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...with their disease. But researchers think the benefits of gastric bypass may indeed be greatest in those obese patients who are recently diagnosed with diabetes, since their bodies are more likely to revert back to normal sugar metabolism after surgery. That's because much of the post-bypass weight loss is spurred by a shift in the hormonal feedback loop that controls hunger and satiety. Production of certain weight-related hormones, such as ghrelin, or the hunger hormone, are directly reduced by the patient's physically smaller stomach (ghrelin is produced by glands in the stomach), leading to a reduction...
...difference in weight loss between the two groups? Campos notes that although the procedure is the same from patient to patient, doctors currently do not use a standard size when creating the new stomach sac. Instead, surgeons use anatomical landmarks unique to each patient to determine the size of his or her new, smaller stomach. But because the stomach lining remains elastic and flexible, sometimes the small stapled-off pouches simply balloon back to a larger size, which explains why 5% to 15% of people who get gastric bypass surgery often experience little or no weight loss...
...particularly from obesity-related diseases, including diabetes and coronary artery disease - but that in some patients with diabetes the surgery is practically a cure, resulting in normalization of blood sugar, often within days. That's part of the reason that gastric bypass is now the most commonly performed weight-loss surgery in the U.S., with nearly 140,000 procedures done each year...
...other reason for the weight-loss disparity, Campos says, may have something to do with the medications that diabetes patients take to control blood sugar. "One of the known factors for why diabetics have trouble controlling their weight is the types of medications they take," says Campos. "Diabetes is a consequence of being overweight, but [another complication] is having to take medications that add to weight gain. It's a double-edged sword, and a vicious cycle." The solution, he points out, may be to rely on newer anti-diabetes drugs, such as the DPP-IV inhibitors (like Januvia...
...best chance of losing weight and reaping the heart and metabolic benefits of being slimmer; among diabetes patients, those undergoing surgery early on in their disease might fare better than those who wait longer. Both Campos and Hamdy remind patients that surgery is never the final answer - weight-loss maintenance continues long after you're discharged from the hospital, and can only be done the old-fashioned way, with a healthy diet and exercise plan. Surgery, after all, can only get you so far. (See photos of what makes you eat more food here...