Obesity and Bariatric Surgery

WASHINGTON - According to the World Health Organization, obesity is one of the most serious worldwide epidemics of the twenty-first century. Bariatric surgery (BS) has been demonstrated to be an effective treatment to achieve not only sustained weight loss but also significant metabolic improvement that goes beyond mere weight loss.

Researchers at Oregon Health & Science University (OHSU) in Portland have found in a new study that more than half of adults with type 2 diabetes had long-term remission following gastric bypass surgery. The study has been published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism.

Although type 2 diabetes mellitus (T2DM) has been traditionally viewed as an intractable chronic medical condition, accumulating evidence points towards the notion that a complete remission of T2DM is feasible following a choice of medical and/or surgical interventions.

Weight-loss surgery helps people with severe obesity lose a lot of weight and improve their health. Two common types of bariatric surgery are:

• Lap band surgery: Places a band around the top of the stomach to create a very small pouch that can hold only a small amount of food.
• Gastric bypass: Reduces the size of the stomach, causes hormonal changes, and can lower the amount of nutrients that are absorbed from food.

One of the biggest benefits of bariatric surgery is that it can improve or eliminate type 2 diabetes.

"If a patient with type 2 diabetes is considering weight loss surgery, choosing gastric bypass soon after diagnosis can increase their chance of remission or achieving a blood sugar level that does not need treatment," said study author Jonathan Q. Purnell, M.D., of the Oregon Health & Science University in Portland, Ore. "Our large study confirms the importance of weight loss on inducing diabetes remission, but also finds gastric bypass has benefits independent of weight. If we can understand what these benefits are, it could lead to new diabetes treatments."

The researchers studied 2,256 adults with severe obesity (a BMI of at least 35 kg/m²) who completed annual research assessments for up to seven years after bariatric surgery, roughly 35 percent of whom had type 2 diabetes.

• Fifty-seven percent of participants with diabetes achieved remission after gastric bypass surgery, and 22 percent reached remission after lap band surgery.
• For both procedures, remission was more common in younger participants and those who had diabetes for a shorter time prior to their procedure.
• The researchers found a greater likelihood of diabetes remission after gastric bypass independent of weight loss, suggesting mechanisms beyond weight loss are contributing to improved blood sugar levels.

For further reference log on to:

"Diabetes Remission Status During Seven-year Follow-up of the Longitudinal Assessment of Bariatric Surgery Study," The Journal of Clinical Endocrinology & Metabolism, dgaa849, https://doi.org/10.1210/clinem/dgaa849