Two seemingly groundbreaking studies, published this week in the New England Journal of Medicine found that type 2 diabetes, or “diabesity”, could be cured with gastric bypass surgery. The flurry of media attention and medical commentary hail this as a great advance in the fight against diabetes. The cure was finally discovered for what was always thought to be a progressive incurable disease. But is this really a step backwards? Yes, and here’s why.
No one is asking the most obvious question. How did the surgery cure the diabetes? Did the surgeons simply cut out the diabetes like a cancerous tumor?
No. The patients in the studies changed their diet. They changed what they put in their stomach and that’s something that doesn’t require surgery to change. If they had surgery and they didn’t stop binging on donuts and soda they would get violently ill and vomit and have diarrhea. That’s enough to scare anyone skinny. If I designed a study that gave someone an electric shock every time they ate too much or the wrong thing, I could reverse diabetes in a few weeks. But you can get the benefits of a gastric bypass without the pain of surgery, vomiting, and malnutrition.
Most don’t realize that after gastric bypass diabetes can disappear within a week or two while people are still morbidly obese. How does this happen? It is because food is the most powerful drug on the planet and real whole fresh food and can turn on thousands of healing genes and hundreds of healing hormones and molecules that create health within days or weeks. In fact, what you put on your fork is more powerful than anything you can find in a prescription bottle.
The researchers asked the wrong question. It should not have been does surgery work better than medication, but does surgery work better than intensive lifestyle and diet change.
Astonishingly, the researchers just compared surgery to medication, which has been proven over and over not to reverse diabetes, and often promotes progressive worsening of the diabetes. Patients who get on insulin gain weight and their blood pressure and cholesterol go up. And in recent studies, those who had the most aggressive medical therapy to lower blood sugar had higher rates of heart attack and death.
These two new studies on gastric bypass should have included a treatment group that had intensive lifestyle therapy as well as medical therapy or surgery.
Lifestyle change and changes in diet work faster, better, and cheaper than any medication and are as effective or more effective than gastric bypass without any side effects or long term complications. These changes are not easy, but then neither is gastric bypass.
A recent study entitled Reversal of type 2 diabetes: normalization of beta cell function in association with decrease pancreas and liver triglycerides proved that diet alone could reverse type 2 diabetes. The bottom line: A dramatic diet change (protein shake, low-glycemic load, plant-based low-calorie diet but no exercise) in diabetics reversed most features of diabetes within one week and all features by eight weeks.
That’s right; diabetes was reversed in one week. That’s more powerful than any drug known to modern science and as or more effective than gastric bypass. But since it was a diet study, it got no press or attention. Other research proves that intensive lifestyle therapy can achieve the same results.
We don’t have to heal with steel, we can heal with meals.
As I write this, new guidelines and insurance coverage for this new surgical diabetes cure are in motion. But this is a grave mistake. One in four people over 65 years old, nearly one in five African Americans, and almost one out of ten of our entire population have type 2 diabetes. By 2050 there will be one in three Americans with type 2 diabetes.
Recommending gastric bypass as a national solution for our diabetes epidemic is bad medicine and bad economics. If the nearly 30 million diabetics in America took advantage of this new miracle cure at $25,000 a pop, it would cost three quarters of a trillion dollars ($750,000,000,000.) If we paid people $100 a pound to lose weight we would still be better off. To treat the nearly 400 million diabetics around the globe that would cost $10 trillion. Does this make any sense?
Shrinking someone’s stomach to the size of a walnut with surgery is one way to battle obesity and diabetes and may be lifesaving for a few, but it doesn’t address the underlying causes. And many will regain the weight because they didn’t change their understanding of their bodies or relationship to food.
Clearly, weight loss is critical and important for obtaining optimal health. However, what we are finding in patients who have gastric bypass surgery is that even a dramatic change in diet in a short period of time creates dramatic metabolic changes.
All the parameters that we thought were related to obesity, such as high blood sugar, high cholesterol, high blood pressure, inflammation, and clotting, are dramatically reduced even without significant weight loss because of the rapid effects of dietary changes that control which genes get turned on or off. This is called nutrigenomics – the way food talks to your genes. While weight loss is important, what’s more important is the quality of food you put in your body – food is information that quickly changes your metabolism and genes.
Unless we address the root causes – what we eat, our sedentary lifestyle, and the social and environmental conditions that drive obesity and disease–we will have tens of millions of more diabetics lining up for stomach stapling! The only ones to benefit would be the bariatric surgeons, the makers of the surgical instruments, and the hospitals who are paid handsomely.
To paraphrase President Clinton, “It’s the Food, Stupid!”
My book, The Blood Sugar Solution, is a personal plan for individuals to get healthy, for us to get healthy together in our communities, and for us to take back our health as a society. Obesity and diabetes is a social disease and we need a social cure, not a surgical one.
My personal hope is that together we can create a national conversation about a real, practical solution for the prevention, treatment, and reversal of our diabesity epidemic.
To learn more and to get a free sneak preview of the book go to www.drhyman.com.
Now I’d like to hear from you …
Do you think we should promote gastric bypass as a national strategy to deal with the diabetes epidemic?
How have you reversed diabetes with food?
Have you had gastric bypass and did you maintain the weight loss? Or gain it back?
Please leave your thoughts by adding a comment below.
To your good health,
Mark Hyman, MD
It is my belief that gastric bypass should be used for extreme situations… definitely NOT as a cure for diabetes. My first impression on this is how absurd.
People need to be taught how to eat right, how to put their lives in balance, all aspects of their life; and an operation is not going to do that for them.
We are a country that is geared to the instant gratification… instant foods, the quicker and easier it is to make the better. I can make a “healthy” meal and have it on the table in 30 minutes and no it is not a meal like the popular show on the Food network. Just a bag of frozen mixed vegetables – carrots, cauliflower, broccoli – the entire bag is just 150 calories. Steam them, add them to a stir fry and I want to add… I stir fry in chicken broth. when I buy it, it is low sodium organic chicken broth, Otherwise I make my own and freeze it!
I completely agree with your statement: Obesity and diabetes is a social disease and we need a social cure, not a surgical one.
I think everyone should watch HUNGRY FOR CHANGE!
The two people I personally know who have had surgery did not change their lifestyles and have gained most or all of the weight back.
