Success Rates, Medical Benefits and Diabetes
Surgery Success Never Guaranteed, but Overall Health Often Improves
"Generally, the success rate of weight loss surgery is quite good and there are potentially impressive medical benefits" said David Greenbaum, M.D., medical director of the bariatric surgery program at Lourdes Medical Center of Burlington County.
"The success rate varies with the procedure and with what your definition of success is. The past measurement has been to consider success as losing and keeping off 50 percent of your excess weight."
While all bariatric procedures can produce "successful" results, there is a definite distinction between the weight losses achieved by the various types of procedures. He provided his view of that distinction based on his experience.
"The duodenal switch operation probably has a 90 percent success rate or greater, while the Roux-en-Y gastric bypass is about 70 percent and the gastric band is 50 percent or less, but it depends on who you do the surgery on."
Dr. Greenbaum said there was a recent move to redefine success in some cases.
If the gastric band is performed on very heavy people, then the success rate is terrible, he said. "That's why the definition of success has been changed to 25 percent of excess weight loss and it boosts the numbers."
Dr. Greenbaum said that when patients lose significant weight, that physical fact often improves numerous problems such as sleep apnea and hypertension.
"But the issue of diabetes is an interesting one that is changing perceptions of what we do in weight loss surgery," he said.
"If you just lose a lot of weight, even with no surgery, non-insulin dependent diabetes will get better. That's why the gastric band patients can see that change - their food intake is greatly reduced and the diabetes gets better.
"But it has been found that in some people with any kind of diabetes, just days after gastric bypass and duodenal switch surgery their diabetes already is significantly better, even though their weight has not yet changed."
Some little-understood changes in gastrointestinal hormones seem to be responsible for this phenomenon, Dr. Greenbaum said. Experiments bypassing the duodenum on some mildly obese and diabetic patients found that the diabetes improved even though the patients did not lose weight.
"This and other information leads us to understand that this is metabolic surgery and some people think that an operation similar to the duodenal switch may become a treatment for Type 2 diabetes.
"The fact is, in many cases when you have these operations your cholesterol gets better, your hypertension gets better, sleep apnea improves, ovulation, hormonal balance, menstruation, pregnancy is better. The forward-looking thinking is that bariatric surgery is treating all of these metabolic problems, so this is something to watch."
To locate a Lourdes Health System bariatric surgeon by phone, call 1-888-LOURDES.
