Bariatric Surgery For Diabetes? Oh, Cut It Out …

Sometimes when I read health and medical articles in the newspaper, I don’t know whether to laugh, cry, scream, or just bang my head against the wall.  If memory serves, a recent article about the wonders of gastric-bypass surgery prompted a full round of each, followed by a string of expletives that made me grateful my daughters were in school.  (If my memory is fuzzy, it’s probably because of the head-banging.)

The article, which appeared in our local newspaper but originated with the Los Angeles Times, was headlined: Gastric bypass: Is it a diabetes fix?  Here is a link to the online version so you can read the full story in all its glorious stupidity.  In the meantime, I’ve pasted several snippets below, with my comments interspersed.

The discovery came about by accident more than a decade ago: Weight-loss surgery often led to dramatic improvements in the control of Type 2 diabetes, often before patients had even left the hospital.

Wow, that’s amazing!  I wonder what it is about having surgery that reduces a patient’s runaway blood sugar so quickly.  Perhaps by the time most of us reach adulthood, we have a big wad of undigested cotton candy sitting in our small intestines, left over from childhood trips to the state fair.  Remove the intestines, remove the cotton candy.  Makes sense.

Or perhaps it has something to do with the post-surgery diet, which consists of two to three ounces of sugar-free liquids or sugar-free gelatin.  Newsflash:  if you stop dumping sugar and starch into your digestive system, your blood sugar goes down.

Today, evidence of the connection is so solid that some doctors say surgery should be considered as a treatment for diabetes, regardless of a person’s weight or desire to lose weight.

Yes, more surgery is clearly the answer.  Granted, a couple of generations ago we had only a fraction of the Type 2 diabetes rate we see today, and that was long before surgeons were comfortable ripping people’s guts out.  But what the skeptics forget is that safety standards were lax in those days, and lots of people used to accidentally rip their own guts out in day-to-day activities like chopping wood, tossing lawn darts, and going fishing with really big hooks.  It’s much safer and far less painful to let a surgeon remove your intestines.

“We thought diabetes was an incurable, progressive disease,” says Dr. Walter J. Pories, a professor of surgery at East Carolina University and a leading researcher on weight-loss surgery.

Well, of course you did, Doctor Doofenshmirtz.  That’s because people in your profession have been trying to cure diabetes with low-fat diets, then scratching their heads in amazement when the diets don’t work.  By the way, if you’re ever quizzed on the topic of alcoholism, the answer is: No, you can’t cure it by switching from bourbon to scotch.  I thought you should know.

“This operation takes about an hour, and two days in the hospital, and these people go off their diabetes medication. It’s unbelievable.”

No, I believe it.  They’re able to go off their medication because the surgery also forces them to go off sodas, corn chips, bread, Cocoa Puffs, mashed potatoes, pancakes, cookies, bagels, french fries, snickerdoodles, Little Debbie Snack Cakes, Twinkies, and Chunky Monkey ice cream.  In fact, about all they can eat are tiny portions of meat and vegetables.

But experts still aren’t sure why obesity surgery helps resolve Type 2 diabetes or how long the effect might last.

It’ll last as long as the newly-mangled patients avoid sodas, corn chips, bread, Cocoa Puffs, mashed potatoes, pancakes, cookies, bagels, french fries, snickerdoodles, Little Debbie Snack Cakes, Twinkies, and Chunky Monkey ice cream

This much is clear: Patients who have weight-loss surgery begin to lose weight rapidly, which by itself improves Type 2 diabetes, allowing diabetics to more easily control their blood glucose levels. But something else appears to be occurring as well.

The “something else” is what’s not occurring:  consuming sodas, corn chips, bread, Cocoa Puffs, mashed potatoes, pancakes, cookies, bagels, french fries, snickerdoodles, Little Debbie Snack Cakes, Twinkies, and Chunky Monkey ice cream

There is strong evidence that surgery — especially gastric bypass surgery, which makes the stomach smaller and allows food to bypass part of the small intestine — causes chemical changes in the intestine, says Dr. Jonathan Q. Purnell, director of the Bionutrition Unit at Oregon Health & Science University.

Yes, all kinds of wonderful changes occur in the digestive system when you rip out several feet of it.  Here are just a few:

  • Reduced ability to absorb fat-soluble vitamins, leading to chronic deficiencies in vitamins A, B12, D, E and K – even if you take a lot of supplements.
  • Dumping of poorly-digested food into the large intestine, causing dizziness, bloating, diarrhea and fatigue.
  • Ulcers.
  • Nausea and vomiting

But researchers now suspect it has other functions related to metabolism.

