Weight Loss Surgery Can Cure Diabetes
Big Improvements Seen in High Blood Pressure, Sleep Apnea, Other Obesity-Related Conditions
WebMD News Archive
Oct. 12, 2004 -- Researchers say weight loss surgery is giving people who are morbidly obese a new and healthier start on life.
At 626 pounds, 33-year-old Bo McCoy suffered from high blood pressure, high cholesterol, and sleep apnea that were so severe he had spent half his life sleeping with a pressurized air mask over his nose to control it - until he had weight loss surgery. McCoy is now 35, almost 400 pounds lighter, and he no longer needs the machine to sleep through the night, nor medication to control his blood pressure.
Two years ago McCoy had gastric bypass surgery. His experience is similar to that of most people who have weight loss surgery, according to the largest review ever to examine improvements in obesity-related conditions among surgery patients.
Published in the Oct. 13 issue of the Journal of the American Medical Association, the review of more than 130 studies and 22,000 obese or morbidly obese patients shows that the vast majority of people who have weight loss surgery experience dramatic improvements in type 2 diabetes, high blood pressure, high cholesterol, and sleep apnea.
Safety Reviewed for Weight Loss Surgery
The review also presents the most comprehensive picture to date of the risks of various weight loss surgeries. Gastric banding was the safest procedure, with a mortality rate within 30 days of the procedure of 0.1%. Whereas one out of 200 patients who underwent gastric bypass procedures died within 30 days and one of 100 patients who had biliopancreatic diversion or duodenal switch procedures died.
These latter weight loss surgeries are more complicated procedures requiring more operative skills. They are considered to cause more malabsorption compared with banding procedures known better as restrictive procedures.
Although gastric banding was the safest procedure, it was not as effective as the other weight loss surgeries. Gastric banding patients lost an average of 47% of their excess weight, compared with an average of 62% excess weight loss by patients who has gastric bypass surgeries, and 70% excess weight loss by patients who had biliopancreatic or duodenal switch procedures.
"It is true that there are risks with these surgeries," researcher Henry Buchwald, MD, PhD, tells WebMD. "But the risks compare quite favorably with other major surgeries. And the risks of obesity are much greater than the surgical risks."
In studies reviewed by Buchwald and colleagues that assessed type 2 diabetes before and after weight loss surgery, the disease completely disappeared in just under 77% of patients and it improved or resolved in 86% of patients. Improvements in cholesterol were seen in 70% of patients and high blood pressure either resolved or improved in 78% of them. In studies assessing sleep apnea before and after weight loss surgery, the condition disappeared in 86% of patients who lost weight.