I take a much different position when it comes to gastric bypass surgery and long-term benefits for those with type 2 diabetes. I’d like to start by saying that those who have ridden the metabolic syndrome train from overweight with elevated blood pressure, cholesterol, midline fat deposits, and blood glucose progressing to pre diabetes and finally progressing to type 2 diabetes have a common denominator: this train ride is fueled by insulin imbalance.
Insulin is a fat gain hormone…excesses will cause increased fat stores on the body and in the blood (cholesterol/triglycerides). Over time, fat cells expand in size from excess insulin release and insulin resistance occurs. At this time, plenty of insulin is being released, but has lost its effectiveness. At the very same time, a person with pre diabetes has excess insulin AND excess blood sugar.
As time passes, the pancreas gradually fatigues and cannot keep up with increased insulin needs. This is the onset of type 2 diabetes. But…along this entire trainride…during which time the person with insulin imbalance (I call this uncontrolled Metabolism B) is getting “fatter”. It is not a matter of excess calories and inadequate activity alone that got him here…the underlying weight gain’s precursor was and is insulin imbalance.
Fast forward to the day the person has gained over 150 excess pounds, can’t succeed on a 1200 calorie low fat diet (remember, his main issue is not calories!) and opts for gastric bypass.
For 1 1/2 to 2 years after the surgery, he will lose weight. This is because his stomach (which once held 8 cups) holds 2 ounces after surgery. (At the end of 2 years, it holds only 1 cup.). As if that were not enough, his GI tract has been cut in two, and reconnected, but leaves the area of the small intestine that absorbs vital nutrients rendered null and void. During these 2 years, he may lose 125#….but……
BUT……when the stomach pouch stretches to hold about 1 cup, his carb intake can be substantial enough to trigger that darn insulin release and he will stop losing weight. Not only stop…he will then begin to regain weight!!!!! Why? Not because he’s doing anything wrong…but because gastric bypass does not bypass the pancreas!
The answer…If weight is causing immediate health danger and there is no time to wait until an effective weight loss program takes effect, the person may consider bypass. When 1.5 years pass, he/she will need to follow a diet protocol that targets insulin release. (The Metabolism Miracle or Diabetes Miracle).
If weight is not causing an immediate life threatening situation…he/she should consider not rerouting their GI tract, slicing their stomach in half and stapling it together, and malabsorbing nutrients forever….when in the end they will need to “diet” anyway….but to follow the diet protocol in The Metabolism Miracle or Diabetes Miracle and lose weight permanently…without surgery.