Of course it does, you @#$%ing idiots!  When you’re limited to a few ounces of protein and vegetables per day and have to give up sodas, corn chips, bread, Cocoa Puffs, mashed potatoes, pancakes, cookies, bagels, french fries, snickerdoodles, Little Debbie Snack Cakes, Twinkies, and Chunky Monkey ice cream, your metabolism changes.

Surgery somehow alters the secretion of hormones in the gut that play a role in appetite and help process sugar normally.

No, making a drastic change in your diet alters the secretion of hormones.  When you give up sugar and starch, you don’t need nearly as much insulin anymore.  Ask Dr. Jay Wortman.  He gave up sugar and starch after becoming a Type 2 diabetic, and he doesn’t need medication either.  (But of course, the Canadian government is convinced his new diet causes heart disease.)

But diabetes also tends to resolve or improve in 50% to 80% of people who have lap-band surgery, in which a band is placed around the top of the stomach to make it smaller, he says. And there is some evidence that the effect occurs in a newer type of weight-loss surgery called gastric sleeve, in which a portion of the stomach is removed so that it takes the shape of a tube or sleeve.

Uh, what a minute … I thought you were just telling us that removing several feet of the intestines creates magical hormonal changes.  The lap band and the lap sleeve just force you to eat less — which for most people means focusing on protein foods and giving up sugar and starch.  Do you see the contradiction here?

Evidence suggests the effect on diabetes can last for an extended period or even indefinitely, particularly if people don’t regain a lot of weight.

It’s not regaining the weight that causes diabetes to return.  The weight gain and the diabetes are both caused by people deciding they can fill their itty-bitty stomachs with itty-bitty servings of sodas, corn chips, bread, Cocoa Puffs, mashed potatoes, pancakes, cookies, bagels, french fries, snickerdoodles, Little Debbie Snack Cakes, Twinkies, and Chunky Monkey ice cream.  Then they get insulin spikes that make them ravenously hungry, so they eat more than they’re supposed to.  Some even manage to stretch their itty-bitty stomachs back to a nearly-normal size.

“There is durability, but we also know that some people do get the disease back again,” Purnell says… It’s not clear yet why people have different responses.

Well, let me take a shot at explaining this mystery, Dr. Frankenstein:  some people stick to the recommended post-surgery diet of meat and vegetables.  Some people go back to eating the sugar and starch that made them fat and diabetic in the first place.

Studies from several other countries show that surgery also results in remission of diabetes for people who are not morbidly obese.

So let me get this straight:  obesity causes diabetes, yet we can cure people who aren’t obese but still have diabetes by ripping their guts out and forcing them to stop filling up on sodas, corn chips, bread, Cocoa Puffs, mashed potatoes, pancakes, cookies, bagels, french fries, snickerdoodles, Little Debbie Snack Cakes, Twinkies, and Chunky Monkey ice cream.  Call me crazy, but it’s starting to sound like diet might have something to do with developing Type 2 diabetes.  (No, wait … it’s a progressive, incurable disease that nobody can really explain …)

There is even discussion, particularly in other countries, of performing weight-loss surgery for people with Type 2 diabetes who are not overweight.

Of course there is.  Other countries don’t have our obesity rate.  How the heck are the bariatric surgeons in France and Spain supposed to make a living if they’re only allowed to operate on fat people?

“Doctors say, ‘If I can lower glucose by medications, why send patients to surgery?'” Purnell says. “Surgery, however, allows people to have meaningful and sustained weight loss and their diabetes is better. There are risks involved with surgery, obviously, but it makes sense, to me, to do surgery.”

Spot-on, Dr. Frankenstein.  As you know from your advanced medical training, there are only two types of treatments that can make sick people well: drugs and surgery. 

Now if you’ll excuse me, I need to go bang my head against the wall.

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41 thoughts on “Bariatric Surgery For Diabetes? Oh, Cut It Out …

  1. Glen

    It amazes me that qualified educated doctors can’t see the glaringly obvious links between insulin and sugar/starch intake. What on earth are they smoking?

    Just keep repeating: it’s a progressive, incurable disease that we don’t understand …

  2. Arlo

    Every time I think we’re making inroads into the Conventional Wisdom, I read something like this that is so completely backwards. Start at the source.. the food! Sheesh!

    Stupid, stupid, stupid.

    I used more colorful words when I first saw this one.

  3. zbiggy

    “but it makes sense, to me, to do surgery” – note that he said “makes sense [b]to me[/b]” not for the patient!

    I believe you’ve hit the nail on the head.

  4. Dr.A

    I am doing a university course in nutrition (now THAT’ll make you bang your head on the wall!).
    Excerpt from course text:
    “There is no clear link between the intake of either sugar or starch and obesity. Carbohydrates are not normally converted to fat. Excess carbohydrates are normally used for energy. Overweight individuals are more likely to develop diabetes, but there is no link with carbohydrate consumption.”
    Then in the summary on the very next page:
    “There are numerous links between carbohydrates and impaired health, including tooth decay and diabetes.”

