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Metabolic Surgery for Obesity Is No Quick Fix — It’s a Tool

By Kent Sasse July 09, 2022 Health and Fitness

Metabolic surgery is both the same and different in many ways from other medical treatments or surgical interventions. While it is true that as a surgical intervention it cures disease and prolongs life, it is also quite true that the outcomes depend significantly on the person receiving the treatment.

If you think about it for a minute, you realize this is true for most of other medical treatments or surgical interventions. Imagine the person taking a blood pressure medicine or a diabetes medicine who makes no effort to control their calorie and carbohydrate intake or who refuses to quit smoking.

Likewise, think of a patient undergoing hip reconstruction surgery who refuses to follow doctor’s orders or do their physical therapy. The outcomes, the benefit of the treatment, won’t be as favorable.

The Benefits Are Too Many to Ignore

The same thing is true with metabolic surgery. Nowadays, we have enormous databases from large health systems and even entire countries that show unmistakably the powerful, beneficial effects of metabolic surgery.

People who undergo a bariatric surgical procedure (a.k.a., sleeve gastrectomy, gastric bypass) live longer – and significantly so – than their counterparts who did not have the surgery. That survival advantage, in and of itself, is a profound finding not realized by many medical therapies.

People also have lower risk of strokes, heart attacks, kidney failure, and even cancer. So, there’s no denying the tremendous benefit for people with obesity or type two diabetes receiving the treatment of metabolic surgery. But why doesn’t it work to the same degree for every single person?

Results Are Individual

Some of the variation has to do with our individual genetics and biology. Metabolic surgery acts by changing the hormonal levels of key hormones that emanate from the gastrointestinal tissues. By altering those tissues, the hormone levels change to more favorable levels substantially and for the long term.

Those hormone changes reset the metabolic rate, the levels of fat storage, long-term blood sugar levels, and the body weight setpoint, all for the better. But the individual plays a role also.

Positioning Metabolic Surgery as a Tool

In this way, metabolic surgery is a tool and not a quick fix. Body weight and blood sugar regulation are some of the body parameters that are most influenced by the choices we make, what we do, and what we eat.

So, it makes sense that a person who shifts their dietary choices away from high calorie, high carbohydrate foods to things like healthy vegetables and lower carbohydrate items will indeed have lower blood sugar and somewhat lower body weight.

Likewise, a person who starts walking their dog 30 minutes a day and gradually builds up to a 90-minute walk seven days a week will maintain a healthier long-term body weight than the person who stays on the couch. 

The take-home lesson is that if you or a loved one is struggling with obesity or type two diabetes, you will be well-served to take an objective look at the safest and best treatment for the conditions. But you would also be well-served to utilize that treatment – metabolic surgery – as a tool, and not simply as a quick fix.

Have you ever tried a quick fix for a health issue? What was it? Did it work? Do you think there is a tool you should have considered instead?

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I had a sleeve gastrectomy in 2014, at age 59. I lost 80 lbs and my BMI was in the normal range. That’s 8 years ago. Over the first 6 years I gained 10# back. It’s normal to gain back a tad. I felt so much better and more stamina. But the last 2 years I’ve gained 20#, Covid and all. Even now that Covid is waning, my son who works for the MN Dept of Health, in the genetic sequencing, tells me its still to risky to go back to a gym to workout. If I must go he insists that I wear a N95 MASK. His department had recently done a study on the relationship of Covid and those that work out indoors with people outside of their POD group. Not favorable results in the study for working out indoors.

Linda Loftin

I have known people who have had this surgery and have regained the weight. The real long term success is had by following Dr Jason Fung’s recommendations for a low carb lifestyle and intermittent fasting. Many people have been successful by following this lifestyle. There are Facebook groups that are adherents to this lifestyle who folks on there who have lost 75, 100, or even 150 pounds. Simply avoid packaged and processed foods, emphasize low carb vegetables and meats and limit the number of hours in a day that you eat (such as 11am-7pm). Following this lifestyle (not a diet but a permanent change) also reverses Diabetes II. Dr Fung is a Canadian nephrologist who got tired of watching the kidney failures in his diabetic patients and then he learned that their was a way to reverse Diabetes II and help his patients lose weight.

Jean Anspaugh

Oh it would get great if Medicare paid for it. I have fighting for it.

Diana Craig

I don’t know anyone who refused to control unhealthy eating habits or refused to quit smoking. I only know people who have tried and failed to change those habits many, many times. If anyone refuses, it’s likely because they are tired of trying and failing and have lost hope of success. Doctors tend to lecture without offering new tools especially for weight loss. Surgery is a drastic tool with serious complications. It is not to be considered lightly. I’m disappointed you would suggest surgery without links to the research results you are quoting.

Susan McKie

I had a lapband inserted but I ran into trouble as the band eroded. I had lost sixty pounds. Needless to say, I was disappointed and have put that weight back on.
It works for a lot of people but not for me. I had to have it removed.

The Author

Dr. Kent Sasse, an Alpha Omega Alpha top medical school graduate of UCSF, earned fellowship at the prestigious Lahey Clinic in Boston and published research on pelvic floor therapy and metabolic surgery. He founded and directs The Continence Center and the nationally accredited Metabolic and Bariatric Surgery program in Reno, Nevada. His most recent book is Outpatient Weight-Loss Surgery.

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