Thursday, March 25, 2010

How Weight-Loss Surgery Reverses Type 2 Diabetes: New Study Offers Explanation

This article is another in a long line of articles that is giving (false) hope to type 2 diabetics that there will be a way to put their diabetes into remission.
I belong to a couple of diabetes lists, and this link appeared on one of them, with a few comments from members of the list saying "Yeah good news if only I could find someone who would do it & ins to cover it over the age of 65." and similar things. No concerns about future complications from that kind of surgery; in fact, one person had the comment: "If you are healthy enough to survive a hysterectomy, then a bariatric surgeon would probably do the surgery for you. The risk of dying during the bariatric surgery is the same as that for a hysterectomy. The insurance is a another story. If you qualify for disability Social Security then all it takes is a phone to call to Medicare and within 2 weeks you would be qualified. Unlike other insurance companies Medicare views obesity as an illness and treatable by surgery." That doesn't take into account the risk of dying in the first week after bariatric surgery, or the first month, let alone what any of the other complications of bariatric surgery are and how they can be much worse than any of the complications of type 2 diabetes.
How scary is it that Medicare would qualify someone over the age of 65 for bariatric surgery in 2 weeks? Doesn't sound to me like Medicare would be doing the necessary psychological evaluation, and bariatric surgeons are notorious for not caring about the psychological health of their patients, as long as those patients are healthy enough to make it out of surgery (and their insurance will pay for that surgery).

So, back to the article -
"Bariatric surgery currently is considered to be the most effective long-term treatment for human obesity and often leads to marked improvements in diabetes," said the study's lead author Peter Havel, a professor with joint appointments in the School of Veterinary Medicine and Department of Nutrition.

If bariatric surgery is the most effective long-term treatment for obesity there is, we are in a heap of shit, people, because it ain't that effective. Most "obese" people don't lose enough weight to become "overweight", let alone thin. A good percentage of those who lose weight end up regaining most or all of what they lost, and those who don't regain end up with complications that are so much worse than any of the so-called ill effects of "obesity" that they would much rather have stayed fat than have had the surgery.

"This study confirms our clinical observations that metabolic regulation -- specifically homeostasis of glucose -- occurs quickly after gastric bypass surgery," said Mohamed Ali, an associate professor of gastrointestinal surgery and a specialist in bariatric surgery at UC Davis Health System. "It's clear from the outcome that something physiologic is at work with controlling diabetes that is not related to weight loss.

And instead of trying to find out what the physiologic cause is, let's just go with modifying a functioning digestive system, because that has to be where the problem is. After all, when we mutilated a functioning digestive system, we managed to accidently put type 2 diabetes into remission for a short period of time, so maybe, if we fuck with it some more, we can extend that period of time (yeah, right, I'm not going to hold my breath on that one, folks).

In severe cases of obesity -- usually when the patient is 80 to 100 or more pounds overweight -- bariatric surgery is used to alter or reconstruct the stomach and/or the intestinal tract. In such cases, obesity is not just a weight issue but also a life-threatening health problem that often leads to type 2 diabetes, heart disease and sleep apnea.

Yeah, how many thin people have type 2 diabetes, heart disease, and sleep apnea? Why did they get it? Can't blame it on fat in their cases, so why is fat blamed when fat people get the same diseases as thin people? Logic FAIL, researchers.

Havel and colleagues set out to test a hypothesis that certain bariatric surgical procedures were successful in improving type 2 diabetes, at least in part, because the procedures increased the flux of unabsorbed nutrients to the far end of the small intestine and, in doing so, triggered increased secretion of two hormones. Those hormones -- glucagon-like peptide-1 (GLP-1) and peptide-YY (PYY) -- are known to have a role in controlling food intake and improving insulin secretion and insulin sensitivity, thereby helping to stabilize blood sugar levels.
To test the hypothesis, the researchers carried out a surgical procedure known as ileal interposition in a line of rats that were predisposed to obesity and type 2 diabetes. The rat model, developed in Havel's laboratory, was known as the UC Davis Type 2 Diabetes Mellitus (UCD-T2DM) Rat. The pathology of type 2 diabetes in these animals is more similar to type 2 diabetes in humans than other existing rodent models of the disease.

So they used rats predisposed to develop type 2 diabetes (gee, just like some people are genetically predisposed to develop type 2 diabetes). Whoever would have thought of that? (/sarcasm)

They found that the rats receiving the ileal interposition surgery developed type 2 diabetes 120 days later than did the rats in the control group. Furthermore, by the time the rats were one year old, 78 percent of the control group rats were diabetic while only 38 percent of the rats that had received the ileal interposition procedure had developed diabetes.
Havel said the delay in onset of diabetes in the rats would be similar to delaying the age of onset of diabetes by approximately 10 years in a person, which would be expected to significantly decrease the amount of time for diabetic complications to develop, and to reduce the health care costs associated with treating this costly and prevalent disease.

