Utah study reveals gastric bypass surgery keeps the weight off
The results are similar for 62 percent of the study's 1,156 subjects, ages 18 to 72, who were recruited from throughout Utah using the U.'s Utah Health Family Tree Program.
Six years after surgery, their diabetes remains in remission, according to the research. Less than 8 percent of individuals who do not undergo surgery experience the same result.
Dr. Steven Simper, a bariatric surgeon at Rocky Mountain Associated Physicians and LDS Hospital, said gastric bypass surgery was originally thought to facilitate a change in behavior that would result in weight loss.
However, altering the gastrointestinal tract actually changes a person's metabolism and the enteral hormones that regulate it, Simper said.
"We have looked at obesity as a behavioral disease for over 100 years, and we've made zero progress in treating it," he said, calling obesity instead an environmental genetic disease.
"There are so many things in our environment that are poisoning us … it is easier to blame the patient for having the disease," Simper said. "The real answer to obesity is prevention, but that has to start early and has to be population-wide and is really going to take some fundamental changes to take effect."
While gastric bypass surgery is fast becoming the most popular surgery in the world, Utah has one of the largest populations of bariatric surgery patients in the country, according to the U.S. Centers for Disease Control and Prevention.
Many Utahns also are very willing to participate in clinical studies, and not many Utahns end up leaving the state, making for optimal conditions when looking to follow up for research purposes, Simper said.
He said the latest study further enhances the validity of gastric bypass surgery.
"It certainly shows, at least, that the glass is half full," Simper said. "(Gastric bypass surgery) is showing a profound effect in people's lives."
Patients who undergo bariatric surgery should weigh the risks and benefits, and be committed to eat a balanced and healthy diet, as well as participate in regular physical exercise, Adams said.
"We discourage the idea that this is a fix-all," he said. "This is a treatment that has been shown to be successful, but to maximize success long-term, you need to have in place good activity and dietary practices."
Adams said doctors and patients can make a more informed decision about the surgery knowing that there are continued benefits even six years out.
"It's a major surgery. It's a major change in lifestyle. And it is expensive," Adams said. "Patients have to be quite committed."
The study arose out of a continuous inquiry from patients to know the long-term effects and outcomes of gastric bypass procedures, information that isn't readily available, Adams said. He and his colleagues have received funding from the National Institutes of Health to continue the study another four years and will apply for additional funding after that.
"My sense is that surgery patients will continue to have better health outcomes than the control groups," Adams said, adding that in-depth research will likely help to encourage insurance companies to cover the procedure for more people.
Only the Swedish Obese Subjects study has followed subjects longer than Adams’, but the overseas research involves primarily patients who had gastric banding procedures and only a small percentage of gastric bypass patients.
Further research on gastric bypass surgery, which is one of the most popular procedures conducted worldwide, also may have an impact on insurance coverage, making the surgery available to a larger percentage of individuals.
According to the U.S. Centers for Disease Control and Prevention, more than one-third of all adults in America are obese, and obesity is a factor in some of the leading causes of preventable death, including heart disease, stroke, Type 2 diabetes and certain types of cancer.
Stevenson is working on the last 15 pounds, but he's able to enjoy the foods he likes, in moderation, and ride a road bike and exercise.
"It doesn't matter what the charts say," he said. "It's where you really feel good and look good; that's where you need to be. I'm much more cognizant of the overweight people around me — at the mall, at work and at the airport. They struggle.
"Knowing what those people are going through, I don't even want to think about going there again."
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