Tuesday, June 21, 2011

Are You Obese? Diabetic? Try surgery! Right?

Glucometer. Flickr: AlishaV
This article is not for or against surgery, I have lost my weight on my own, but that does not mean I think surgery is wrong of unnecessary, it depends on the person and the situation, I know that, I just wanted to put that out there first.
In 2009, over 220,000 people had bariatric surgery. The International Diabetes Federation announced that they now recommend bariatric surgery as a treatment for diabetics with a body mass index (BMI) of 35 or more; and also as an alternative treatment for diabetics with a BMI of 30-35, either when diabetes is not being adequately controlled with medication or in the presence of major cardiovascular risk factors. As its rationale, the IDF cites effective reversal of diabetes, reduced health costs, reduced risk of all-cause mortality, and reductions in cardiovascular risk factors that occur as a result of the surgery.

Of course, bariatric surgery is effective for reversing diabetes but please note however that diabetes remission rates do decrease over time. Obesity is the primary risk factor for diabetes, and bariatric surgery forces weight loss by physically limiting either intake or absorption of food so of coarse it worked, but should bariatric surgery be recommended before radical lifestyle changes? The IDF and the American public seem to think so.  Good Morning America, stated that gastric bypass was a “breakthrough” treatment for reversing diabetes. According to the physician that discussed bariatric surgery on Good Morning America, “For people who are truly obese and have diabetes, diet and exercise just aren’t really effective.”

Really? Diet and exercise aren’t effective?
Hundreds of formerly obese, formerly diabetic individuals have followed dietary recommendations would disagree with that statement.
Do you disagree too? Have you reversed your diabetes by changing your lifestyle? If so, let Good Morning America know about it. Comment on the article, or send them your story.
I think that the hundreds of people who have reclaimed their lives by losing over 100 pounds following my high nutrient dietary recommendations would also agree that it is not that diet and exercise aren’t enough it’s just that small changes aren’t enough. A slightly modified version of the standard American diet is not enough. Artificially sweetened sodas and processed foods, excess meat, and a modest increase in vegetable intake cannot do the job of reversing diabetes. With their position statement, the IDF is perpetuating a misguided view, that lifestyle changes are not powerful enough to reverse disease.
Only dramatic changes will produce radical results AND Surgery is radical, but there is a radical lifestyle change, like to a natural high-nutrient plant-based diet-style, plus exercise that will work as well. A high nutrient density diet has tremendous therapeutic potential for diabetes, and for dramatically reducing health care costs. In a recently published study, the efficacy of a high nutrient density diet for treating diabetes was conducted and 62% of the participants reached normal (nondiabetic) HbA1C levels within seven months, and the average number of medications dropped from four to one.4 All participants were able to eliminate or reduce medication, except one, who was already on the lowest dosage of Metformin.
We live in an obesity and diabetes-promoting food environment, but we can find freedom from these influences. Most find that a high nutrient eating program derails toxic hunger and food addictions enables overweight people to achieve dramatic weight loss results that parallels or exceeds the long-term results of gastric bypass, and likewise, when diabetic, it most often resolves or dramatically improves.
Diabetics should be aware that superior nutrition works and it works better than drugs or surgery, it has been proven. Surgery will physically limit your portion sizes, but it will not remove addictive foods from your diet, and it will not give your body the nutrients it needs to protect you against heart disease, cancer, and other chronic diseases. Most often the initial results recede over the years as most of the surgery-treated individuals gain back much of the lost weight.
Once you become nutritionally aware, consider the sense of satisfaction, accomplishment, and improved self-esteem that can come from losing the weight and watching diabetes disappear. Consider that you may be stronger than you think you are, and that you capable of reclaiming your health.

