Our Summary

This study looked at the long-term effects of weight loss surgery on people with type 2 diabetes. They focused on two things: how the surgery affected the patient’s diabetes over five years, and how it affected certain complications of diabetes that can affect the kidneys and eyes. They studied 82 people, most of whom were women, who were overweight and had been diabetic for an average of 8 years. Some of these people controlled their diabetes with diet, some with medication, and some with insulin. They found that after five years, only 5% of patients had optimal control of their diabetes and 15% showed improvement. The surgery did help reduce the presence of a protein in the urine, which can be a sign of kidney damage, and seemed to prevent further damage to the retina, which can occur in diabetics. However, the researchers concluded that the surgery didn’t help control diabetes as much as they had hoped, suggesting that better strategies are needed to manage diabetes after surgery.

FAQs

  1. What were the two main focuses of this study on weight loss surgery and type 2 diabetes?
  2. Did the study find that weight loss surgery was effective in controlling diabetes in the long term?
  3. How did the surgery help with the complications of diabetes that can affect the kidneys and eyes?

Doctor’s Tip

A doctor might tell a patient considering obesity surgery to make sure to follow up regularly with their healthcare team, including their primary care doctor and endocrinologist, to monitor their diabetes control and overall health. They may also recommend working with a dietitian to develop a healthy eating plan and engaging in regular physical activity to support weight loss and improve diabetes management. It’s important for patients to understand that surgery is just one part of their weight loss journey and that ongoing lifestyle changes are essential for long-term success.

Suitable For

Patients who are typically recommended obesity surgery are those who have a body mass index (BMI) of 40 or higher, or a BMI of 35 or higher with obesity-related health conditions such as type 2 diabetes, high blood pressure, sleep apnea, or heart disease. These patients have often tried and failed to lose weight through diet and exercise alone, and may be at risk for serious health complications due to their obesity. Weight loss surgery is considered a last resort option for these patients to help them achieve significant and sustainable weight loss, improve their overall health, and reduce their risk of developing obesity-related diseases.

Timeline

  • Before surgery: The patient may have struggled with obesity for years, trying various diets and exercise regimens without success. They may have developed health complications such as type 2 diabetes, high blood pressure, or sleep apnea. The patient would meet with a healthcare provider to discuss the risks and benefits of weight loss surgery, undergo psychological evaluation, and make lifestyle changes in preparation for surgery.

  • Surgery: The patient undergoes weight loss surgery, such as gastric bypass or sleeve gastrectomy, which reduces the size of the stomach and limits the amount of food the patient can eat. The surgery is typically done laparoscopically, with a shorter recovery time compared to traditional open surgery.

  • Immediately after surgery: The patient will be closely monitored in the hospital for any complications and will begin a liquid diet before gradually transitioning to solid foods. They will be instructed on how to eat smaller portions and make healthier food choices to support weight loss.

  • Months after surgery: The patient will continue to follow up with their healthcare provider for monitoring of weight loss progress, nutritional deficiencies, and potential complications. They may experience rapid weight loss in the first few months and need to adjust their medications for conditions like diabetes or high blood pressure as their body adjusts to the changes.

  • Years after surgery: The patient should continue to follow a healthy diet and exercise routine to maintain weight loss and prevent weight regain. They may need additional surgeries for skin removal or to address complications like gallstones. They should also be monitored for long-term health effects of weight loss surgery, such as changes in bone density or vitamin deficiencies.

What to Ask Your Doctor

  1. What are the different types of obesity surgery available and which one would be most suitable for me?
  2. What are the potential risks and complications associated with obesity surgery?
  3. How much weight can I expect to lose after the surgery?
  4. What lifestyle changes will I need to make after the surgery to ensure long-term success?
  5. Will I need to take any supplements or medications after the surgery?
  6. How will the surgery affect my current medical conditions, such as diabetes?
  7. How often will I need to follow up with you after the surgery?
  8. Are there any support groups or resources available to help me through the process?
  9. Will my insurance cover the cost of the surgery?
  10. What are the chances of the weight loss being maintained long-term?

Reference

Authors: Miras AD, Ravindra S, Humphreys A, Lascaratos G, Quartey KNK, Ahmed AR, Cousins J, Moorthy K, Purkayastha S, Hakky S, Tan T, Chahal HS. Journal: Obes Surg. 2019 Dec;29(12):3907-3911. doi: 10.1007/s11695-019-04095-w. PMID: 31372874