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Weight Loss Surgery and Type 2 Diabetes

Weight loss surgery (also called bariatric surgery) can help improve type 2 diabetes. When you’re at a healthy weight, your blood sugar levels could get back to the normal range, meaning you may need fewer or no medications.

Your doctor may suggest weight loss surgery as a way to improve your health, since diabetes can damage your heart, kidneys, nerves, and eyes.

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The Basics of Weight Loss Surgery

Two kinds of weight loss surgery are commonly used: gastric bypass and gastric banding. Both types usually reduce your stomach from the size of a football to about the size of a golf ball. This helps people eat less and feel full faster after smaller meals. A normal stomach can hold about a quart of food, whereas the small pouch created after surgery holds only about a half-cup.

Gastric bypass, the more invasive bariatric surgery, makes your stomach smaller and bypasses the top of the small intestine. It cuts the calories and nutrients your body can absorb after eating. It’s also known as the Roux-en-Y gastric bypass.

With gastric banding, your surgeon places an adjustable band around the upper part of your stomach, making a small pouch there. To adjust the banding balloon, the surgeon adds saline fluid to tighten it or takes fluid out to make it looser. The band controls how quickly food can pass through the stomach pouch and how quickly you feel full. Banding is a less risky, less invasive weight loss surgery than gastric bypass. Banding also is often reversible.

Is Weight Loss Surgery Right for You?

Generally, weight loss surgery is most useful for people who have a BMI of 40 or higher, which is about 100 pounds overweight for men and about 80 pounds overweight for women.

But you can also think about the surgery if you have a BMI of 30 or higher and you have type 2 diabetes or another obesity-related condition like heart disease, high blood pressure, arthritis, or sleep apnea.

Insurance plans may require that you complete a 6- to 12-month, doctor-approved diet and exercise plan before they'll cover the surgery. The goal is for you to show that you can change your lifestyle, which is key to keeping weight off.

Weight loss surgery may not be an option for you if you have any of the following conditions:

  • Obesity that comes from a metabolic or endocrine disorder
  • Current substance abuse
  • Untreated psychiatric disorders
  • Heart disease or other medical conditions that make any surgery a high risk
  • Women planning pregnancy within 18 months of surgery

What Happens After the Procedure?

To feel your best, you still have to make a lifelong commitment to diet and exercise.

Your meal sizes will have to shrink a lot. Start with a half-cup of food, and move up to three-quarters or a whole cup. You’ll find that the same foods that are good for managing your diabetes -- protein, vegetables, and other nutrient-rich choices -- are also ideal for getting the best results from weight loss surgery.

WebMD Medical Reference

Reviewed by John A. Seibel, MD on July 18, 2012
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