For obese people with diabetes, doctors have increasingly been offering gastric bypass surgery as a way to lose weight and control blood glucose levels. Short-term results are often impressive, but questions have remained about the long-term benefits of such operations. Now, a large, international study has some answers.
Soon after gastric bypass surgery, about 50 percent of folks not only lost weight but they also showed well-controlled blood glucose, cholesterol, and blood pressure. The good news is that five years later about half of those who originally showed those broad benefits of surgery maintained that healthy profile. The not-so-good news is that the other half, while they generally continued to sustain weight loss and better glucose control, began to show signs of increasing risk for cardiovascular complications.
Caption: This is a PET/CT scan of a rat before (left) and after (right) gastric bypass surgery. This kind of a PET scan shows that after surgery the intestine (the looping structures) are using more glucose, which appear yellow and orange. By comparison the before surgery snapshot (left) reveals that there is very little glucose uptake in the intestines, which are barely visible. Credit: Courtesy of the Stylopoulos Laboratory
A dramatic, lasting, weight loss treatment for morbidly obese patients is gastric bypass surgery. Although there are many variations of this surgery, each with its signature metabolic pros and cons, the Roux-en-Y bypass is the most popular. The operation involves reducing the stomach size by 90% (which restricts food intake) and reconnecting the remaining stomach pouch to a latter section of the small intestine called the jejunum. Food thus “bypasses” digestion in the stomach and the upper portion of the small intestine. The result of this gastrointestinal re-engineering is that less food is eaten and fewer calories are absorbed in the gut. Continue reading →