The Bypass Effect On Diabetes, Cancer

(CBS)  It's pretty well known to doctors that the most successful treatment for obesity is surgery, especially the gastric bypass operation. But here's something the medical world is just realizing: that the gastric bypass operation has other even more dramatic effects. It can force type 2 diabetes into almost instant remission and it appears to reduce the risk of cancer.

Surgeons have been performing bariatric, or weight loss operations since the 1950s, but they're much safer than they used to be. They're typically done laparoscopically now, where doctors use tiny surgical tools and video cameras instead of making big, deep incisions.

Despite the increase in obesity, only a small number of people have had the gastric bypass operation.

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Correspondent Lesley Stahl met some people who were once morbidly obese.

There was Tony Sideman, who underwent surgery in April 2007 and has lost 140 pounds; there was Janet Rovak, who lost 90 pounds in the eight months since her surgery; and there was Travis Goodbou, who lost 260 pounds in the seven months since he underwent the operation.

Dr. Neil Hutcher from Richmond, Va. has performed more than 3,000 bypass surgeries. Asked how many people gain the weight back, Dr. Hutcher tells Stahl, "You know I think when you're dealing with an incurable disease that kills many people, if you have an 85 to 90 percent success rate, that's pretty darn good."

"Is that what you have?" Stahl asks.

"Yeah," Hutcher says.

There's no diet, no exercise regimen, and no pill with a success rate like that. These patients lose a ton of weight and keep it off.

Here's how Hutcher does the surgery: first, he sections off a small pouch of the upper part of the stomach, which is then attached to a lower part of the small intestine, bypassing most of the stomach, so that there's not a lot of room for food.

It used to be that roughly one in 100 people died from this operation. Hutcher says it's now about one in 1,000, which makes it less deadly than most major surgeries.

"It's less than gall bladder surgery. It's about one-tenth of cardiac surgery," he explains.

It's safer because of new surgical techniques which have also made it more effective. For instance, they can make the stomach pouch smaller than they used to.

"Even if I wanted to eat a whole cheesecake, my stomach is very tiny. It holds four ounces max, stretched to the max. And that's not even one piece of cheesecake," a female patient explained.

A big reason the operation works is because it seems to suppress appetite. "If you listen to your patients, they come back and they say, 'Doctor, you put the fire out,'" Hutcher says.

"When you see a sign for fast food or…she's already shaking her head at me," Stahl asked a patient.

"Don't want it," the female patient replied. "I used to crave sweets all the time. I couldn't go past the gift shop at work without getting a candy bar. Now I go past it and I never give it a thought."

Paul Delios of Saugus, Mass. has lost 90 pounds. He owns a doughnut shop with his siblings, but he's able to resist the cravings. "Before I'd have cravings for everything. Now I really don't," he told Stahl.

For most patients the cravings really do disappear. One theory is that's because the operation suppresses the levels of a stomach hormone called "grelin" that activates the sensation of hunger.

Yet most people who have this operation do not get skinny. Dr. David Cummings, an expert on appetite at the University of Washington, says as a rule these patients end up just one third lighter.

"Most people with severe obesity who undergo gastric bypass do not become fully normal, in terms of body weight. They go from severely obese to mildly obese, or from obese to overweight. But nevertheless it's an enormous change," Dr. Cummings explains.

And not just in terms of weight loss. Dr. Hutcher says the operation itself can take type 2 diabetes - which has ballooned in this country - and throw it into complete remission.

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[Remy416]

Did you ever have the surgery and mostly did it correct your diabetes?

[1seattle]

I've went to Mexico when no insurance would cover the lap band x 6 years ago. Have lost 100 pounds and have kept it off. Now have another hiatal hernia and the band doesn't work. Insurance would rather pay for all my diabetic drugs and side effects than pay for a bypass. Absurd. Obesity is the last predjudice we tolerate. We see obese people as fat, rather than for morbid obesity, its a wireing problem. One that the bypass and band turn off. Right now insurance companies cover surgery in 15 states, but not here in Oregon, wa and idaho, mainly run by regence blue shield. Shame on you.
PS for the frequent comments from bypass people that theirs work and so there must be a reason why your bypass doesn't-shame on you too. Their are plenty of reasons that surgeries fail.. Reherniation, pouch enlargement,strictures, poor surgical skills etc. Be kind, you may be there someday.

[mommaterra]

This is absolutely bogus and designed, not for patient health, but for Big Pharma and Mega Medicine profits! Diabetes is never "cured" and to suggest such a thing is unprofessional, at the least. Insulin resistance can be ameliorated, but it comes back without good nutrition. It is tremendously easy to control diabetes, eat meat, preferably fatty meat, whereas it is dangerous and debilitating to undergo gastric bypass -- and the surgery doesn't work for long if it works at all! I know far too many former bypass patients that have no positive effects, but certainly have amassed a wealth of negative ones. No, research this before doing it, really research.

For diabetes, it's easy -- count and control carbohydrate intake. Concentrate on fatty meat. Then be amazed by the numbers. Been here, done this since 1997, and not only are my numbers great, I have more energy than anyone I know. Saturated fat is brain and muscle food!

Two good reference books are "Dr. Bernstein's Diabetes Solution" and Gary Taubes's "Good Calories, Bad Calories," a stupidly-named book full of excellent info. The one caveat for both is that calories are insignificant; carbohydrates are THE issue.

