| Dr. Aurora D. Pryor |
Obesity is common, serious, and costly. More than one-third (36.5%) of U.S. adults have obesity, according to the Centers for Disease Control and Prevention.
Indeed, obesity is now understood to be a national epidemic and a major contributor to some of the leading causes of death in America, including diabetes, among other potentially life-threatening diseases.
Here, Aurora D. Pryor, MD, chief of our Bariatric, Foregut, and Advanced Gastrointestinal Surgery Division and director of the Stony Brook Bariatric and Metabolic Weight Loss Center, answers questions about diabetes and obesity and their treatment with bariatric surgery.
Q: What is type 2 diabetes, and what is its relationship to obesity?
A: Type 2 diabetes is a long-term disorder where the body produces insulin but resists its ability to move blood sugar into the cells to be used as energy. Untreated diabetes can be life threatening.
The relationship between type 2 diabetes and obesity is very clear: Obesity is probably the number one factor in the development of insulin resistance. The risk of type 2 diabetes increases with the degree of obesity and its duration. So as our nation's rate of obesity increases, so does the rate of type 2 diabetes.
We offer a comprehensive, individualized treatment strategy, which may include surgery, medical management, diet and exercise, behavior modification, and psychological counseling, or a combination of these approaches.
Q: How is type 2 diabetes affected by bariatric surgery?
A: The results are nothing short of amazing. The majority of patients who have gastric bypass or duodenal switch surgery experience complete resolution of their diabetes. Results also have been good for gastric banding and sleeve gastrectomy. Patients who have bariatric surgery typically experience lower insulin resistance, and their risk for metabolic syndrome, high blood pressure, and high cholesterol also decreases.
Q: Are there large-scale studies showing that bariatric surgery helps type 2 diabetes?
A: Yes. One of the most well-known studies, published in the Journal of the American Medical Association, looked at 136 scientific reports totaling bariatric surgical results of 22,094 patients (see summary). It showed that nearly 77% of bariatric surgery patients were cured of diabetes, with a total of 86% reporting an improvement in their symptoms.
Q: How does bariatric surgery work?
A: Bariatric surgery makes the stomach smaller so the patient feels satisfied with less food. Many procedures also reduce the body's ability to absorb calories from food. All bariatric surgery works best with lifestyle and behavior changes.
Q: Who is a candidate for bariatric surgery?
A: We follow National Institutes of Health (NIH) and Food and Drug Administration (FDA) guidelines.
Most surgical patients are about 100 pounds or more overweight, but those who are less overweight and have a related medical condition may qualify for adjustable gastric banding. Patients who are between 30 and 50 pounds overweight may qualify for our nonsurgical balloon treatment program.
Q: What's exceptional about Stony Brook's approach?
A: First, we have an extraordinary interdisciplinary team of professionals. We work side by side with each patient, every step of the way.
We offer a comprehensive, individualized treatment strategy, which may include surgery, medical management, diet and exercise, behavior modification, and psychological counseling, or a combination of these approaches. We offer a pre-surgery medically supervised weight loss program and monthly support group meetings after surgery.
We have a lifelong commitment to our patients. We meet with them regularly during the first year post-surgery, then annually or as needed for the rest of their lives.
We provide advanced procedures with advanced techniques. Most bariatric surgeries are performed laparoscopically, which means minimal scarring and faster recovery. We offer sleeve gastrectomy, Roux-en-Y gastric bypass, adjustable gastric banding, and duodenal switch (read more).
What's more, we have access to Stony Brook Medicine. We can tap into the broad range of expertise, services, technology, and facilities available at Long Island's only academic medical center and Suffolk County's only tertiary care hospital.
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Type 2 diabetes is a long-term metabolic disorder where the body produces insulin, but resists it. Insulin is necessary for the body to utilize sugar. Studies have shown that the majority of patients who have gastric bypass surgery experience complete resolution of their diabetes. Results also have been good for gastric banding. In addition, patients who had bariatric surgery experienced lower insulin resistance, and their risk for metabolic syndrome, high blood pressure, and high cholesterol also decreased.
Weight-loss surgery quickly improves blood sugar control in people with type 2 diabetes, and should be recommended or considered as a treatment for certain obese people with diabetes, according to a joint statement endorsed by 45 international professional organizations, which appears in the June 2016 issue of the journal Diabetes Care (summary). The new guidelines, based on the results of multiple clinical studies, are the first guidelines recommending surgery as a treatment option specifically for diabetes. |
Learn more about obesity and diabetes and different treatment options from the Obesity Action Coalition. Learn more about bariatric surgery at the Stony Brook Bariatric and Metabolic Weight Loss Center.