Can Surgery Help More People With Diabetes?

Study finds non-morbidly obese people may benefit

woman giving herself insulin that could be eligible for bariatric surgery

If you’re a morbidly obese adult suffering from diabetes, bariatric surgery is an option to help you lose weight and control your condition.

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But according to a new study, if you’re considered obese — but not morbidly obese — you too may benefit short-term from bariatric surgery.

As for the hope that surgery may provide long-term diabetes control, though, the jury is still out.

Study finds benefits for non-morbidly obese adults

Rand Health researchers viewed more than 50 studies comparing surgical and non-surgical therapies for treating diabetes in people with a body mass index (BMI) of 30 to 35. Morbid obesity is considered to be BMI of 35 or above.

The researchers found bariatric surgery did promote greater short-term weight loss and glycemic control in people with a BMI between 30 and 35. But researchers acknowledge the data is very limited.

 Stacy Brethauer, MD, who did not take part in the study but is a bariatric surgeon at Cleveland Clinic, agrees.

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“The short term benefits of surgery are pretty clear,” says Dr. Brethauer. “What is less clear based on the current evidence is the long-term benefit for patients with lower body mass index. We understand that we need better long-term data.”

Even with surgery, no quick fixes for obesity or diabetes

Bariatric surgery is effective in weight loss and glycemic control. For the effect to be long-lasting, though, any patient with diabetes or obesity needs to still focus on diet and exercise.

 “These are chronic diseases and there are no quick fixes for obesity or diabetes,” says Dr. Brethauer. “The effect of gastric bypass on diabetes does occur rapidly, though,  and several of the effects are independent of weight loss. But in order to maintain the effects of surgery long-term, patients need to continue eating properly and exercising.”

 “It takes a lot of hard work and dedication from the patients to be successful after bariatric surgery,” he adds.

Who will benefit most from surgery

For diabetic patients, the best candidates for bariatric surgery are obese people with poorly controlled diabetes who have had trouble achieving control with medical therapy, says Dr. Brethauer. For these, the potential benefits of surgery are great in terms of weight loss and better glycemic control.

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 “For an overweight person with a BMI 25-30, with early, mild diabetes that is easy to control with a pill, there is no strong evidence right now to say that the benefits of surgery outweigh the risks,” Dr. Brethauer says.

“For an obese person with poorly controlled diabetes, though, the risk of long-term complications from diabetes is great and these patients have a much more favorable risk/benefit profile for surgery.”

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