The medical establishment has been trying for years to get obesity to be “officially” defined as a disease so that insurance would cover treatment and more people would use services that would create more PROFIT. That hasn’t worked so far. Now, they have figured out a faster way – make a medical intervention a “cure” for an existing condition and once again they are back on the road to HUGE profit. We will all ultimately pay the price for this folly. Our medical “disease care” system is unsustainable as it is. Adding this could be the tipping point that brings the whole thing crashing down sooner rather than later.
I previously worked for a bariatric surgery group, and I can testify that you are 100% correct. The most important part of any bariatric program is the lifestyle change that goes along with it. Bariatric surgery of any kind will not work, and may even be deadly without proper diet and exercise. In my opinion, the only thing that the surgery itself provides is the motivation to change, for those who lack the willpower to change on their own. I am one of those people, I have a BMI of 36 and mild diabetes controlled by oral medication, but am having a hard time changing my diet and exercising, although I did lose over 20 pounds when I was first diagnosed 3 years ago. It is also especially difficult for me, since I am uninsured and currently unemployed, so I can’t go to the doctor as often as I would like, and am not able to see a dietician or nutritionist. Regardless, I have no plans to resort to bariatric surgery.
Thank you for your informative blog!
Hello Jennifer,
You don’t need to see a dietitian or nutritionist. You need to rely on God’s Word. He made our food and gave it to us to keep us feed and healthy. If you eat what he gave us in its whole natural form (doesn’t need to be organic) you will lose weight and your blood sugars will normalize. Also it takes self-control. Stay away from man’s processed junk food. Man thinks he can improve God’s food but he can’t. Ever since the process-food and beverage industries became popular, diabetes and many other illnesses emerged from these process-foods.
Your best medicine are real foods (fruits, vegetables, nuts, whole grains, and certain clean meats).
I know doctor Hyman has a few books. His information seems straight forward. I also reference Doctor Joel Fuhrman. He has a web site with good information pertaining to many illnesses. He has a book called “Eat to Live” that has straight forward information that I never would have thought about. He doesn’t sugar-coat anything. His previous edition can be googled and downloaded in a PDF.
After years of traditional nutrittion advice, I just turned 46 last week, I ended up weighting 400 pounds, and everything conviced me that the only solution was a by-pass. So glad I didn´t we I had the chance, I would be banging my head against the wall right now, it changes your life for ever, and besides, over 60% of them fail, most of them due to the person inhability to stop eating, what good is a by-pass when you can drink milk shakes and licuafied snikers.
You see, to lower your weight from 400 to what ever you want to weight, requires a mind change, if you change your mind, you will change the way you eat, and what you eat.
Medicine today is getting pretty good at offering solutions to the most obvious symptoms, and we allow this by giving them the power to make us feel that they know more, they don’t know more, if that were the case, there wound be obese or sick doctors right?
So the cure its not in the food we eat, fix the head, and you will fix everything else, but to fix the head, you need to star eating right.
I like your work and I’m enjoying now a healthier way of living, I’m loosing weight, I read a lot of nutrition from people like you, Robb Woolf, Chris Kresser, Jummy Moore and many, many other that are helping me become a better person and all that implies.
So, to answer your questions….gastric surgery doesn’t work for most.
My regards from Mexico!
Thanks for your insight Rafa! We are glad you are enjoying a refreshinf new outlook on your health! be sure to join Dr. Hyman’s online virtual community to chat with others just like you: http://drhyman.com/groups/diabesity-diabetes/
In good health,
Lizzy
Thank You Dr Hyman for covering this topic so quickly. I do not think we should promote this as a strategy for diabetes. I know a woman who had gastric bypass many years ago and the weight came back because she didn’t change her relationship with food. I’ve had a family member consider gastric bypass or the lap band for weight loss, and I think it’s the worst idea ever. For one, these surgeries can have serious complications, and for two she ate her way into her obesity and she needs to eat her way out. The problem is that we are creatures of habit and have become lazy. It’s too easy to go to the Dr.’s office with complaints and the Dr.’s are far to willing to hand you a prescription for a “magic bullet” that will make you sicker in the long run. It’s way beyond time for people to stop blindly following the advice of many Dr.’s who hand you a “script” to make you happy, and start taking repsonsibility for our own health. We all know we should be eating healthy and excercising we need to stop making excuses and just do it.
I agree completely. We must as a society change the way we treat and think about food. Our children are being poisoned by soft drinks and junk food. Surgery is no cure. Education is.
I had the gastric bypass in June 2002 and reduced my weight from 306 to my today’s weight of 205…I didn’t have type 2 diabetes at the time and 4 years ago developed reactive hypoglycemia…when my doctor had me take a fasting glucose test…I failed miserabably…my blood sugar rose to over 279 then dropped to 39!…so I was given the diagnosis of type 2 diabetes…..yet the drug metformin made me miserable…so he prescribed starlix…and my blood sugar numbers were erratic and I was having hypoglycemic episodes multiple times a week…so.I visited a local diabetes clinic who retested my blood sugar and my insulin levels…again the same result ….He suggested I take no meds…eat protein and veggies and keep a record of my numbers….8 weeks later, he studied the results of my numbers and suggested continuing my plan…I asked if I was diabetic and he waffled his answer…He said the closest he would say was I was probably type 2 and was controlling it with diet…He said if I dropped 40 pounds, to come back for a retest… last year I had a fasting blood work up test from my primary physician..and the blood sugar number was 79…so if I eat correctly, I do not test positive for high blood sugar but if I test with fasting glucose method I do..so what gives?..now I have the diagnosis of diabetes and have difficulty getting health coverage now…
Hi Brenda,
Your story is so common…thank you for having the courage to share it with the community. Regardless of arbitrary numbers, how do you feel and are you able to live your life as you need to without discomfort or symptoms? Sometimes, having the right physician is the best answer to solving the confusion of healthcare. We stronly recommend you get the appropriate care you need to ensure your best health. To locate a doctor near you who practices functional medicine like Dr. Hyman, go to http://www.functionalmedicine.org/practitioner_search.aspx?id=117 and scroll down to where it says “locate a practitioner” and enter your zip. Progress accordingly from there.
