Bariatric Surgery Achieves better results in Diabetics that are Really Fat

This is not a big surprise, since the morbidly obese do achieve great weight loss with the surgical approach.

Bariatric Surgery vs Intensive Medical Therapy for Diabetes
Research · March 31, 2014

In a 3-year trial, researchers compared intensive medical therapy alone or intensive medical therapy plus Roux-en-Y gastric bypass or sleeve gastrectomy for effectiveness in lowering glycosylated hemoglobin to ≤ 6.0%. At 3 years, 5% of the patients in the medical therapy group vs 38% of those in the gastric bypass group (P < .001) and 24% of those in the sleeve gastrectomy group (P = .01) achieved glycemic control.


Among obese patients with uncontrolled type 2 diabetes, 3 years of intensive medical therapy plus bariatric surgery resulted in glycemic control in significantly more patients than did medical therapy alone. Analyses of secondary end points, including body weight, use of glucose-lowering medications, and quality of life, also showed favorable results at 3 years in the surgical groups, as compared with the group receiving medical therapy alone.
The New England Journal of Medicine
Bariatric Surgery vs Intensive Medical Therapy for Diabetes—3-Year Outcomes
N. Engl. J. Med 2014 Mar 31;[EPub Ahead of Print], PR Schauer, DL Bhatt, JP Kirwan, K Wolski, SA Brethauer, SD Navaneethan, A Aminian, CE Pothier, ESH Kim, SE Nissen, SR Kashyap

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3 responses to “Bariatric Surgery Achieves better results in Diabetics that are Really Fat

  1. I would not have expected Junkscience to promote such poor science. Not only was this study not about “really fat” people, since over a third weren’t even in the obese category, but it looked at short term surrogate endpoints (reflective of reduced caloric intake or malabsorption and initial weight losses which were already rebounding, as expected), not actual health outcomes. The most important complications already exhibited among the surgical groups are also concerning. This appears to be more marketing by the bariatric industry, rather than good science. Bariatric surgeries have been being performed for nearly half a century and have yet to show they improve long-term morbidity or all-cause mortality… which many people still believe is the most important endpoint.

    • To add clarification, more than a third of the patients were not fat enough to have met the original qualifications for the surgeries, with BMIs less than 35.

  2. Hey, don’t start lecturing about what i do or don’t believe or promote or what Junk Science should or should not put up–i got no dog in the fat surgery or fat diet game–my personal experience is seeing the very fat for medical problems, not worrying about how the really fat should stop being really fat.

    Incidentally plenty of it–just go to a Walmart, which is where i shop in our little town. Amazing, and instead of walking, they ride scooters..

    The study was done, they made their claims–I use the word really fat and I know that bariatric surgery is often used for those with less than BMI 36.

    I will tell you this the surgery is heroic, the Roux en Y is a monster and associated with a lot of complications–I see them when things go south.

    However, these, usually women, lost weight adn a lot, putting up with big lifestyle changes–I wouldn’t wish the surgery on an enemy however.

    I am not a seller, I just put up what comes across from my alerts system. Lord knows the commenters who are interested in a subject will find the weaknesses in the study or some omission of the researchers. I repeated the headline they had.

    Just one more thing–do you think that BMI of 36 is essential to the study? Really? or Something to fuss about. Really fat people have diabetes, and if bariatric surgery improves their diabetes it might be an indication for people less than BMI 36, however such a heroic surgery is a burden to contemplate, isn’t it?

    Amazing weight loss results i see, but it is a big surgery with high rates of post op complications. When we see them with abdominal pain they often have serious even late complications like obstructions and torsions and internal hernias with incarcerations, for example.

    When I see a Roux en y patient I immediately get concerned, since they are a medical IED. The other old time short bowel surgeries had metabolic problems, the sleeve surgery seems to be easier to do and the balloon thing is advocated by some. I am not really watching it that close.

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