Study: Weight loss surgery keeps diabetes at bay long term, reverses complications
Weight loss surgery may keep diabetes and heart woes at bay for long periods of time -- and might even reverse some disease complications, new research suggests.
Researchers at the Cleveland Clinic looked at a group of people with diabetes who underwent weight loss, or bariatric, surgery to treat their obesity. After tracking patients for up to nine years after getting the procedure, the researchers found obesity-related health conditions like diabetes vanished for several of them.
Specifically, 80 percent of patients who had the surgeries met target blood sugar levels of 7 percent HbA1c, a level recommended by the American Diabetes Association. Nearly 30 percent of those who underwent a gastric bypass procedure experienced complete remission of diabetes that allowed them to stay off medication for at least five years, effectively curing them.
"That was a remarkable finding," Dr. Stacy Brethauer, the study's author and an associate director of the Cleveland Clinic's Bariatric & Metabolic Institute, said to CBSNews.com.
Obesity affects nearly 36 percent of Americans, raising their risk for related health conditions for Type 2 diabetes, heart disease, stroke, and certain types of cancer, some of the leading causes of preventable deaths in the U.S.
Obesity itself was declared a "disease" by the American Medical Association in June so doctors would tackle it with immediate treatment rather than look at it like a lifestyle condition that needs to modified.
This study suggests bariatric surgery may be the cure for these conditions.
There are three main types of procedures: gastric bypass, gastric banding and what's called a sleeve gastrectomy. Most of the patients in Brethauer's study had underwent a gastric bypass, in which doctors create a small pouch by stapling a portion of the stomach together to limit how much food a person can eat. The procedures were not pitted against each other directly for this study.
Researchers looked at nearly 220 patients with Type 2 diabetes who underwent bariatric surgery between 2004 and 2007, and had been tracked for at least five years after.
They found reductions in high blood pressure and high cholesterol on top of drops in weight. All these factors at the same time comprise metabolic syndrome, a condition that raises risk for heart disease, stroke and diabetes.
Brethauer added that a subgroup of patients had early stages of kidney disease when they underwent their surgical procedure. High blood pressure and diabetes are major risk factors for kidney disease. Following bariatric surgery, almost all of these patients' kidney disease had stabilized or reversed entirely.
The researchers want to see if bariatric surgery can reverse other diabetes-related conditions, like eyesight or nerve problems.
The study was published Sept. 19 in the Annals of Surgery.
Previous studies of weight loss surgeries have also reported protective benefits against obesity-related chronic diseases.
A June study in JAMA found lowered blood sugar levels and reduced need for medications after following patients for a year who underwent a gastric bypass. Last October, a Cleveland Clinic study from one of Brethauer's colleagues, Dr. Phil Schauer, found improvements in high blood pressure, cholesterol levels and diabetes control in bariatric surgery patients tracked for five years.
One expert not involved in the study pointed out to Medscape that some studies have found disease protection at 10 years or longer, but called this research more "elegant and far more detailed" than previous studies.
"Today's paper adds even more proof," Dr. Walter J. Pories, director of the Metabolic Institute at East Carolina University in Greenville, N.C., said.
If the surgeries offer this kind of disease protection, should everyone with a weight problem seek out a bariatric procedure?
"I think patients in that situation who are obese and have metabolic syndrome need to talk to their primary care doctor and open the discussion about having bariatric surgery," said Brethauer.
While the procedures carry risks -- less than 5 percent of procedures may lead to serious complications -- the surgeon says those are outweighed by the health risks of having uncontrolled diabetes and heart disease down the road.
"That poses the greatest risk for their lives in the long term," he said.