    My lord, that’s pathetic. What’s the name of that book? And who wrote it?

  5. Rambodoc

    You might remember me from my visits a while back. Let me tell you at the outset that I like your blog, and do follow the Primal lifestyle to a large extent, because of which I like fat and go a little tight on the carbs.
    That said, you are way off here, mate! There are several issues in science stories that newspapers don’t cover because the editor is worried the reader will go to sleep and miss the ads besides the article. Reading original research will serve up the beef in all its glory.
    There is truth in what you say re the benefits of a low carb diet in diabetes. However, this doesn’t work for all. There are patients whose blood glucose can’t be controlled in spite of high doses of insulin or other drugs. Surgery may be of benefit for them, especially if they are obese.
    Now, you say that is obvious, and this can be done with diet control, but no, you are wrong. Not always. The hormonal change the article talks of pertains to the ‘Incretin Effect’. Incretins are a group of some 200 hormones that are being researched, that have a significant effect on the B-cells of the pancreas (that secrete insulin) and make the body markedly responsive to that hormone. This effect is dramatic and precedes weight loss. The mere fact of being hospitalised and operated does NOT reduce the blood glucose. If it were so, no post-surgical patient would need insulin or have a wound infection from uncontrolled diabetes.
    The article also hints at metabolic surgery for the non-obese Type II diabetic. This is experimental at this point of time, and I cannot say we know too much. We can say merely that this seems to be an exciting area of research. For millions of diabetics, there is a real chance of cure or significant control. This may or may not fructify under the cold glare of evidence, but let us just say there is a lot of research and real-world human cases where amazing things are happening, apparently.
    Incidentally, Pories is a highly acclaimed name in the world of obesity surgery. 🙂
    Regarding the blood glucose lowering benefits in the lap sleeve gastrectomy or lap band operations, there are hormonal and metabolic issues at play. There is a hormone called ghrelin that interacts with insulin and other hormones that could be leading to this.
    In short, metabolic surgery deserves more respect than you give it. The world is not that cut-and-dried, unfortunately, as we might think. There are so many complicating factors in medicine and science that we cannot be too linear in our thought process. Or else we end up being like the people we have always rightfully condemned.

    If real evidence eventually suggests surgery can help a few people who can’t be helped through drugs and/or carb restriction, then it should be on the table as a last resort.

    How does a band or sleeve produce hormone changes? If we’re not removing a part of the intestines, I don’t understand what’s affecting ghrelin aside from the forced restriction of portions and carbohydrates. And if surgery produces hormonal changes independent of the drastic dietary change, I’m curious why we’d see the high diabetes recurrence rates cited in this article, linked in Dan’s comment:

    Either way, I’m appalled at how this surgery is being advertised and promoted as the miracle cure, preferable to drug therapy, and pushed on people who’ve never been told to try restricting carbs first.

  6. Olga

    Hi Tom:

    I read a few months ago that there is a high incidence of bone fracture in people who have undergone bariatric surgery. It turns out that some of that “weird stuff you don’t need” is required for calcuim absorption. Huh…who would of thought that an evolutionarily conserved body part might be essential???
    Here’s a link:

    Thanks for all the great info!

    I remember that. I wrote about the fracture problem as well.

  7. monasmee

    “Disease begins with the mouth.” Old Chinese proverb.

    Shhhh! If they hear that, they’ll start removing patients’ tongues.

  8. Diana

    Hey Tom!
    While I was checking out the link to the NY Times article, I clicked on this other story- check it out- you could have a field day with this one!,0,507157.story
    I am a type 2 diabetic, controlled with DIET and Metformin. ( I capitalize DIET because that is 90% of it). My last A1c test was 5.1%. Referring to the link I posted, do ya think the reason “diabetics” LDL cholesterol is small and dense is because of the crappy diet (read: hi-carb) the ADA is recommending? My head is dizzy from banging against the wall too!
    Keep up the good work Tom! You rule!

    Thanks for the link. And of course, they believe fat causes heart disease, so they respond to the higher risk of heart disease for diabetics by putting them on starchy, lowfat diets. Amazing.

  9. aurelia

    About three Christmases ago I learned that a sister-in-law was to have bariatric surgery in the spring. We’re not close and I didn’t say to her what I said to husband.

    “That’s just going to force her onto a low-carb diet. Why not just do that instead of surgery?”

    On the table that day, Snickers Salad. A recipe if you want to appreciate the full horror.

