A person falls into the category of morbidly obese when body mass index is rated 40 or above. Severe obesity is defined as a BMI between 35-39. Bariatric surgery is permitted for these two groups as long as they have additional complicating conditions such as diabetes and high blood pressure. Dakin adds that a number of bariatric surgery options are being offered, including gastric bypass, adjustable gastric banding, sleeve gastrectomy, and duodenal switch.
The surgery typically results in the reduction of some 50 to 70 percent of a person’s excess weight. In a majority of cases, diabetes is forced into remission. Dakin notes that a significant meta-analysis displayed a complete reversal of diabetes in over 70 percent of patients. Another comparative study exhibited a 96 percent reduction in diabetes-related deaths following weight-loss surgery when compared to control patients.
Dakin speculates that the mechanism involved in the alleviations in diabetes goes beyond weight loss and lowered caloric intake. Previous studies suggest that a surgical manipulation of the stomach and small intestine may affect the production of specific hormones, leading to a reversal of diabetes.
Additional research further reveals the contribution weight loss surgery has on curing type 2 diabetes. UK researchers discovered nearly three quarters of obese patients with type 2 diabetes (72 percent) who had undergone bariatric procedures displayed no clinical markers for type 2 diabetes two years later.
The researchers observed 34 obese patients with type 2 diabetes who underwent gastric bypass surgery. Not only did these patients demonstrate significant weight loss of almost a third (30.6 percent) but most (72 percent) of these bariatric surgery patients saw their diabetes cured. A second portion of the research discovered that all bariatric patients saw a raise in insulin production and an improvement in insulin resistant following a week after surgery.
Though the underlying mechanisms behind these results are not yet clear, the implications behind the study suggests that the radical remission of type 2 diabetes cannot be attributed to weight loss alone. Many improvements were observed far ahead of any reduction in weight.
The likely explanation lies in the impact the surgery has on key gut hormones, such as glucagon-like peptides (GLP-1). These hormones are believed to mimic other hormones directly responsible for stimulating insulin release from the pancreas, resulting in the restoration of normal blood sugar levels.