https://www.eurekalert.org/pub_releases/2020-08/wuso-mwl081820.php
News Release 19-Aug-2020
Washington University School of Medicine
Gastric bypass surgery is the most effective therapy to treat or reverse type 2 diabetes in severely obese patients. Many achieve remission of diabetes following surgery and no longer require diabetes medications. This observation has led to the theory that gastric bypass surgery has unique, weight loss-independent effects in treating diabetes, but this has remained a longstanding question in the field. Now, new research from Washington University School of Medicine in St. Louis indicates that weight loss after surgery, rather than the surgery itself, drives metabolic improvements, such as the remission of diabetes.
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In an accompanying editorial in the journal about the paper, researchers from Tufts University, Harvard University, Massachusetts General Hospital and the University of Maine write that the study "delivers a straightforward and important message for both clinicians and patients -- reducing adipose tissue volume, by whatever means, will improve blood glucose control in persons with type 2 diabetes."
"However, losing 18% of body weight with diet therapy alone is extraordinarily difficult and unrealistic for most people with obesity," Klein explained. "In contrast, gastric bypass surgery leads to marked and sustained long-term weight loss, which makes it a potent therapy for people with diabetes."
Klein's study was focused on the effects of gastric bypass surgery on metabolic function, and did not look at other medical complications associated with obesity.
"Our study does not exclude the possibility that gastric bypass surgery has unique weight loss-independent effects on important clinical outcomes such as arthritis, lung function or cancer risk, which were not assessed. But when it comes to metabolic health, gastric bypass surgery is effective because it causes weight loss," he said.
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