TAICHUNG, Taiwan, Sept. 17 (UPI) -- Researchers found in a new study that weight loss surgery is more effective at helping patients control type 2 diabetes than non-surgical treatment for five years. The long-term benefits have not been established yet, however.
Bariatric and other weight loss surgeries reduce the size of the stomach, which results in less consumption and absorption of calories in patients. Previous studies have shown surgery can be more effective at extending patients' lives because of its effects on cardiac and other conditions such as type 2 diabetes.
"This study offers comparable rates of diabetes remission and obesity with metabolic and bariatric surgery as shown in prospective studies with three-year follow-up and higher body mass indeces," Dr. Robin Blackstone, a professor at the University of Arizona, wrote in an editorial published by JAMA Surgery. "MBS results in an effective treatment for other components of the metabolic syndrome, and the quality-adjusted life-years of bariatric surgery meet criteria for an effective intervention."
In the study, also published in JAMA Surgery, researchers followed 52 obese patients who had one of two types of weight loss surgery and 299 who received medical treatment for obesity between 2007 and 2008, and followed up with them 2013.
Of the surgical group, 19 received a standard sleeve gastrectomy, where part or all of the stomach is removed, and 33 received a gastric bypass, where the stomach is portioned off and intestine reattached to the smaller stomach "pouch" created by the portioning. In each case, less food can be consumed by patients at a time, resulting in lower caloric intake.
The researchers found that the average BMI of patients who'd had surgery fell from 31 to 24.5 after five years. The BMI of patients who were treated medically and with lifestyle changes saw their BMI stay nearly the same at 29.
Diabetes also was completely reversed in 36 percent of the surgical group and partially in 28 percent, compared with disappearing completely in 1.2 percent of medically-treated patients and partially in 1.6 percent.
Blackstone writes that, as shown in other studies, such as one in Sweden that found significantly obese patients survived 15 years longer after surgery than medical treatment, the safety and efficacy of weight loss surgery has been proven and can be used with more patients.
"Many advocate adopting behavioral treatment, which has far less efficacy and durability but is more widely applicable," Blackstone said. "Weight regain appears to be driven by the genetic reset that occurs when epigenetic changes hardwire the phenotype of obesity. How else can it be explained that when a person loses weight in comparison with a similar patient who was always lean, the formerly obese patient has to take in significantly fewer calories to maintain the same weight?"
