Weight loss surgery may be more effective than lifestyle change for some diabetics

by Barbara Hewitt on July 6, 2015

A new study suggests that weight loss surgery could be more effective for obese people with type 2 diabetes than lifestyle changes over the course of three years.

Past studies have shown that surgery sometimes results in an improvement, but it is a controversial subject, as many experts advise lifestyle change as a simple and cost effective means of helping people manage their condition and point out that surgery carries risks for those who are overweight.


Weight loss surgery is typically used on type 2 diabetics who are severely overweight with a BMI of 40+

Generally, weight loss surgery is typically used on type 2 diabetics who are severely overweight with a body mass index (BMI) of 40 or more.

Now a study in the United States suggests that it can be more effective over a three year period than lifestyle changes involving diet and exercise. According to lead researcher Dr. Anita Courcoulas of the University of Pittsburgh Medical Centre, the benefits should be looked at over time.

The research team studied 61 people aged 25 to 55 with type 2 diabetes who were overweight and randomly assigned them to receive one of three treatments. First was an intensive lifestyle intervention for one year to help them lose weight with diet, exercise and behaviour changes, followed by a lower intensity lifestyle intervention involving behavioural counselling a few times a month for two years.

Second was Roux-en-Y gastric bypass (RYGB) surgery and thirdly a laparoscopic adjustable gastric banding (LAGB) surgery. Both these groups were then given the same low intensity lifestyle intervention the non-surgery group got, for two years.

After three years some 40% of the RYGB group, 29% of the LAGB group and no one in the lifestyle intervention group had at least a partial remission of their type 2 diabetes. Three people in the RYGB group and one person in the LAGB group had their diabetes disappear entirely, which did not occur for anyone in the lifestyle group.

Researchers also found that blood sugar control improved more in the surgery groups, compared to the lifestyle intervention group. The surgery groups were also more likely to no longer need medication for their diabetes.

Courcoulas said the results are encouraging but researchers now need to follow more patients at several medical centre over a longer period of time to draw definite conclusions. They are also pooling their data with similar studies from across the country.

‘We’ll be able to see what the remissions look like at five and seven years. I think that’s the next step in this field,’ she added.

For the time being the arguments surrounding surgery are likely to continue. Indeed, Dr. Osama Hamdy, medical director of the Joslin Diabetes Centre’s Obesity Clinical Programme suggested that people with type 2 diabetes and their doctors should not get overly excited about the results.

‘In any study like this we need to be very cautious when reading them and read between the lines. Newer lifestyle only interventions can be very effective and people have to weigh the risks and benefits,’ he added.

The opinions expressed in this article do not necessarily reflect the views of the DiabetesForum.com Community and should not be interpreted as medical advice. Please see your doctor before making any changes to your diabetes management plan.

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