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The Ultimate Failure: Bariatric Surgery

By David Kliff: Publisher of Diabetic Investor

Last Update: April 15, 2009

According to a recent study by the University of Minnesota, bariatric surgery is a virtual cure for type 2 diabetes. University researchers analyzed 621 existing studies that collectively looked at more than 8,000 patients with diabetes and found that 78.1 percent had no symptoms of diabetes after their weight-loss surgeries. The study also looked at patients who had their surgery two years earlier and found that 74 percent reported no diabetes symptoms.

Another recent study by Professor Julian Shield, consultant pediatrician at the Bristol Royal Hospital for Children and lead author of a paper in the Archives of Disease in Childhood, of 73 adolescents with type 2 diabetes found that children tended to put on weight over the year instead of losing it, and complications had already begun to set in the case of some children. He said more radical measures were called for in order to help the children control their weight issues which could help cure the disease.

"We are just treating the side-effects," he said. "To lose really large amounts of weight, which you have to do to give yourself a chance to resolve diabetes, is difficult. Adolescents do struggle. Some of them manage to lose 35 or 40 kilos. But others find it very, very difficult."

While some may be encouraged by the findings of the University of Minnesota study and others may agree with Professor Shield's assertion that more drastic methods are needed to help obese children, "Diabetic Investor" see this move towards using surgery as a "cure" for diabetes as the ultimate failure. What really bothers "Diabetic Investor" isn't the data, but the fact we have to resort to such drastic measures when there are alternatives. Even if this type of surgery was cheap -- which it isn't -- and carried no risk -- which it doesn't -- surgery should only be considered as a last resort when all other methods have failed.

Contributing to this move towards using surgery to treat diabetes is this attitude that somehow someone who is obese had no role in becoming obese. Have we become so politically correct that we can no longer state the obvious, the reason most people become obese is that they don't eat properly, fail to exercise regularly, and basically ignore their personal health situation. Are we afraid to admit that parents of obese children are a contributing factor to their child's obesity? Isn't it about time physicians started telling parents of obese children that eating at McDonald's everyday isn't such a good idea? Whatever happened to the concept of personal responsibility?

This move towards using surgery to treat diabetes is disturbing from another perspective and points to just how out of whack our healthcare system has become. A few years ago the New York Times ran an excellent series on diabetes and pointed out that insurance companies would rather spend $30,000 for a foot amputation that was caused as a result of poorly controlled diabetes than spend that same $30,000 on diabetes education which could prevent complications from developing in hundreds of patients.

Here we are in 2009 with some of the best devices and drugs available to treat diabetes, and still nearly 80 percent of patients are not achieving control. Yet for reasons that are unfathomable, patient education, the most effective tool of all, is tossed aside like an old shoe. "Diabetic Investor" thinks it's about time to stop ignoring that the patient's behavior plays a critical role in treating diabetes or obesity effectively. With the cost of treating the complications of diabetes skyrocketing isn't this the time to acknowledge that our current system just isn't working?

Obesity is a leading cause of diabetes. It's also true that obesity can be controlled without expensive and risky surgery. However, this will never happen as long as physicians tell patients that being obese isn't their fault. While this may be true in some cases, for the majority of obese patients the reason their obese is largely their own doing. The fact that no one uses the word "fat" anymore is a perfect example of how low we have fallen.

Unfortunately, "Diabetic Investor" sees this trend towards using surgery as a treatment option growing. Once again we're opting to spend vast sums of money on treating a preventable situation rather than dealing with the root cause of the problem. Once again insurance companies would rather spend money treating a preventable situation rather than spend that money where it would do some real good and prevent hundreds of costly procedures.

Finally it's about time that parents understand that their kids are fat for a reason, and they should be part of the solution not part of the problem.

David Kliff authorized me to provide this article here at mendosa.com in April 2009. David is the publisher of the "Diabetic Investor" newsletter, the only electronic newsletter devoted exclusively to the business of diabetes. Written by David Kliff, an insulin using type 2 patient himself, "Diabetic Investor" is the source of information when it comes to the growing diabetes marketplace.


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