Are you following Dr. Hyman’s Blood Solution? It sounds like it was made for YOU! And it requires no health insurance- a double whammy of goodness! Check it out here: http://www.bloodsugarsolution.com
Dr Hyman’s nutrition coaches are available via a free 1 month patient centered counseling trial upon signig up for the program. You can learn more about how this works here: http://www.bloodsugarsolution.com/nutrition-coaching/
In good health!
Lizzy
So happy you covered this subject so quickly. Seems to me this study was done to promote gastric bypass surgery to make money for the hospitals and doctors… Most insurance companies stopped paying for these surgeries some years ago so fewer people have the money to have the surgery and now if this study is accepted as fact the insurance companies will probably rethink the decision to make this surgery available to more people. This is a ploy to promote big business not to help people… I know of a few people who have had this surgery and either they’ve stretched their stomachs and gained alot of the weight back because they didn’t change their eating habits, or they suffer from multiple side effects including malnutrition, ulcers and many other complications… How sad that our society believes that there is a quick fix for everything without changing our terrible eating habits and sedentary lifestyle!
Hi Dr Hyman… well surgery is a last desperate resort for people that cannot afford to have nutritionists and personal trainers or go to somewhere like Pritiken or yourself for a course of treatment and cannot manage on their own…. I have researched this whole subject quite a lot both as a registered nurse and as a wife of a husband with type 2 diabetes…. the surgery works in a way that they do not really know yet as the diabetes is reversed within a day or 2 of the surgery… not by the horrible diet that these people have to endure after the surgery… the new thought is that it is something to do with the duodenum and jejunum as using an duodenal stent also reverses diabetes in the same quick period (must be to do with absorption in some way). I have had my husband following the Mayo Clinic Diabetes diet from their book and his sugars normalised during the day within a few days and his blood pressure and cholesterol were also within normal levels in 2 weeks. However his fasting sugars although improved are not at a good level yet….we need to keep going to get the weight off and keep the clean diet going to get him off his nocte insulin which I have no doubt we will manage over the next month or two…. just thought I would mention that it is not the diet which reverses diabetes with the weight loss surgery as it occurs almost instantly… Jo
I am only two weeks into my life change. I watched Dr. Hyman one evening and promptly bought the book. My wife and my 23 year old son have embarked on changing.
My wife and I both have metabolic syndrome. My son, while not obese, is overweight. Since we started the program less than two weeks ago, I have lost 12 pounds, my wife 7, and my son 14. We all are active in walking, running, playing basketball, etc. However, we were before the diet and never lost any weight. My wife and I have tried WW’s several times in the past an always ended up putting the weight back on. I had actually lost 50 pounds TWICE, and 25 the most recent last time. Every time I ended up back to 240. Now I am 228 and amazed and encouraged. Also, my blood sugar levels and blood pressure are dropping steadily. I see changes almost every day.
The video “Hungry For Change” is informative, but it encouraged me that I’m on the right path with Dr. Hyman. Everything He has said has proven to be true.
I am pretty sure I have told you this, I had a lapband done a few years ago, nothing changed for me, I tried very hard, went for the regular weigh in and lapband tightening etc., and in the end my husband was more worried about why I couldn’t eat properly, so I made them take out most of the fluid in the band, I didn’t put on any more weight, but lo and behold last June a had a very large brain tumour removed that apparently had a lot to do with cognative, organisational and emotional behaviours, I have since then lost over 30 kilos (roughly 65 pounds), I walk 45 minutes like I did previously, I am now not in the diabetic range. I am living proof of fresh food diet works, I still have some problems like low iron and have tried many brands of iron tablets, but now that I am off the anti seizure tablets have been told this should help, I hope it does as I have lost a real lot of my hair (seven and half hour) surgery, but still no real advice on this matter.
Dr.Hyman and your wonderful staff I always look forward to your information, actually I would like to know what sort of blood tests I should request at my next lot at the begining of May.
I totally agree with the fact that the food is the cure. I had gastric bypass surgery 3 months ago, and I’ve lost over 70 pounds since., I’m off the insulin, Actos, and take metformin only for now.
My appetite has totally changed. The sugar, fat and gluten laden foods that I used to love and crave now make me nauseous. I have no desire for them. I also do not get hungry very often, and am very pleased at getting full with such small portions of healthy food.
I credit the surgery with these appetite changes, and the “surgical substitute” for my lack of willpower. It was the catalyst that enabled to “fix my mind”, and change my lifestyle and diet. Now the new diet and exercise regimin is normal for me, and not a chore at all.
If the general population can find any non surgical catalyst, that would be great, but history has proven that it isn’t happening. So, if the surgery is what starts the healthy lifestyle and diet that all above are recommending, then perhaps that is what is necessary.
If the drug companies could come up with a “will power enhancer”, that would be a miracle, now wouldn’t it.
Once the healthy mountain is climbed, it’s really easy to maintain.
My mother told me just yesterday about hearing that bypass surgery was the latest treatment for diabetes. I’ll guarantee you the diet-change alternative wasn’t mentioned. We have a relative who had bypass surgery for other reasons and has done extremely well, so I plan to suggest that a diabetic family member try her radical post-op diet instead of signing up for surgery. Thank you, Dr. Hyman, for always standing firm on the body’s ability to heal itself given the proper care!
March 31, 2012
The FDA has declined to ban BPA. Do your research on BPA and contact congress often and persistently until this decision is reversed. Do not give up this fight. BPA and other chemicals in our food supply are one of the reasons for the high incidence of diabetes and other modern illnesses.
I reversed my diabetes, a couple years ago. And I did it simply by changing the food. I also took some natural supplements, in the beginning, that did the same thing as the drugs, only better. Now my A1C is in the 5′s, my weight is 150 lbs down from where it once was (no surgery), and I don’t take any drugs or supplements for BS control, at all. I eat mostly meat, veggies, some fruit, some yogurt, and occasional cheese and nuts. Occasionally, I might have a little bread, pasta, brown rice, and potato at a restaurant, but that’s it. I don’t have them at home. They are just occasional “treats.” I don’t eat ice cream, except for the Spumoni that comes with the meal from Old Spaghetti Factory. I might have a literal “bite” off a Starbuck’s brownie my hubby gets, occasionally. I sometimes have a literal “bite” off his pancakes at Denny’s. And I do mean a “bite.” I don’t have any interest in those things much more than that. I just don’t care for those types of foods hardly at all, anymore. I really like being able to have the foods, if I want them. I just don’t “want” them very often.
