Two seemingly groundbreaking studies, published this week in the New England Journal of Medicine, found that type 2 diabetes, or “diabesity,” could be cured with gastric bypass surgery. The flurry of media attention and medical commentary hail this as a great advancement in the fight against diabetes. The cure was finally discovered for what was always thought to be a progressive incurable disease. But is this really a step backwards? Yes, and here’s why.
For Diabetes Treatment
Dietary and Lifestyle Changes
Are More Effective Than Surgery
No one is asking the most obvious question. How did the surgery cure the diabetes? Did the surgeons simply cut out the diabetes like a cancerous tumor? No. The patients in the studies changed their diet. They changed what they put in their stomach and that’s something that doesn’t require surgery to change.
If they had surgery and they didn’t stop binging on donuts and soda, they would get violently ill and vomit and have diarrhea. That’s enough to scare anyone skinny. If I designed a study that gave someone an electric shock every time they ate too much or the wrong thing, I could reverse diabetes in a few weeks. But you can get the benefits of a gastric bypass without the pain of surgery, vomiting and malnutrition.
Most don’t realize that after gastric bypass diabetes can disappear within a week or two while people are still morbidly obese. How does that happen? It is because food is the most powerful drug on the planet and real whole and fresh food can turn on thousands of healing genes and hundreds of healing hormones and molecules that create health within days or weeks. In fact, what you put on your fork is more powerful than anything you can find in a prescription bottle.
The researchers asked the wrong questions. It should not have been: Does surgery work better than medication, but does surgery work better than intensive lifestyle and diet change.
Astonishingly, the researchers just compared surgery to medication, which has been proven over and over not to reverse diabetes, and often promotes progressive worsening of the diabetes. Patients who get on insulin gain weight and their blood pressure and cholesterol go up. And according to recent studies, those who had the most aggressive medical therapy to lower blood sugar had higher rates of heart attack and death.
These two new studies on gastric bypass should have included a treatment group that had intensive lifestyle therapy as well as medical therapy or surgery.
Lifestyle and dietary changes work faster, better and are cheaper than any medication. They are as or more effective than gastric bypass without any side effects or long-term complications. These changes are not easy, but then neither is gastric bypass.
A recent study, titled “Reversal of Type 2 Diabetes: Normalization of Beta Cell Function in Association with Decrease Pancreas and Liver Triglicerides,” has proved that diet alone could reverse type 2 diabetes. The bottom line: A dramatic diet change (protein shake, low glycemic load, plant-based low-calorie diet but no exercise) in diabetics reversed most features of diabetes within one week and all features by eight weeks. That’s right, diabetes was reversed in one week. That’s more powerful than any drug known to modern science and as or more effective than gastric bypass. But since it was a diet study, it got no press or attention. Other research proves that intensive lifestyle therapy can achieve the same results. We don’t have to heal with steel, we can heal with meals.
As I write this, new guidelines and insurance coverage for this new surgical diabetes cure are in motion. But this is a grave mistake. One in four people over 65 years of age, nearly one in five African Americans, and almost one out of ten of our whole population have type 2 diabetes. By 2050 there will be one in three Americans with type 2 diabetes.
Recommending gastric bypass as a national solution for our diabetes epidemic is bad medicine and bad economics. If the nearly 30 million diabetics in America took advantage of this new miracle cure at $25,000 a pop, it would cost three quarters of a trillion dollars ($750,000,000,000). If we paid people $100 a pound to lose weight we would still be better off. To treat the nearly 400 million diabetics around the globe would cost $10 trillion. Does this make any sense?
Shrinking someone’s stomach to the size of a walnut with surgery is one way to battle obesity and diabetes and may be lifesaving for a few, but it doesn’t address the underlying causes. And many will regain the weight because they didn’t change their understanding of their bodies or relationship to food.
Clearly, weight loss is critical and important for obtaining optimal health. However, what we are finding in patients who have gastric bypass surgery is that a change in diet in a short period of time creates dramatic metabolic changes.
All the parameters that we thought were related to obesity, such as high blood sugar, high cholesterol, high blood pressure, inflammation and clotting, are dramatically reduced even without significant weight loss because of the rapid effects of dietary changes that control which genes get turned on or off. This is called nutrigenomics – the way food talks to your genes. While weight loss is important, what’s more important is the quality of food we put in our bodies. Food is information that quickly changes metabolism and genes.
Unless we address the root causes – what we eat, our sedentary lifestyle and the social and environmental conditions that drive obesity and disease – we will have tens of millions more diabetics lining up for stomach stapling. The only ones to benefit would be the bariatric surgeons, the makers of the surgical instruments and the hospitals that are paid handsomely. To paraphrase an election campaign slogan from President Bill Clinton: “It’s the Food, Stupid!”
My book, “The Blood Sugar Solution,” is a personal plan for individuals to get healthy, to get healthy together in our communities and to take back our health as a society. Obesity and diabetes are a social disease and we need a social cure, not a surgical one.
My personal hope is that together we can create a national conversation about real, practical solutions for the prevention, treatment and reversal of our diabesity epidemic.
To learn more and to get a free sneak-preview of my book, go to www.drhyman.com.
Now I’d like to hear from you. Do you think we should promote a gastric bypass as a national strategy to deal with the diabetes epidemic? Have you been able to reverse diabetes with diet changes? Have you had gastric bypass surgery, and did you maintain the weight loss or gain it back?
Please leave your thoughts by adding a comment below.
Mark Hyman, MD is a physician and widely acclaimed book author. He is chairman of the Institute for Functional Medicine and serves on the board of directors of The Center for Mind-Body Medicine. He is the founder and medical director of The Ultra Wellness Center in Lenox, Mass.
The articles written by guest contributors are the sole responsibility of the individual writers in terms of factual accuracy and opinion and do not necessarily reflect the views of the publisher of this blog.