Gastric Bypass Cures and Kills

Yesterday night the TV news show, 60 Minutes, ran a segment promoting the idea that gastric bypass surgery can cure diabetes. Not content with promoting this dangerous surgery to the morbidly obese, surgeons are now recommending it for people who are merely overweight.

This is scary.

Why? Because this surgery kills people. Doctors promote it for the morbidly obese by claiming that their weight will kill them anyway. What they don't point out, is that the surgery can kill them a lot faster than their weight will. Something like 1 in 200 people who have gastric bypass surgery die within six weeks of the surgery.

But what is far more significant is that many more people who have this surgery--including those who lose a lot of weight--die within five years of the surgery.

Unfortunately, the way that surgeons collect data about the success of their surgeries ensures that the public does not learn these statistics. Doctors claim that the surgery is no more dangerous than gall bladder surgery, but this is only true if you look at the statistics collected within a few weeks of the surgery. But unlike gall bladder surgery, once the surgery heals the complications have only begun.

The Junkfood Science blog alertly reported on a study that tracked long term mortality after weight loss surgery. That study is found HERE but the full article is pay only so we have to rely on the blog authors for the details.

What Junkfood Science reports is that this study found this: "We also estimated the long-term mortality for individuals who had undergone surgery many years ago. For the 1995 cohort who had at least 9 years of follow-up, 13.0% had died. From the 1996 cohort with 8 years of follow-up, 15.8% had died, and from the 1997 cohort with 7 years of follow-up, 10.5% had died. For the 1998-1999 cohorts with 5 to 6 years of follow-up, the total mortality was 7.0% to 2004."

Junkfood Science's author then looked at death rates for people with the same demographic who did not have surgery and reports "The U.S. National Center for Health Statistics of the Centers for Disease Control and Prevention data reports that the overall death rates among Americans of the same age is 0.352% — for men it is 0.44% while for women this age it’s 0.26%."

So basically people who had weight loss surgery were dying at a rate many times higher than normal--even the rate normal for obese people.

All this is abstract and statistical until we start putting a face on some of the victims who did not make it into the mortality statistics because their deaths--though caused by the complications of weight loss surgery--took five or more years to occur. One of them turns out to be Claudette Yamin, the much-beloved mother of Elliott Yamin, the American Idol finalist who uses in insulin pump to control his Type 1 diabetes.

Many of us fell in love with "Mama Yamin" as she qvelled with happiness at her son's unexpected success. What we didn't know when we saw her hobbling through the crowds was that she had undergone dozens of operations for the complications of the weight loss surgery she had undergone five years ago and was periodically hospitalized for protein supplementation because she was starving to death. This past month the complications killed her. She died rail thin, at 65 years old, still full of vitality and enthusiasm for life.

She spoke about her complications from weight loss surgery on this television interview: http://www.youtube.com/watch?v=28JEjVK6dnw

As you can see in the interview, Claudette Yamin was told that her anorexia after surgery was an emotional problem. In fact, it probably was not. The incidence of severe psychiatric problems after such surgery is surprisingly high, as documented by Bama Gal in the Back Across the Line blog. Because the surgery changes the functioning of incretin hormones which are known to affect how the brain relates to food, the anorexia that is caused by this surgery is most likely physiological in nature.

I personally have experienced how powerful the manipulation of incretin hormones can be in affecting the hunger response when I became anorexic after two months on Januvia. The anorexia vanished when I stopped taking the drug, but while I did it became harder and harder to eat anything, which for me, food lover that I am, was bizarrely odd. But for the last month while the drug was in my system it was as if food no longer was food, but plastic. Eating became a weird experience as it seemed odd to put this stuff into my body.

Gastric surgery permanently changes how incretin hormones work--which is probably why it can "cure" diabetes in some people, since incretin hormones are deeply involved in the secretion of both insulin and glucagon. But the anorexia when it occurs does NOT go away and as we all know, anorexia kills.

The other way that weight loss surgery kills, long term is by destroying the stomach's ability to absorb nutrients from food. Though some forms of weight loss surgery are supposed to be reversible, this is not always true. Bands can grow into the stomach and cannot be removed. Wounds in the stomach may not heal and may end up destroying stomach tissue permanently. And once the stomach tissue is destroyed, you may fall victim to relentless malnutrition syndromes because your body can no longer absorb nutrients from your food no matter what you eat. Then it is time for visits to the hospital for intravenous supplementation. For the rest of your life.

At that point, the fact that you "cured" your diabetes may be a wry triumph, since you are basically starving to death.

So before you let some knife happy surgeon--who only follows his patients for six weeks after surgery--talk you into what might be a fatal cure for your diabetes, try some of the other strategies that will control your diabetes and help you lose weight without risking your life.

1. Cut the carbs. It appalls me that this dangerous, irreversible weight loss surgery is being promoted as safe by the the same doctors and organizations who continue to warn people with diabetes that "low carb dieting might be dangerous" despite the fact that a decade of research has not yet uncovered any evidence that low carbing does anything but lower blood sugar and improve lipids.

2. UPDATE (April 2, 2013): Before you take Byetta, Victoza, Onglyza, or Januvia please read about the new research that shows that they, and probably all incretin drugs, cause severely abnormal cell growth in the pancreas and precancerous tumors. You'll find that information HERE.

original text: Try Byetta for weight loss. The anorexia induced by Byetta is reversible and it doesn't appear to do anything permanent to your stomach and intestines. For some people it can lead to dramatic weight loss. It is worth a try. For many people with diabetes Byetta is much more effective for hunger control than it is blood sugar control so if you use Byetta, keep an eye on your blood sugars and if they are too high, make sure you have other strategies in place to control the blood sugars while you limit appetite.

3. If you are on insulin, ask your doctor about Symlin. It may also have weight loss benefits for some people.

4. Ask yourself: Is it worth "curing" your diabetes by having a surgery that gives you a 1 in 6 chance of being dead in 10 years? The reality is that it takes 20-30 years of extremely poorly controlled diabetes to kill most people. And if you control your blood sugar which most of us can do very well and keep your A1c in the 5% range you will live much, much longer than that, complication free. Being thin might be nice, but the fact is all of us know obese people who have lived long and productive lives while tipping the scales at 300 lbs for decades. I certainly have. Perhaps there is nothing right now that will get the weight off you, but you can still control your blood sugar, and there is always the possibility that in time some new finding will lead to a medication that will be effective for you.

It's worth staying alive to find out. Even if you have to put some effort into controlling your blood sugars.