Diabetes took my mother down in a horrible way, 10 years ago. And I was once starting to follow in her footsteps. But I was able to figure things out, and turned them around, before it got too late, thank goodness. And the “secret” really is letting go of the “bad” foods that are screwing us all up.
Dr. Hyman, you are God sent to educate the world on the truth about maintaining good health and making lifestyle changes to prevent or reverse diabetes. You are the ONLY Dr trying to encourage people to make a permanent food lifestyle change and I thank you for your wealth of information. You have changed my life for the better in preventing diabetes and being aware of what i allow my body to consume. My mom has type 1 diabetes and I’m purchasing the book, “The Blood Sugar Solution” for her today. I know that once she follows your plan that diabetes will be reversed in her life. I just want to thank you for taking a stand that many Dr’s have yet to do because the pharmaceutical business is big bucks. I thank God for leading me to your television seminar on channel 21 in NY/NJ, because from watching your seminar in it’s entirety, my eating habits have changed and I know that my mom’s life will soon change for the better once she receives your book. Thank you and may God continue to bless you and your family.
I was thin until I had pneumonia and asthma, was taking prednisone and quit smoking. I gained 60 pounds in less than a month and I was the only one concerned. I’m still that heavy without eating more than I did before the illness or smoking cessation. My breathing has really been affected so it is very hard to exercise or even walk. I still work every day sitting nine hours a day= not good. My doctor asked if I would be interested in lapband surgery and I told her no because I am terrified of surgery and also because my hunger is in my head and not my stomach. When my blood sugar is very high or very low I am ravenous and even if I’ve just eaten, I’ll continue to graze. I’m fortunate that I’m not a sweets lover but I do love potates and rice so it’s a constant battle. I really believe a lot of our problems with weight and cancer and immune disorders comes from eating “bastardized” food. There are so many changes made to seeds and animal feeds that we are consuming genetically altered food which is altering our genetics. Government wants to control our lives but fails to step to stop the hybridizing of foods and that’s where it will have to start. In the meantime we ourselves must limit what we consume and hope for the best. I eat a lot of fresh vegetables but I’m not sure how healthy they are for me. I haven’t had a tomato as I remember from childhood for many years as stores don’t sell “heirlooms”. They would be terribly expensive anyway, Most of our healthy choices have been altered from 30 years ago, and that added to mega portions and salt and sugar content is killing us.
Oh where to begin!? I have been eating very healthy for a long time but my weight still continues to stay high after several years of additional health problems with numerous medications. I am unable to walk for exercise due to pain in my legs from lower back, hip and knees which is not from the weight but injuries, genetics, etc. I am currently on 13 medications, 3 for hypertension, 2 pills plus insulin for my diabetes, an anti-inflammatory for the knee problem that no one will help me with due to my weight, etc. I am not sure of having this surgery but I have been doing the best diet I can which is what Dr. Hyman recommends and still have problems. My current level of health and quality of life just stinks! At the rate of decline I will risk more health issues if I do not have the gastric bypass. So, what to do when I have done all else possible. I agree there is much to be gained my so many people if they just learn what is a better way of eating. So many have such a poor diet it is frightening! In my case, I wish I had a better sense of what choice to make next. Surgery or not? That is the question.
Hello Gloria,
Since you are on medication you should be monitored by your physician while following Dr. Hyman’s suggestions. And if you are unsure about what to do, please get another medical opinion on your condition.
Best,
Dr. Hyman Staff
I agree with all you said. Just have a question; removing a portion of the stomach removes many grenlin sites. That may be halpful to some people, right? I realize emotional eating will wtill happen unless one can adress the issue.
I was diagnosed with type 2 diabetes last year. Since then I have discovered Dr Hyman (diet) and Dr Mercola (exercise) and changed my diet and started exercising. I have lost 28lbs and toned up. The type 2 has gone and I am feeling so much better. I have much more energy and am going to loose another 28lbs this year. For me diet and exercise has been the answer.
I have a friend who has been successful in losing weight with lap band surgery. I have two friends that were not. The latter two have both passed away due to complications leaving young adult children and husbands behind. If I could do anything to honor their lives I would encourage anyone who is thinking about this procedure to think twice. Educate yourself about what diet changes can reverse diabetes and make weight loss successful because there are ways that truly work. Find a support group of others who are serious about changing. Watch Raw for 30 Days if you haven’t seen it. If you will have to change your diet after surgery anyway, why not do that part first and see if it helps. Changing the diet heals the body and brings good changes in many different areas like mood, cognitive ablility, energy and weight loss, plus the improvement of other chronic diseases like hypertension and hypothyroidism. Changing the body with surgery only forces you to change the diet. Remember that there are serious risks of complications and death with this surgery. One friend of mine slipped up and ate something “wrong” and later died from her violent reaction to it. There is no risk from eating more vegetables and delicious fruits and healthy proteins. If you slip up you get back on board instead of ending up in the ER or worse.
A friend of mine was on the table for gastric bypass to “cure” diabetes in 1974. This is not a new idea.
Now, advertising has bled into medicine. Billboards hint that cancer is no more serious than getting a cold. The same tactic is being used for gastric bypass surgery. Soon, we’ll all look like the Borg. Want a new head? No big deal.
It seems like a different topic, but the root subject is really the transfer of wealth to the medical estate. As it gets richer, it gains influence. Much makes more.
About a year ago, at age 50, on a routine visit to my primary care physician, I was informed of an A1C of 13 and abnormal liver results. I had been on high blood pressure medicine for a year. I was on CPAP for sleep apnea for several years. I was on prilosec for GERD for many years. I was 290 lbs, 5’10″. My doc perscribed insulin 4 times per day.
Because the diagnosis scared the hell out of me, I began an exercise schedule and returned to an Atkins-type diet as I had 10 years earlier. Within 2 months, my blood sugar levels were normal, I didn’t need the insulin, prilosec or CPAP. Two months later, I no longer needed the high blood pressure medicine.
Over the past year I have been reading Mark Sisson and Dr Hyman. I have lost 60 pounds. My doc couldn’t believe that lifestyle change could effect that kind of result. Nonetheless, he still suggested that I eat more carbohydrates and less fat, referring to the food pyramid.