And do they know what the possible side effects of this surgery in humans could be? Are those side effects worth the 10-year delay in the onset of type 2 diabetes (will it be cheaper to treat the side effects or the diabetes for that 10 years)? No one knows, and I'd venture to say that no one has even considered those questions.


  1. Huh? Why would they have to do any surgery at all? Why not just inject the hormones if it's the hormones causing the delay in the onset of diabetes?

  2. Why is it so hard for these researchers to understand basic logic? For one, the mere fact that your food intake is DRASTICALLY REDUCED most likely accounts for a huge part of this "mystery". You think eating an amount of food equivalent to the size of an egg would have anything to do with that????? Nevermind the lack of absorption of nutrients in the digestive track.....or the "Pay no attention to the man behind the curtain" syndrome~! It still boggles my mind that medical professional (!) and most everyone else fully believes that ALLLLLL fat people will get diabetes, sleep apnea, and heart disease...even though the actual statistics that track those things verify it's less than 20%, at least for the diabetes part. And how do they even explain that the paradox that average size people have sleep apnea too? And heart disease?? *headcementwall*

  3. If bariatric surgery is the most effective long-term treatment for obesity there is, we are in a heap of shit, people, because it ain't that effective.

    This cracked me up.

  4. I have sleep apnea, but would say it predates my obesity as I had sleep problems from childhood that when away when I got my CPAP.

    Secondly, I saw a billboard the other day I want to bitch about. I live in Texas and have frequently seen billboards that say "Your wife it hot! Get your a/c fixed" with company contact information. I saw a new billboard that said "My wife is hot! Thank you" with contact info to a bariatric surgeon, proving once again weight loss surgery isn't about health, it's about appearance.

  5. It's almost sweet to see how much they talk up bariatric surgery because the failure would be more on them than usual.

    Their self esteem preservation techniques should inspire us all.

  6. deeleigh - Why try to create and market the hormones when you've already got the surgery in place and it's a proven money-maker? After all, it takes money to create the hormones, test them, get them to pass the FDA requirements, and then market them. All of that takes time, probably more time than they want to spend, not to mention more money than the drug companies want to spend.

    Regina - I know, and it's like talking to that cement wall to get them to listen to us and our experiences.

    the fat nutritionist - sometimes the truth is the funniest thing out

    Kate - weight loss and WLS has never been about health, no matter what was said. It's always been about appearance and what the media thinks is HOT, never mind what actual people think is HOT.

    wriggles - yeah, they keep talking it up, but I think people are finally getting wise to the fact that it just doesn't work as well as it's advertised to work. I'm looking forward to the day when insurance companies get wise to the fact that the $25,000 they spent on a fat person's WLS ended up costing them more than $1,000,000 to treat the complications from the WLS, while treating the fat person might not have cost them half that much (or could have cost even less if the fat person didn't ever end up with any of the so-called co-morbidities of "obesity").

  7. Havel said the delay in onset of diabetes in the rats would be similar to delaying the age of onset of diabetes by approximately 10 years in a person

    And how exactly are they going to determine exactly who should get this procedure, and when they should get it, in order to delay the onset of diabetes? Are they going to give it to babies at birth if they have diabetic parents? To 20-year-olds whose 50-year-old parent is diagnosed with type 2 diabetes? What about the chance that the people they decide need the surgery MIGHT NEVER HAVE DEVELOPED DIABETES anyway and now they're stuck with a mucked-up GI tract and dealing with whatever side effects come about?


  8. Amy - Exactly!! They have no way of determining who should have the surgery or when they should have it since they can't predict exactly who will get type 2 diabetes or exactly when they will get it.


    Life expectancy for those who survive WLS is about the same as for those who don't have it.

    Doctors lie like hell. The will tell you that the death rate from gastric bypass is 1 in 2000. The NIH says it is 1 in 100. The butchers who do gastric banding with tell you that gastric bypass is kills 1 in 200. CBS News says 1 in 50 die within the first 2 months.

    This goes way beyond obesity. Our medical system exploits real disease for obscene profits and it medicalizes other things for even more profit.

    The leading cause of death in the US is NOT cancer, heart disease or obesity. The leading cause of death and injury in the US is our health care system.

    Medical Holocaust is dedicated to the many millions of Americans who are killed and maimed each year as a result of medical errors and hospital acquired infections. This blog is here to raise awareness regarding the true nature of the health care crisis in the United States of America. I will attempt to provide credible scientific information that you won't see in the mainstream corporate run media. STOP THIS GENOCIDE!


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