More and more, chronically overweight and obese patients with diabetes who’ve been unable to achieve long-term weight loss to ensure good blood glucose control are turning to weight-loss surgery. Weight-loss procedures—including gastric bypass, the sleeve gastrectomy and, to a lesser extent, the gastric band—are now considered to be an effective and durable “treatment” for diabetes.
If you are overweight or obese, have type 2 diabetes and want to explore weight-loss surgery, there is no shortage of advertisements on TV, billboards, bus placards and the Internet. Some of the promises are legitimate, while others range from slightly misleading to blatantly inaccurate. How to make sense of it all? Here, five of the most common weight-loss-surgery myths to consider while investigating these procedures:
Myth #1: Weight-loss surgery is a quick fix. Many people believe that all they have to do is pick a procedure, and their weight-loss surgeons will do the rest. They mistakenly think that after a short recovery, they can just stand in front of the mirror and watch the weight fall off. If that were true, everybody would be doing it! What a weight-loss surgeon provides is the tool to help patients achieve their goals. Weight loss doesn’t happen overnight; it takes daily vigilance with making smart food choices. And for the people who don’t believe that weight loss is hard work, it may not happen at all. Weight-loss surgery is a lot of things…but it’s certainly not a quick fix.
Myth #2: Weight-loss surgery is only a temporary solution. Weight-loss surgery is a permanent solution if the patient makes it one! Surgeons would never put patients through the risks and rigors of an operation for a solution that only had a limited shelf life. When surgeons “rearrange the plumbing” with a gastric bypass or a sleeve gastrectomy, they’re not fooling around. And when they install a device in the body like a gastric band, they have no intention of removing it (without a very good reason). A weight-loss procedure will only be effective permanently if the lifestyle changes necessary for success are permanently maintained.
Myth #3: Weight-loss surgery is a cure for diabetes. Not exactly. While many patients do show extended improvement in glucose levels, sometimes as soon as the day after surgery, rather than calling it a cure, endocrinologists prefer to term this a remission of diabetes. This remission is due to the anatomical and hormonal changes resulting from a gastric bypass; many sleeve patients can also see similar changes. The slower, more moderate weight loss in gastric band patients might generally take a little longer to impact blood glucose levels, but these patients, too, should see improvement in their A1C. When blood glucose levels return to the normal range, medications may be reduced or eliminated entirely following a doctor’s approval. Even patients on insulin may see their dosages reduced.
Myth #4: Weight-loss surgeries carry no risk. All surgeries carry risk—a fact not widely promoted on the television commercials and billboards that hype weight-loss surgery. The people who experience these complications usually come in with serious, preexisting health problems—usually uncontrolled diabetes and/ or hypertension with varying degrees of accompanying illness. Someone between the ages 25 and 40 years, in relatively good health—which describes the average patient who is going to be having weight-loss surgery—is at very low risk for having a problem in a reputable facility.
Though many weight-loss procedures are performed in small outpatient surgical centers, there are good reasons to choose a program that can admit you to the hospital overnight, especially for people who have significant conditions that make them high-risk for anesthesia. The risk factors for weight-loss surgery are considered to be on a par with having your gall bladder removed—if you go to a larger medical center or one with the Accredited Bariatric Centers of Excellence designation. The bottom line is that there are risks inherent in all surgery, and everyone who is considering weight-loss surgery should discuss those risks with their physicians, who will help them weigh the surgical risks against the potential health benefits.
Myth #5: Weight-loss surgery is the easy way out. Achieving weight-loss success with surgery actually requires quite a bit of hard work and dedication. In assessing patients’ qualification for surgery, surgeons do their best to determine patients’ level of commitment to the process through psychological assessment, pre-op nutritional counseling and support. If weight-loss surgeons educate patients about the work and commitment involved at the beginning of the process, their patients have the best chance at changing their unhealthy behaviors and making the most of their procedures. It’s not enough to change on the outside; without making changes on the inside, patients have little hope for lasting success.
Hopefully, this article has debunked a few of the most common myths and misconceptions about weight-loss surgery. Having a clear picture of what to expect before, during and after surgery is essential in evaluating whether or not weight-loss surgery is the right choice and what to look for in a weight-loss surgery program and facility.
Material excerpted in part from 21 Things You Need to Know About Diabetes and Weight-Loss Surgery, published by The American Diabetes Association, © 2017 by Scott A. Cunneen, MD, FACS, FASMBS and Nancy Sayles Kaneshiro, reprinted with permission from The American Diabetes Association.