Gastric surgery should not be standardly authorized for diabesity. Such a strategy is exactly opposite to the current efforts to change healthcare to an efficient, accountable system that pays better for health than disease. The behavioral healthcare industry has a technology for treating severe eating disorders for those who need a more intense intervention than office visits with a primary care physician and a diabetic educator. But, as long as physicians are paid for doing more procedures and the food industry, with the support of the FDA, continues to produce grain and sugar based “food”, the projections of an unhealthy population will absolutely continue.
Wayyyyy down at the end of the article published in our newspaper was the “success” story of one person. She had the surgery 3 years ago, lost 80 pounds, and has now gained “13 or 14 pounds” back–16 to 18% of the weight. What say we check with her in another 3 years and see how many more pounds she has gained? The diabetes will return as people find a way to cheat on the diet they were given.
I’ve been told that in order to qualify for the surgery a person has to go on a special diet for several months and has to demonstrate that they have lost a certain amount of weight. This shows the surgeon that diet will cause weight loss and that the person will stick to the diet. I’ve never understood why the docs don’t just say, okay, diet works, just continue that and you will lose weight.
On the other hand, even good foods can cause inflammation in people who are sensitive to them. I’ve eaten a very clean diet for many years, but the pounds continue to add up. Dr. Hyman helped me get rid of another health issue, and if I could afford the 1000 mile trip more often, he would have helped me with this as well. As it is, I finally found a real nutritionist in my area who is guiding me through the process of finding out what is inflaming my system and causing my high blood sugar, which just continues to rise along with the weight. The numbers don’t indicate I have diabetes yet, but then “they” have moved the numbers over the years as more and more people get high blood sugar.
She started me on a very restricted diet, much like the one in Dr. Hyman’s UltraSimple book, in order to “reset” my system and I am slowly adding one food at a time to find out which ones cause the inflammation and high blood sugar. In the first week I lost a pound a day and my blood sugar is very close to normal. If you knew my history you’d understand that losing weight at all is revolutionary and no physical cause could be found for the high blood sugar. The inflammation is obvious and profound. Now I have energy and I can think. The pain is gone. Yes, I said the pain is gone. From the first day.
We haven’t yet found the foods I was eating that are bad for me, but I assure you, whatever they are, I will have no trouble avoiding them. Forever, if necessary. Because of the weight loss? No. Because of the blood sugar? No. I could easily talk myself into cheating on those to see if I could get away with it.
It’s because the pain is gone. I think this is the problem with the diet the surgery patients are given. No one takes the time to find out what works for this individual. It’s one size fits all. At one time, I couldn’t tolerate rice, the most hypoallergenic grain of all, while wheat, the most common problem for people, worked well for me. What regular doc would have taken the time to sort that out? If it were me on that diet, even if I were losing weight (an abstract concept when faced with hunger) I’d still be hurting and I wouldn’t care about the weight loss anymore. Take away the abdominal discomfort, the back pain, the knee ache, the neck stiffness, the gall bladder pain, the energy loss, the sleepless nights, all caused by inflammation, and I’m going to be thrilled with my diet no matter how restricted it is.
Most people don’t realize how much they hurt until they don’t hurt. And then they are converts. I did know how much I hurt, but I needed help in designing an elimination diet for me.
I know it’s an uphill road, and I’m so happy Dr Hyman has the energy and stamina to walk it. He, his staff, and his family deserve our eternal thanks for what they do for all of us.
Although I agree that gastric bypass is not a cure-all and healthy eating is a much better approach, I also believe that there are situations when gastric bypass is a reasonable alternative. I was 64 and had been obese since being on high-dose prednisone for a number of months. I worked for 12 years to get that excess weight off and was never able to keep it off. I had type 2 diabetes that was getting worse, NASH with cirrhosis, sleep apnea, GERD and a bunch of other things. My meds list was ridiculous. It’s been 2 1/2 years since my RNY gastric bypass and I lost all I needed to, then gained back 15 lbs. My weight has stayed stable since then. I watch what I eat, can go out to restaurants, etc. Vomiting and diarrhea after eating do not happen to everyone and when they do, it’s often a signal that our bodies can’t deal with that food (or quantity or speed of eating). For example, I just can’t eat salmon but can eat reasonable portions of just about anything else.
What is helping me now is the need to eat slowly, eat small meals, and make sure that every bite I eat is food that is good for me. Are there downsides (besides the surgery and post surgery time)? Yes, there certainly are. Gastric bypass induces a state of malnutrition that requires careful and thoughtful eating to manage. Is it for everyone? Certainly not!
Would I have preferred to do this without surgery? ABSOLUTELY! But I simply wasn’t able to do it so this was the next best option if I wanted to stay alive for more than a few more years. I would do it again even though I wish it hadn’t been necessary.
I know 6 people who have had this surgery and all but 1 put all the weight back on. The 1 who kept the weight off is suffering from malnutrition.
Hello, I just learned about Dr. Hyman and his work via a friend. I have had juvenile diabetes for 52 years. I am 60 years old. I have a brother, 4 years older than me and a sister, 2 years younger than me, both of whom developed diabetes a year earlier than me. Neither our Mom or Dad had diabetes. I believe this dated back to an auto immune reaction we all had to getting the chickenpox 4 years before we developed diabetes. When I was 32 years old, I contracted Rubella and have an inflammatory disease as a result. I wonder if following the diet changes in Dr. Hyman’s book could cure me of type 1 diabetes or at least help to stabilize my whacky blood sugar dips and spikes? Do you people have experience with patients such as myself? I have a great naturopath who uses many of the products with me, that I see recommended on Dr. Hyman’s site. But, nothing works for more than a short period of time. I am wondering where you would start with a person like me. I am not over weight, neither are my siblings. Should I get the book and try the diets in there? Should I get an appt. to come see one of Dr. Hyman’s Dr’s? Does Dr. Hyman see patients himself? My situation is quite unusual. I follow close medical and alternative therapy, yet i struggle daily. I have a master’s degree in nursing. I look forward to hearing your response. Bridget
Hello Bridget,
Thank you for your message and your interest in Dr. Hyman’s work. Information on becoming a patient at The UltraWellness Center can be found at “How to Become a Patient” at http://www.ultrawellnesscenter.com. You may also feel free to call The UltraWellness Center at (413) 637 9991. Yes, Dr. Hyman does see patients himself.
