, there are some nasty side effects that can occur days, weeks, or months after weight-loss surgery. Some individuals experience bleeding, leaking, infection, diarrhea, or blood clots. People may have trouble absorbing adequate nutrients, develop gallstones, hernias, reflux, or a narrowing of the remodeled stomach.

About 20 percent of weight-loss surgery patients need further procedures to address post-surgical complications; up to 30 percent need help with problems related to malnutrition.

Still, the International Diabetes Foundation considers weight-loss surgery a potent and cost-effective option for ameliorating diabetes in those affected by severe obesity, and not meeting their targets with medical therapies. Those interested should first consult a physician to see whether they meet the criteria for surgical weight-loss procedures.

Sources: ASMBS; NIH; Diabetic Lifestyle; American Diabetes Assoc; Diabetes Self Management