You might have heard that bariatric (weight-loss) surgery “cures diabetes.” As an outcome, bariatric surgeries are being done on individuals at ever-lower weights. However do these surgical treatments really work, and if so, how? And are they safe?
Bariatric (weight-loss) Surgery
In December, I went to a program at University of California, San Francisco, about bariatric surgery for diabetes. The speaker described that these surgical treatments need to appropriately be called “metabolic surgery,” because they do NOT work primarily by restricting consumption or obstructing absorption. They work by changing the method our intestines respond to food.
It turns out that the intestines are filled with glands that secrete all sort of hormones and neurotransmitters. The digestive glands are accountable for signaling insulin production, promoting storage of starch and fat, hunger control, and a lot of other things. The gut does a lot more than just soak up food into the blood. It manages how our bodies use food.
Different parts of the intestinal tract have various glands. So if you rearrange the intestinal tracts so that food is kept away from particular glands, and shunted toward other glands, it can change the method we deal with carbs, proteins, and fats. One brand-new “metabolic surgery” is called an “ileal transposition.” The surgeon takes a piece from completion of the small intestine (a part of the hindgut called the ileum), and sews it back in at the top of the intestinal tract, right where food comes out of the stomach. Nothing is completely removed or bypassed, but simply moving the glands around causes big weight-loss and better glucose control.
How does this work? Even the surgeons who are doing it don’t actually comprehend. It may be that the hindgut produces more of an insulin-promoting hormonal agent called GLP-1, the very same one that is promoted by drugs like Byetta (exenatide).
Apparently moving glands that used to be at the end of the intestine, where all the food was already combined and partly absorbed, up to the top, where they handle all the refined foods straight off the plate, causes very various production of insulin and other vital hormonal agents, like being on constant natural Byetta or Januvia. However there are undoubtedly other aspects included.
Note that these positive outcomes were completely unanticipated. Physicians believed they were simply reducing the intestine or shrinking the stomach so individuals would eat less or take in less. They didn’t realize they were screwing around with individuals’s hormones and body chemicals, however it ends up that might be a good idea. Or it may not.
Some critics argue that our intestines evolved over millions of years, and we have no idea why they are the way they are. If we just start chopping them up and moving them around, there are bound to be nasty long-term effects. But the cosmetic surgeons would reply that the environment our intestinal tracts developed for is extremely different from the environment we’re residing in now. It may be that our developed intestinal tracts are no longer well geared up for the changed food world, with all its sugars and improved foods.
Is It Good For You?
Many studies reveal that various kinds of metabolic surgery aid control blood glucose. But that does not necessarily make them a smart idea. The side effects can be crippling. They can make your life miserable. I spoke to one female who had actually lost 130 pounds and developed near-normal blood sugar after a Roux-en-Y gastric bypass. Her other half, who had left her since she was “too fat”, returned to her.
Success story, right? Perhaps (although I don’t know about taking the spouse back)… however physically she’s miserable. She can eat just really small amounts, and the majority of foods she can’t eat at all without getting sick. She has constant nausea and regular abdominal pains. Is this worth it for her? She’s not sure.
We also don’t know yet for how long the metabolic “benefits” will last. We do know that weight is often regainedin 2 — 5 years after surgery. A recent study shows that postprandial (after-meal) glucose levels can stay high in people who have had metabolic surgery, even if their A1Cs indicate that their diabetes is “treated.”
If you’re thinking about “bariatric” or “metabolic” surgery, I would motivate you to check it out in detail. What are you obtaining into? If you do go ahead, choose a surgery with the fewest side effects. (Although they all have pretty many, some have less than others.) Seek advice from other people who have had the surgery, consisting of some that are at least two years past their operation. See if it’s still worth it for them.