[bobswife87]

My doc referred me to the bariatric surgeon, and I have been through the surgeons evaluation, a psycological evaluation, and a nutritional evalution. It has been proven that I am a candidate for Gastric Bypass. I have type II diabetes, sleep apnea, acid reflux, depression and more. I am on insulin, 2 pill form prescriptions for diabetes, Prilosec, and 3 other prescriptions. I have been fighting with the Trust for my insurance for over a year now to no avail. They come back every time with one thing or another. First it was money, and they found they would save money if I had the surgery, then it was risks and the first medical consultants approved the surgery so they have found another medical consultant in a different state that says the complications are too many and too expensive. Can anyone give me any suggestions?

[UnderSix_Org]

Here's a suggestion, DON'T DO IT! Gastric bypass will make your life difficult for no reason. Cut out the carbs from your diet, stay away from starches and sugars, exercise a little, and ALL should improve, without obnoxious recovery

[davisjoyce]

In April,2002 I had 5 heart bypass surgery and it took a very long time to overcome the stress. In 1994 I was diagnosed with diabetes, high blood pressure, high cholestrol,eye problems, and over weight. My mother died of kidney failure due to complication diabetes. I want to live to see my grand kids and great-grand kids go to school. I am 61 years old and I do not enjoy going to prepare for my own funeral. I want to live! The insurance companies and pharmaceutical companies are run by human beings. They want to live too! Why shorten my life? Medicare,Medicaid,Aetna,and BCBS would not have "baby boomers as a problem" any more "IF" they allow us to get this surgery. Not only allow it, but encourage it! It is the only HUMANE thing to do.

[UnderSix_Org]

I respectfully disagree. I don't think there is anything humane about cutting out a vital organ and destroying the body's natural ability to absorb healthy fats, vitamins, and minerals. Thus, forcing a diet plan that would make you lose weight and have less blood sugar spikes anyway. Gastric Bypass is bad business

[ranger1948]

deb3256
There are many good surgeons just across the border in Mexico who can perform the tummy tuck at a fraction of the cost here in the U.S. just click on websites for tummy tucks.

[deb3256]

I had RNY Gastric Bypass nearly four years ago and lost 110 pounds! I have gained back 10 pounds since my surgery but completely healed of diabetes, blood pressure problems, sleep apnea, asthma and knee pain! I would like to lose 50 more pounds however cannot find the right diet or program to start losing again. If anyone has any suggestions that has been through gastric bypass please respond to this comment....I feel like a new person but would love to drop these extra pounds! One other thing...my insurance has denied a tummy tuck. This is one side effect, if you will, that should be covered by insurance. With the excess loose skin you will develop a rash and continually have irration around the loose skin. Any suggestions on how to get insurance to cover a tummy tuck if you are having skin irration?

[studboy1965]

Dear CBS,
I saw your story and have been trying hard to get a referal for that bypass surgery. I have been diagnosed with diabetes in Nov 04 and found out that taking zyprexa because a doctor perscribed it to me gave it to me. I get sick and im on the toilet all the time. I want to have the bypass surgery but been having a hard time getting my doctor to refer me to a surgeon. Why wouldnt they want to corrrect a fellow doctors mistake when my insurance covers the proceedure? Im on medicaid and medicare and live in Wisconsin!
Sincerly
Clifford M Johnson

[formerfatty]

I had WLS in June 2002. This June, it will be 6 years. I lost a total of 300 pounds and have kept off every single one of those pounds. In fact, unlike most patients I struggle to maintain my weight, as I lose weight without trying. WLS saved my life. I was 29 when I had this surgery. One thing that I will say is that it is not a gift. WLS is not a magic bullet for weight loss. You need to work hard. You need to change your eating habits and exercise.
I know many people who have had gastric bypass and I know many people who have had a lap band. I know groups of both that have had great success, some success and no success. And after talking to the people who have not lost weight, you learn why. They don''t follow the directions, they don''t exercise, they expect the surgery to do all the work for them.
It is a life long committment. You need to drink water, eat protein, take vitamin supplements, etc. But I personally do not think it is any more than anyone who has not had WLS would need to do.
As for those people who feel that gastric bypass failed them, please review your own habits. See how you are eating and be honest with yourself. Go back to the diet you followed immediately after your surgery. Begin exercising. If you are exercising, then up the amount of time or intensity that you are exercising.
I am 35 years old. I have gotten my life back. Had I not had this surgery 6 years ago, I do not think that I would be here now.

[UnderSix_Org]

What if you had taken on the same lifestyle changes without the surgery? Eating high protein, restricting or eliminating consumption of sugary beverages or starches? Exercising on a regular basis? I bet six years of that regimine, you would have lost a bunch of weight too.

My mom was diagnosed with diabetes somewhere between 2003-2004. She has been obese all my life. She did the research and determined how to be successful and healthy, and cut her carbs way way down. Since, she lost just over 100 lbs within a year, and is the smallest she's ever been since as long as I can remember. She has taken up motorcycle riding, and is as healthy as ever. The reason this surgery "cures" diabetes, and helps you lose weight, is because the post-op diet doesn't spike your insulin levels, therefore, making you store less fat!

[gamiche1974]

You have to take enough protein, with food AND with supplements if you don''t want to have severe malabsorption. So yes, you failed the surgery. If you had taken 100g of protein everyday, you wouldn''t have those problems today. For the anemia, did you take iron supplements? Enough iron supplements? Good iron supplements that are easily absorbed by gastric bypassers? Did you take your iron on an empty stomach, a couple of hours after any calcium intake?