Wishing You the Best of Health!
This is another example of researchers getting it wrong. To be a researcher does it mean you must abandon common sense? Well that is what is becoming apparent reading more and more articles like this. We live in a society where we take our gratification from outside sources instead of finding it within. We feel bad, depressed or lonely well then eat this great tasting high sugar fat ladened food and you will feel better, after all why deal with the actual emotion. See all the happy skinny people at McDonald’s enjoying a Big Mac with smiles on their faces. Or the sugar ladened breakfast cereal that makes your kids so happy in the morning! When will we wake up and stop being spoon fed our emotions by the food industry. McDonalds does NOT make me skinny and happy, sugary cereal does not make mornings any easier with my kids. We need to start NOW with children to stop this epidemic. When sugar is a treat then kids want it more. It should be against the law to feed kids the crap that we do. My kids were told if they were well behaved they would get a treat. A treat in our house was carrot sticks, broccoli and cauliflower. They grew up thinking that if your parents took you to McDonalds then well your parent’s didn’t love you very much. Pop was something only stupid people drank. Yes I completely brain washed my kids into eating healthy but from birth until around age 14 they had a solid nutrition foundation. Today they are teenagers and eat crappy food now and then but they always make the connection with how they are feeling with what they just ate. It amazes me when I hear someone complain of being exhausted and not feeling well and cannot connect it to the half dozen donuts they ate that morning.
We need to stop sticking our heads in the sand and wake up. Food is our body’s fuel and if we eat the wrong fuel we will cause problems. No matter how much fat you get sucked out or how small your stomach becomes, we need the right fuel.
That was my rant for the day, Thanks!
I TOTALLY agree….By Pass is NOT the answer. Only Me, personally, I am having a duffult time both losing weight and controlling my blood sugar even tho’ I have followed Dr. Hyman’s diet to the tee. I’m almost VEGAN. I eat NO SUGAR, NO WHEAT, NO GLUTEN. NO DAIRY, NO ALCOHOL, NO Practically EVERYTHING. I never had diabetes until after I was diagnosed with Addison’s disese. I was instantly put on 60 MG of Hydrocortisone daily……and no matter WHAT I eat or dont eat….My body weight doesn’t budge…I now also have high blood pressure-NEVER had that or High Sugar. I’ve tried for 2 years to bring these numbers down “Naturally” and last week I gave in and started on Mediform as my sugar was averaging around 300…..so far the Medicine hasn’t done anything. Any suggestions when one is on high levels of STEROIDS??? I KNOW my body can heal itself….but I’m not sure what the next step is I should take.
THANKS for any input…..
Hi Linda,
Considering that you are taking medication, you should get the advice of your physician on this matter.
Best,
Dr. Hyman Staff
At the time my blood was drawn for the A1C test In September of 2010, I had been what my doctor termed a “border-line” type 2 diabetic for at least 10 years. The lab report showed I had finally crossed the line into full-blown type 2 diabetes so my doctor started me on metformin. I had a very dramatic negative reaction to this drug (blinding headache – my first headache in nearly 20 years……), stomach upset, and the “back door trots.” At first, I thought I had a bug. I stopped taking the metformin because I didn’t want to waste it throwing up. About two days after I stopped, all of my symptoms including the headache were gone. I resumed the metformin and on the second day, the blinding headache was back much more violent than the first time with the same gastric symptoms. I began to suspect the metformin; I got on the Internet and read about its side effects. Bingo!
When I called my doctor and told him I had stopped taking the metformin, he wanted to put me on Januvia in injectable form. I wasn’t too happy to hear this and worried about the cost. Even after my Medicare Supplemental Drug Plan picked up whatever it was going to pay, I would have to start coming up with $45.00 every month – just for this one prescription. That’s when the light bulb went off in my head that there must be something else I could take (in addition to modifying my diet according to the glycemic index) that would not be as expensive. My Internet research identified cinnamon (plain ordinary ground cinnamon that we bake with) and an extract made from the banaba plant (crepe myrtle) leaves which were commonly used in Ayurvedic medicine for thousands of years for the treatment of type 2 diabetes. (Type 2 diabetes didn’t occur very often because the Indian diet naturally prevented it.) I started adding cinnamon to my coffee (a 0 calorie way to make simple home-brewed coffee taste like a Starbuck’s creation) and to any other food I thought it might be good in. The amounts the Internet site recommended varied between a half or a full teaspoon total per day. When my doctor got my blood work back for my next three month blood draw, my blood sugar was well below the danger zone and my cholesterol numbers had improved dramatically. Being disabled, unfortunately, exercise is not something I am able to do at present – so adding cinnamon to just about everything and trying to eat only low or mid-glycemic index foods is all I am able to do to keep my diabetes from returning. I am happy to say I am still diabetes free going on 18 months as of this writing. (I just bought a copy of your book, The Blood Sugar Solution, and have begun to follow it – I am confident that I will soon be “diabesity-free” as well.)
I had gastric bypass surgery nearly 9 years ago, at age 33. I weighed 285 at my heaviest and got down to 135 at my thinnest. I’m 5’5″. I was not diabetic, but had tried everything since I was 12 years old–I was so depressed and hopeless that in my mind it was either gastric bypass or suicide.
Anyway, I lost a ton of weight relatively easily and absolutely loved everything about my surgeon, my surgery, and my results. HOWEVER…
After a year or so, I started eating sugar again, and then discovered the amazing new kind of high I got from drinking alcohol. I started to gain weight again, by eating snacks all the time and drinking a whole lot of alcohol–too much alcohol. When I reached 200 pounds (about 2 years ago), I was like, “enough’s enough!” I knew I needed to stop drinking and haven’t had a drop since. I also knew I had to eat healthful foods to become a healthy person (radical thinking, right?).
