What can be said about bariatric surgery as a treatment for type 2 diabetes in people? After all, the American Diabetes Association has approved it as a treatment option in people who are obese. It works well in the short-term to promote weight loss (often because of the inability to eat as many calories; sometimes the weight loss is  because food won’t stay down – not a very pleasant outcome). We don’t have years of research to know the long-term effects with regards to safety and effectiveness. Nutritional deficiencies due to reduced absorption are one concern. 

It can also be said that bariatric surgery is a huge money-maker for hospitals and surgeons. The surgery itself is quick, and the pre-and post-group counseling is cheap for a hospital or health plan to provide. Caution about being on the receiving end of an elective procedure that has a huge profit margin seems reasonable.

Surgery is expensive, and risky, and unless there are significant, sustained lifestyle changes, the weight loss and diabetes reversal will not be sustained. I have known some people to do quite well with bariatric surgery. However, I have also had patients who have had complications and poor results, and who regret the decision. 

Looking at the adoption of another surgical procedure may be instructive. Surgery to implant a small wire stent to open up partially-blocked arteries in the heart has become the normal way to treat chest pain. Invasive and risky, and often ineffective at preventing future heart attacks, these surgeries continue to be performed. Drs. Ornish and Esselstyn have demonstrated the efficacy of lifestyle in reversing blocked arteries – no surgery required! 

Dr. Neal Barnard and his research team have demonstrated the safety and effectiveness of lifestyle to treat type 2 diabetes. I like Dr. Barnard’s recommendation: better to do “surgery” on what’s in the kitchen. “Cut” out the problem foods, the problem cookbooks, the problem meals out. 

If you’ve been told that you are a candidate for bariatric surgery, at the least, give an oil-free, whole foods, plant-based dietary pattern a try for a few weeks, and see if that does not make a difference. Gain support to make it stick through the Plant Based Nutrition Support Group. The benefits to this specific dietary approach go well beyond weight loss and diabetes control. 

What have you got to lose? 

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