Can Bariatric Surgery Cure Type 2 Diabetes?

Bariatric surgeries, such as gastric bypass and gastric sleeve, are designed to help patients lose weight, but bariatric surgery is not just about fitting into a smaller size. These life-saving weight loss procedures can also have many positive health effects. Studies show that bariatric surgery can improve Type 2 diabetes and even help patients achieve remission from the disease. The American Diabetes Association recommends bariatric surgery as an effective option for patients seeking to treat Type 2 diabetes.

How are obesity and diabetes related?

Obesity is defined by an excess of body fat, but the condition of obesity can be a risk factor for the development of other chronic diseases. Conditions that often accompany obesity are called comorbidities. Obesity comorbidities include hypertension, heart disease, sleep apnea, depression and type 2 diabetes, which is among the most prevalent and harmful of obesity comorbidities. In fact, it is estimated that over 90% of patients with type 2 diabetes are overweight or obese. Diabetes can cause long-term health problems, including neuropathy, vision issues (retinopathy), and kidney disease (nephropathy).

How does bariatric surgery work?

There are several types of bariatric surgery and each procedure is classified as restrictive, malabsorptive, or both. Restrictive procedures limit the amount of food a patient can eat at one time, and helps them feel full with less food, by reducing the size of the stomach. Malabsorptive procedures change the way that food is digested so the patient retains fewer calories. Gastric Sleeve, also known as Vertical Sleeve Gastrectomy (VSG), is currently the most popular bariatric surgery, accounting for over 50% of bariatric procedures recently performed according to the American Society for Metabolic and Bariatric Surgery (ASMBS). Gastric Sleeve involves removing approximately 70% of the stomach. The patient’s new, smaller stomach enables them to feel full with much less food. Gastric Bypass is a bariatric surgery that is both restrictive and malabsorptive, and can also improve type 2 diabetes. In addition to restricting food intake, gastric sleeve and gastric bypass also change the metabolic processing in the body, including reducing ghrelin, a hormone that helps regulate cravings.

What about other diseases related to obesity?

Bariatric surgery, such as gastric bypass and gastric sleeve, can also have a positive effect on other obesity-related conditions, including:

• Hypertension
• Heart disease
• Sleep apnea
• High cholesterol
• Osteoarthritis

What happens after bariatric surgery?

Bariatric surgery is a powerful tool that can help patients regain their health, but it is not an easy way out. Weight loss patients who work with an experienced and reputable bariatric surgeon will be advised on post-surgical diet and activity plans. It is critical for weight loss success and diabetes improvement that bariatric patients are committed to healthy lifestyle habits. There are several key components to weight loss success and post-bariatric health:

• Diet: After surgery, bariatric patients will closely follow a prescribed diet that will start with liquids and soft foods. Once patients reach the point at which they have more food options, it is important to plan healthy meals that are low-calorie, high-protein, and rich in nutrients. Bariatric patients should avoid foods that are fried, highly processed, or have added sugars. A healthful diet may include lean meats, eggs, low-fat dairy, beans, and plenty of vegetables. It is also important to stay hydrated with water while avoiding sugary drinks, carbonated drinks, or alcohol. It can be helpful to choose a bariatric surgeon with an experienced dietitian on staff.
• Exercise: The role of physical activity is sometimes downplayed in the discussion of weight loss, but an exercise routine is a very important part of overall health. The current guidelines from the Department of Health and Human Services advise adults to perform moderate-intensity aerobic activity for between 150 minutes (2 hours and 30 minutes) to 300 minutes (5 hours) as well as muscle strengthening activities at least 2 days per week. Physical activity can be intimidating for patients who are struggling to overcome obesity, but some low-impact exercises that can be good options for post-bariatric patients include brisk walking, swimming, and gentle yoga. You should always consult your doctor before starting an exercise routine.
• Support: A weight loss or health journey can be more fun and more effective with a buddy. Try to involve family and friends in healthy meal planning and exercise. Check with your bariatric surgeon’s office to see if they offer a support group or online resources. It can be beneficial to trade tips and motivation with other patients who have had bariatric surgery and are trying to live healthier while overcoming diabetes. Be sure to attend all follow-up appointments with your bariatric surgeon or general practitioner to ensure your weight loss and diabetes are properly monitored.

Does health insurance cover bariatric surgery?

Many health insurance plans do cover bariatric surgery. It can be challenging to figure out exactly what different health insurance plans cover. So patients who are considering bariatric surgery may benefit by consulting a bariatric surgeon near them who offers a free insurance check. Depending on your insurance plan, there may be pre-requisites, such as medically supervised weight loss or a waiting period, required for insurance approval. Your bariatric surgeon may also offer financing options for qualified patients who choose a self-pay procedure.

I have type 2 diabetes. Is bariatric surgery right for me?

The best way to determine if bariatric surgery, such as gastric sleeve, may be right for you is to schedule a consultation appointment with a bariatric surgeon near you. Look for an experienced surgeon who offers a variety of weight loss options and has excellent patient reviews. When determining if you are a candidate for bariatric surgery, your doctor will take into account your BMI, which stands for Body Mass Index and is a measure of body fat. In general, you may be a candidate for bariatric surgery if you:

• Have tried to lose weight through diet and exercise, but have been unable to succeed or maintain weight loss
• Have a BMI of 40 or higher, or
• Have a BMI of 35 plus a comorbidity such as type 2 diabetes