Also, surgery does not come without risk. Potential complications of bariatric surgery such as gastric bypass are as follows5:
  • Infection
  • Hardening of the connection of the stomach to the small intestine
  • Bleeding
  • Obstruction of the small intestine
  • Gastrogastric fistulae (leaks between the “pouch” and the rest of the stomach), requiring additional surgery
  • Internal hernia, a potentially life-threatening complication that requires additional surgery6
  • Venous thromboembolism (blood clots)
  • Nutrient deficiencies7
  • Neurologic complications are said to be often disabling and irreversible, and many do not produce symptoms until over ten years after the surgery8
  • Bone loss
Diabetes and severe obesity both put the patient at greater risk of complications5 and diabetes is slso associated with poor weight loss following gastric bypass.9
The newest and most popular form of bariatric surgery is Laparoscopic gastric banding, commonly known as the lap-band surgery, and is also not without complications that we are just finding out since it is a relatively new procedure. A recent study reported a long-term complications such as leakages, band infections, and esophageal dilatation in 40%, and a re-operation rate of 20.4%. The failure rate of the procedure after 10 years was 31.6%.10
Addiction and emotional attachment to food is so prevalent and so powerful in our culture that these surgical procedures seem more reasonable than diet change. But it is not – weight loss surgery is extreme and risky; my dietary approach is safe and in most cases, the results are even more effective compared to gastric-bypass surgery. It could save your life.

1. American Society for Metabolic & Bariatric Surgery [http://www.asmbs.org]
2. Surgical and Procedural Interventions in the Treatment of Obese Patients with Type 2 Diabetes: A position statement from the International Diabetes Federation Taskforce on Epidemiology and Prevention.
3. Sjostrom L, Lindroos AK, Peltonen M, et al: Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. The New England journal of medicine 2004, 351:2683-2693.
4. Dunaief D, Gui-shuang Y, Fuhrman J, et al: Glycemic and cardiovascular parameters improved in type 2 diabetes with the high nutrient density diet. J Nutr 2010, 14(6):500. Presented at the International Academy on Nutrition and Aging (IANA) Conference on 
July 26, 2010.
5. Campos GM, Ciovica R, Rogers SJ, et al: Spectrum and risk factors of complications after gastric bypass. Arch Surg 2007, 142:969-975; discussion 976.
6. Schneider C, Cobb W, Scott J, et al: Rapid excess weight loss following laparoscopic gastric bypass leads to increased risk of internal hernia. Surg Endosc 2010.
7. Bell BJ, Bour ES, Scott JD, et al: Management of complications after laparoscopic Roux-en-Y gastric bypass. Minerva Chir 2009, 64:265-276.
8. Juhasz-Pocsine K, Rudnicki SA, Archer RL, et al: Neurologic complications of gastric bypass surgery for morbid obesity. Neurology 2007, 68:1843-1850.
9. Campos GM, Rabl C, Mulligan K, et al: Factors associated with weight loss after gastric bypass. Arch Surg 2008, 143:877-883; discussion 884.
10. Naef M, Mouton WG, Naef U, et al: Graft survival and complications after laparoscopic gastric banding for morbid obesity--lessons learned from a 12-year experience. Obes Surg 2010, 20:1206-1214.


  1. I am so grateful to be maintaining a weight loss of over 200+ lbs achieved with a healthy food plan and moderate exercise. I am angered every time some 'expert' is quoted saying that diet and exercise are not effective. Weight loss and maintenance are not easy but they are the results of commitment, just as weight gain is always due to consumption.

    Surgery should not be the first option. It should not be easy to get. I have met many people who have had this surgery and are still fighting food addiction, let alone the undesirable side effects.

    Thank you for your post!


  2. What an inspirational story! Congrats on your loss and your ability to keep it off!! I know for some surgery is needed, that is why it is available, but I think it is overly available. My mom always pushed for me to get the lap band, and now all her friends who did it are having problems or gaining it back because they expected surgery to do the work for them, they didn't change their thoughts and habits when it came to everyday food choices. That was a hard lesson for me, but because of it, I will be able to follow in your footsteps and keep it off in the long run! Thank you for your comments!


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