If you think gastric bypass surgery is always more effective than drugs, exercise, and diet for treating overweight individuals with type 2 diabetes, think again. Though in recent years bypass surgery (a procedure that reduces stomach size by having your digestive passageway bypass part of the stomach and small intestine) has been held out as a magical cure for the chronic disorder, it now appears this is not always true.

A new study reports that many individuals who go into remission following weight-loss surgery may wind up having their diabetes return. And regaining the weight isn't necessarily the cause: individuals with long-standing or very severe diabetes experienced relapse even if they had not regained the lost pounds, according to research published in Obesity Surgery.

"Some people are under the impression that you have surgery and you're cured," said Vivian Fonseca, MD, president for medicine and science at the American Diabetes Association, according to The New York Times. (Fonseca was not involved in the Obesity Surgery study.) "There have been a lot of claims about how wonderful surgery is for diabetes, and I think [the study] offers a more realistic picture."

Are You a Candidate for Weight Loss Surgery?
Gastric bypass surgery is more likely to be more effective if your diabetes is mild and you're on an oral medication than if you are severely overweight and taking insulin. If you have severe, long-term diabetes, says Mitchell Roslin, MD, chief of obesity surgery at Lenox Hill Hospital in New York City, the only operation that may work for you is the duodenal switch. In this procedure, some 80 percent of the stomach is removed. A valve that allows food into the small intestine remains intact, as does part of the small intestine. But the better part of the intestine is bypassed during the surgery, and the intestine's end portion is connected to the duodenum (the first part of the small intestine) near the stomach.

According to the National Institutes of Health, bariatric (obesity) surgery is currently recommended only if you:

  • have a body mass index (BMI) above 40 or
  • a BMI above 35 and a condition like type 2 diabetes

It's best for individuals who have not had type 2 diabetes for a long time, and those who are not on insulin. It is not effective in individuals with type 1 diabetes.

Consider This
Be realistic about what bariatric surgery can do for you. If you've had diabetes for a prolonged period, and your pancreas (digestive organ) just isn't working efficiently enough to produce insulin, even losing weight may not bring about a remission. But weight loss surgery may be an option, and it certainly can be effective. "Bariatric surgery still is the best chance for remission, whereas drugs just control the type 2 diabetes and try to stabilize it," Roslin says. 

Mitchell Roslin reviewed this article.


O'Connor, Anahad. "Weight Loss Surgery May Not Combat Diabetes Long-Term." 28 November 2012. The New York Times. Web.

"Weight-Loss Surgery Is New Diabetes Foe." 4 January 2013. MedlinePlus.
U.S. National Library of Medicine and National Institutes of Health.