That’s when I read about Dr. Hyman’s Ultrametabolism book (on the Huffington Post). Everything I read about the philosophy made sense–at different times in my life I had been a vegan, a vegetarian, followed Marilu Henner’s plan, etc. Dr. Hyman’s approach was practical and logical to me. I cut out dairy, refined sugar, white flour, all oils except extra virgin olive, caffeine, and of course booze. I ate all the “good stuff” he prescribed. I lost over 50 pounds slowly but easily. Amazingly easily. I was never once hungry, except if I was out and hadn’t planned ahead, but in these cases, I just had some water and waited until I got home. At some point, the idea of eating a cupcake or a piece of bread or anything processed just turned my stomach, so it’s become easy for me to “resist” these foods. Instead, I crave fruits and vegetables and nuts and salmon! This is a miracle for me, who was addicted to all the bad stuff for my whole life.
So I’m not going to say that my gastric bypass failed, because it saved my life at the time and I love it for this. There is no way for me to know for sure if I could have weaned myself of binge eating without it. But Ultrametabolism gave me control of my life, and I am sooooo happy with my lean body, clear skin, shiny hair, abundant energy, and healthy attitude about the foods I decide to eat! Whenever anyone remarks that I am one of the lucky ones for whom gastric bypass succeeded, because it’s almost 10 years and I’m looking so good, I tell them that it’s the combination of the surgery and Ultrametabolism.
I am a physical therapist and work in a community with a very aggressive bariatric surgery department in the local clinic/hospital. I also have a sister who had gastric bypass going on a year and a half. She has loss her weight and has kept it off. My concern with the number of people I see in my clinical practice is what I feel is significant musculo-skeletal issues in these patients. My sister had an episode of dislocating a kneecap with a minimal stress to her knee. I feel a significant number of people show up in my clinic with musculo-skeletal issues and the history of this surgical procedure. No strong evidence, but a clinical observation. My concern for these patients is that their nutritional intake is deficient of essential vitamins and minerals to support a healthy musculo-skeletal system.
My other observation with this drastic procedure is that if you are willing to live your life sipping your meals thru a straw or in 3 oz increments then just make that change now and by pass the surgery. You’ll more then likely see the same results.
My last thought on Dr Hyman’s Blood Sugar Solution is that I myself am hyperinsulinemic. I was tested for my blood sugar 30 years ago because I was having episodes of dizziness for no reason. Of course, the first suspicion was blood sugar. My glucose tolerance test was flat lined. The lab technician commented that I was destined to be a diabetic in my later years because my body was producing too much insulin (ie: my flat blood glucose tolerance test).
My medical doctor did nothing with the test results. So reading Dr Hyman’s book really spoke to me personally and as a physical therapist treating many patients with excessive inflammation from a poor diet. I now have more information to quide them to and will have many of them go online and complete the diabesity questionnaires. Thank you very much for this valuable tool.
I totally agree with you. In 1995 I weighed 315 lbs. I lost 105 lbs. in 18 months and kept it off You must change your thought process about food and your relationship with food will improve. I have learned the same thing with muscles. We are trying to get out of pain by doing many unnecessary surgeries. All we need is to change our thought processes about our muscles and the how they affect our bodies. I recently wrote a book showing massage therapy as a key treatment in 80 different illnesses. The name is Massage Works- The Proof and it is on Amazon.com. I look at the muscles from an engineering view. Our healthcare looks at pain as if the bones move the muscles, when in reality the muscles move the bones. Now, no one would logically disagree, but why do we perform surgery on the bones when it is the muscles that are creating the bulging discs, pinched nerves, and chronic back pain? I work with many people suffering for years with chronic pain. I use Active Isolated Stretching and deep tissue massage to relieve the pain. I believe we are on the same page and should talk more about how we can help the nation make this paradigm shift about our food and chronic pain. I believe we are looking at our health the wrong way.
Okay – I think that nobody has the full picture here. Everyone is grabbing onto what they want to hear. I’m looking at this from 2 perspectives. #1 I had gastric bypass surgery 8 years ago, went from 330 to 140 and am now a life coach for people going thru the surgery #2 I’ve maintained my weight loss by researching and studying healthy eating and implementing many of Dr. Hyman’s beliefs. Both things saved my life. I think weight loss surgery (WLS) is a viable answer in extreme cases. I’ve been reading all the recent articles and studies on WLS and diabetes. I’ve also seen first hand many WLS patients who stopped their diabetes meds within days of having gastric bypass surgery. I don’t think there’s any way that just changing how you eat and losing weight can create that kind of an effect in a couple days – there has got to be more going on from a physiological standpoint. This change only occurs with gastric bypass where the stomach is made smaller surgically and part of the small intestines in bypassed. The remission of diabetes is NOT seen in the gastric banding (lap band) proceedure where their digestive system is not surgically changed,even though these patients have the same diet restrictions as the gastric bypass patients. So why the difference? Yet, I believe 100% that diabetes can also be changed and reversed with lifestyle change. It’s harder though when you are 100 or 200 pounds overweight and CAN’T be very active or your metabolism has slowed down to almost nothing because of a life of yo-yo dieting. I’m not saying it can’t be done but it is SO much harder than the normal person and most doctors realize. I’ve been there! The surgery can give you a jump start if you’re in an extreme situation. Then as you lose the weight it’s imperative to start changing your lifestyle, especially eating habits, in order to maintain your weight loss and your health and keep the diabetes in remission. So everyone get your facts straight, do your research, don’t put everyone into the same box, and don’t dismiss the surgery as an answer in extreme cases. Thanks!
My niece had a bypass five years ago. She has always been heavy. Most of us on my Mothers side of the family have always been over weight. I need to get fifty pounds off myself. Usually I do pretty good about eating right but I let the death of my older Sister be the reason for my bad eating habits as of now and that is what I am doing here. My niece has gainned back some of the weight. She was a size six about four years ago. She looked terrible and she is always in need of iron. A threat her Doctors hold over her head. She can’t eat right and always has trouble with digestion. She is now up to a size 12!!!. I see her gainning most of this weight back as the good eating habit have gone out the widow that they tried to instill in her at the clinic where she went to have her surgery. She had to go for lessons for six months before they would even do the surgery. I know that this will not work any better than anything else unless you want to make the changes yourself and make the changes and stick to them. I don’t know what alot the the information was that they gave her at the clinic as to live style changes in eating. I can only guess that they were’nt very helpful in eating alot of fresh vegies and fruits.
