If I were a stomach and had my reading glasses on, I would be a little disturbed about what I read on today’s front page. March 27, 2012, on the front page of The New York Times is found this headline, “Surgery Is Found to Aid Diabetics”. Two studies have found that weight-loss surgery can reverse and possibly cure diabetes. With 33% of the population obese and about another 30% overweight, it is no great surprise that 8% of the adult population is diabetic. Type 2 diabetes brought on by excess weight is a major problem. These studies showed that surgery, yes surgery on the stomach, that hard working, acid producing organ, helped more than medications in treating diabetes. The surgeries cost $15,000-$30,000. Gastric bypass is one surgery where the stomach is reduced to a small pouch and reconnected to the small intestine. Banding also limits the size of the stomach. Dr. John Buse of the University of North Carolina, an expert in diabetes, calls these studies,”a major advance”.
Let’s back up a moment and think this through. Many of the diabetic medications including insulin act as growth factors and make a person more hungry from a chemical mechanism. I agree that the medications were not doing a good job for type two diabetes. Diabetes is a major cause of heart disease, strokes, and kidney failure. The studies published in the New England Journal of Medicine and presented yesterday at an American College of Cardiology conference in Chicago correctly identified the problem obesity. Yes surgery can get rid of the weight, but is there a better way? Why destroy the stomach, an organ so elegantly designed to break down nutrients?
If I were having a headache from banging my head into the wall, morphine would help the pain. Would this be the solution? What is the real problem here? In obesity is it the stomach’s fault? The real cause is too many calories and not enough exercise or movement. These two studies have followed these patients for a very short period of time. What will be the long term consequences? Will everyone want a quick fix based on these studies? This might help a select few in the short term but is this for the masses when the core problem is not addressed? What will happen to the poor stomach and the other organs when we go against our original design? It just does not make sense to me. Tomorrow everyone will be at the office wanting this procedure they read about on the front page of The New York Times.
I am a fellow in the American College of Cardiology and want us as physicians to find ways to help the overweight by getting at the cause and not just develop another procedure. The article did not emphasize that these patients were counseled on nutrition and movement. We need to develop, promote, and reimburse programs that help patients get at the cause of the problem. These programs, which address the cause then need to be tested and the results published on the front page. When this happens the health of the nation will improve. Money will be saved. To find a real solution we must get at the cause. It isn’t the stomach’s fault.
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