A recent study conducted by the Kaiser Permanente Washington Health Research Institute in Seattle has shown that obesity surgery may drastically reduce the chance of heart attack or stroke in type 2 diabetics. To learn more about this life changing surgery and what it could mean to you or a loved one, we turned to our own board-certified general surgeon and medical director of bariatric services at Florida Hospital Memorial Medical Center in Daytona Beach, Christian Birkedal, MD and Dean Abtahi, MD, an interventional cardiologist at Florida Hospital Flagler in Palm Coast.
Complications from Obesity
Obesity is beyond being simply overweight. It is defined as excessive fat accumulation that presents a risk to health and it's a very common – more than 1 in 3 U.S. adults are obese.
“According to the National Institutes of Health, obesity and being overweight are the second leading cause of preventable deaths in the U.S., right behind tobacco use, and approximately 300,000 people die every year due to it,” explained Dr. Birkedal. “Obesity is a gateway to a vast array of health problems including heart disease, stroke, high blood pressure, diabetes, certain cancers, gall bladder disease and gallstones, chronic pain, osteoarthritis, gout, and sleep apnea are just chief among them.”
Dr. Abtahi explained how excess weight can have a serious and far reaching impact on the body’s overall health.
“Obesity is a major component of the metabolic syndrome which can lead to heart disease, stroke, and diabetes. Metabolic syndrome is marked by increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels,” Dr. Abtahi said. “The metabolic syndrome leads to type 2 diabetes, which is a chronic inflammatory condition. Type 2 diabetes increases your risk for heart disease and stroke because it contributes to premature plaque buildup in your blood vessels and accelerated plaque formation. It also affects blood vessel cell walls integrity and disrupts normal blood clotting pathways. These combined factors - on top of the additional strain on your heart placed carrying extra weight - are a dangerous combination.”
Currently there are more than 30 million Americans living with diabetes, most of which have type 2. With this type of diabetes, the body loses the ability to produce or use insulin to turn food into energy due to excessive weight gain and other factors. In some cases, type 2 diabetes is a reversible condition, but it requires long-term weight loss and lifestyle modifications to be successful.
What is Bariatric Surgery?
Bariatric surgery is a blanket term used for any surgery on the stomach or intestines with the intent of causing weight loss. There are two common forms of bariatric surgery, gastric bypass and sleeve gastrectomy.
Gastric bypass is a surgery that effectively makes your stomach smaller and reroutes your small intestine to the new, smaller stomach. This is usually accomplished by creating two individual stomach spaces. The smaller space will have the small intestine routed to it and you will eat less and feel full faster by having less space for food to go.
A sleeve gastrectomy is a similar surgery to gastric bypass in that it creates a smaller stomach, but in the case of sleeve gastrectomy, 80 percent of your stomach is removed, creating a much smaller and tube-like stomach that will accomplish the same results and induce weight loss.
“If your BMI (Body Mass Index) is above 40, then it’s almost impossible to lose the weight required to get back down to a healthy weight through diet and exercise alone, and we generally consider this to be a situation where bariatric surgery is required to achieve the weight loss needed for a healthy body,” said Dr. Birkedal.
Benefits to Diabetics from Bariatric Surgery
“There is growing evidence that shows the long-term benefits of bariatric surgery in diabetic patients outweighs the upfront risk of the surgery,” said Dr. Abtahi. “For those with type 2 diabetes, bariatric surgery is not only a life-changing surgery, but a life-saving surgery as well.”
In the study performed by Kaiser Permanente, they tracked approximately 20,000 obese patients with type 2 diabetes. Those who had bariatric surgery had a 40 percent lower chance of developing a heart attack or stroke in the five years following surgery, compared to those who received standard care with diabetes medications and insulin.
This means that for every 1,000 patients in the study who had bariatric surgery there were roughly 20 heart attacks or strokes, compared to twice that many who had standard care alone.
The High Cost of Obesity
The obesity epidemic in America is contributing greatly to higher insurance premiums and costs for medical providers and patients, alike. Government health agencies and insurers like Medicaid and Medicare have recognized this and are now covering obesity surgeries to prevent additional expenses later by attempting to correct the problem early on. Other private insurers are getting on board, too.
“I’d say that most insurers these days are covering the cost of surgery but there are still holdouts waiting for more studies to show the cost/benefit analysis before they get on board. I figure it will only be a short matter of time before they all recognize the benefits of this surgery and get on board and cover its cost for the patient,” said Dr. Birkedal.
If you or a loved one are facing a life with diabetes and have a BMI of 35 or higher, you may want to consider the benefits of bariatric surgery to improve your whole health. To speak with a specialist to find out if it’s right for you, please visit our site or call 855-303-DOCS.