I have had gastic bypass and don’t have diabetes, vomiting, malnutrition or weight regain. I had my first bone density scan last year and had great results. Gastric bypass was a lifesaver for me and I would do it again in a heartbeat. It seems only the downside or surgery failure results are written about-believe me there are many others out there who have had great success with gastric bypass. Check out some post wls forms as obesityhelp or livingafterwls for a true picture of things.
I agree with Dr. Hyman’s article, and always appreciate his approach to health and wellness. I am an RN- Holistic Health and Nutrition Counselor and work with many clients who suffer from Diabesity. It becomes discouraging as a health counselor to hear potential clients turn my program down, because it is not covered by insurance plans. Instead they are led to drastic surgical measures, that are now becoming more and more accepted by health insurance. People may have to meet with a Registered Dietician or personal trainer to get documentation and qualify for prior authorization of procedures, but I think it should be mandatory for people to meet with a health and nutrition counselor for at least 6 months prior to being considered a candidate for gastric bypass surgery. So many are looking for a quick fix, a pill, anything but getting back to basics and hard work! It’s sad…surgeons are now marketing their services along with dieticians and personal training services, to make gastric bypass surgery insurance authorization easier for potential patients. I have witnessed this first hand, and watched patients come back repeatedly with serious complications, which ultimately makes more money for the hospital who contracts with the surgeon. Health Care in this country is really messed up…it’s SICK CARE! I invite people with DIabesity to strongly consider health and nutrition counseling. We are equipped with knowledge, compassion, and great resources like Dr. Hyman’s: Blood Sugar Solution!
I had gastric bypass in 2006. I lost 70#”s. I have been working in a place where I sit all night and have begun putting on weight, 25+ pounds. My blood sugars were in the 300′s, and my a1c 10.5 it’s getting scary. I found you on WEDU and went and bought your book. There is no way I can possibly afford your supplements. I wish it were possible but it is not.
I will begin reading after I finish taking my current class.
I have a number of friends who have had this surgery. Some have had the stomach modification type and some the inflatible band type. Initially, both worked as described. Everyone was able to get rid of the medications they were taking, statins, high blood pressure, diabetic and prediabetic type medications. However, after a while, all the friends started gaining weight back and most had to go back to the medications.
You are right, Dr. Hyman. Unless someone changes their diet and lifestyle, their problems will continue. The bypass and lapband surgeries work temporarily very well. Eventually, though, a person is right back in the same track they were in before. There isn’t a “silver bullet trick” that will cure the problem. The problem is eating and life style. Any change that doesn’t alter these two things won’t work.
I lost 80 pounds starting about 4 years ago. I went to an Atkins type diet and walking 25 miles a week. I have since gone to a more time-efficient intense interval training workout and working through the stage 4 Atkins program I have figured out what I can eat and what I must eat. I have kept the weight off for two years now. I have reversed and erased placque buildup, heart enlargement and other markers and results of poor eating and exercise habits. I have also discovered that I have a gene (MTHFR) that makes me likely to have arterial blockage and have begun a simple supplementation program to solve that problem.
Go Doc! Continue to advise people to eat whole, healthy foods in proper amounts, exercise properly and avoid “Quick Fixes” that in the long term don’t “Fix” anything.
One of the challenges that I find working with weight loss clients in my hypnotherapy practice is that they are looking for the magic bullet to solve their health dilemmas. And because we are generally dealing with addictive behaviors, the answer is not in the diet or the “program” but in helping the client come to terms with their practices, learn to be mindful and honest with themselves, and commit to making changes in their lives. I have been working with diabetics on weight loss with a “virtual gastric surgery” that provides virtual supports but focuses on the lifestyle changes necessary to become healthy. My diabetic clients, if they are committed to doing the work, make amaizing progress in lowering their blood sugar without drugs because they are changing their diets, becoming increasingly active, and developing the sense of self-worth that is necessary to sustain change.
I agree that the surgery is not the best option for most people, and many who have them suffer terribly with the after effects, including the shame of weight gain. And my clients who are in this group have a much harder time with weight loss and self worth because the failure is heaped on top of their previous issues.
Anything that you can do to help inform people in simple terms of the value of healthy eating, active lifestyle, and affirming their worthiness is greatly appreciated.
This is a slippery slope. Surgery is something very serious, and should always be a last resort. Thank you for shedding some light on this topic.
A girl on The biggest Looser show, she had the gastric bypass done at age 16, and was on the show to loose weight!!
It is not the be all and end all!
If you don’t eat right, you will gain the weight back. Another woman, who was 600 lbs, and had gastric bypass. They watched her for 7 years after the surgery, and she still had not lost all the weight she should have. She still needed to loose another 200lbs or more, after 7 years! As much as we hate to change how we eat, this is the only way to get the weight off.
Unfortunatly, I wish we could all have private chefs and personal trainers. We could still save a lot of money if we emloyed these people, rather than getting the surgery.
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Like Donna i was diagnosed as pre-diabetic. My blood sugar was elevated, my A1C was up, I had high blood pressure, severe sleep apnea and fatty liver disease. I was 110 pounds overweight with a BMI in the low 40s.
I had a sleeve gastrectomy. I have lost 80 pounds. Recently, I just had my 6 month labwork done. My blood sugar was normal, my A1C was 5.4, my blood pressure was 122/70 and my sleep apnea is gone. In fact, like you said, the diabetes actually disappeared with a couple weeks, but guess what? I would have never been able to maintain it.
You talk about diet, but I have tried time and time again to change the eating habits. I have not been successful until I got this restrictive procedure done. I don’t feel the need and actually cannot eat so much so what I do put in there has to count. Junk does not go in the sleeve. Processed food does not go in the sleeve. Sugar does not go in the sleeve unless in is naturally occurring, but even then I watch the glycemic index.
I do not advocate gastric bypass due to the malabsorptive issues, but I do advocate the sleeve, but only if there are other concerns besides the diabetes. The standards the insurance companies are using now are mostly on track. You should have a certain BMI and at least one co-morbidity. You should also have the right frame of mind. This is a tool and if you try and work around it by stuffing easy to slide junk food and alcohol, you are going to fail.
The exception is the band where I do think the surgery fails. The band seems to have a high rate of failure and complications like esophageal erosion, slipping, breaking and simply not being able to find the right fill level. Too tight and you cannot get anything down. Too lose and it doesn’t work.