    Yee-ikes. That is horrible. In other comments, you’ll see opinions that bariatric surgery perhaps — emphasis on perhaps — produces hormonal changes that reduce diabetes symptoms in some people, independent of the drastic dietary change. We’ll see. But it’s outrageous that surgery is being pushed on people who’ve never been told to try restricting their carbs. And of course if more people were told to restrict their carbs, we’d have far fewer people developing diabetes in the first place.

  10. Dan

    Jenny at Diabetes Update also blogged about this subject. Bariatric sugery isn’t as rosey as it’s portrayed. I’m getting sick of the increased propaganda (err advertizing) for lap band surgery.

    I didn’t need to mutilate my body to control my blood sugar. The bottom line is, diet doesn’t make $$$ for the medical establishment. Surgery does.

    Nice analysis of the statistics. And I like this sentence: “All WLS does to ‘reverse diabetes’ is make significant carb restriction non-negotiable. Eat enough carbs to raise your blood sugar, early on after the surgery, and you’ll vomit it all back up. There isn’t room in your tiny stomach pouch for enough food to raise your blood sugar.”

  11. Elenor

    On the other hand, this article raises *hope* for those of us skating on the edge of Type 2 (with a Type 1 in the family), who cannot seem to get our blood sugars down even with low carb. (Possibly 40 years of living on pasta (with butter, locatelli cheese, and burger — or soy hotdogs! — mixed in {eye roll}) has done some long-term damage?)

    It’s way too early to tell if this type of surgery/’sleeving’ of the upper duodenum is a good last-ditch method (or even works well in humans). (And yes, of course, lots of people will choose it as a ‘first ditch’ method… that’s no reason to deny what it might be to people who need it, right, Mr sort-of Libertarian? {wink}

    Full-blown diabetes is a WAY scarier than surgery — they both can have big-bad complications, but the diabetes keep on complicating!

    Sort-of libertarian? Full-blown, please! No, I wouldn’t outlaw the procedure, anymore than I’d outlaw sugar and cigarettes. But I would definitely try to talk people out of it. It’s outrageous how this procedure is being hawked as the great cure. My friend who had the procedure and now regrets it was never told her diet might be causing her diabetes. She was just told that without a bypass operation, she probably wouldn’t live to see 50.

  12. nonegiven

    You don’t get diabetes without having a problem with your ß-cells, no matter how fat you get or how many Ho-Hos you eat.
    Carbohydrate restriction is the only thing that will slow the progression of diabetes significantly. Less stress on the ß-cells means they will die off more slowly.

    And for some, it means they can skip the medications completely.

  13. Ms. X

    Great post – but you might want to check this line: “Reduced inability to absorb fat-soluble vitamins,leading to chronic deficiencies in vitamins A, B12, D, E and K – even if you take a lot of supplements.

    Probably should say “Reduced ability…”

    Good catch, thanks.

  14. Matt Stone

    It’s true. Blood sugars can be controlled by any form of starvation, whether it’s protein and fat starvation, calorie starvation, etc. But that of course isn’t a solution.

  15. Brian Mallard

    Ah the media. Don’t you just love the little darlings. Shari Roan swallowed the bs whole and never thought to get an opposing view point. Maybe she should have contacted someone like Dr. Mike Eades or even fellow journalist, Gary Taubes for another perspective. When someone puts forth an article that is so slanted and poorly researched one has to assume the author is incompetent or has an agenda. I vote for incompetent.

    Exactly. At least go talk to someone besides surgeons … get a second opinion, so to speak.

  16. musajen

    Son of a . . . when I read stuff like this, the only logical conclusion I can come to is that these doctors are willfully ignorant. Clearly this is job for Captain Obvious . . . bashing my head on my desk.

    Diet just isn’t on the average doctor’s mental radar, as far as I can tell, other than to parrot the advice about the evils of fat. I had a friend who developed fatty liver disease. He asked his doctor what causes it. Doc said, well, too much alcohol can do it. My friend replied that he doesn’t drink, ever. (He’s a Mormon.) Doc had no other possible explanation. So I lectured my friend about high-fructose corn syrup, sugar and white flour. He’s since lost 40 pounds.

  17. BobH

    “Disease begins with the mouth.” Old Chinese proverb.

    Shhhh! If they hear that, they’ll start removing patients’ tongues.


    Sounds like the start of a new movie!

  18. Hiit Mama - Meredith

    I am so thankful for these blog communities. If it weren’t for engaged and interested “citizen doctors” then we’d all be up the creek. A doctor friend of mine said it perfectly when she told me that she didn’t learn anything about wellness or prevention in med school – just how to prescribe chemicals to “fix” symptoms.

    Yup, drugs and surgery. Sometimes they’re the answer, of course. I’ve taken antibiotics when I’ve needed them and I had surgery to repair a messed-up shoulder. I’m grateful for both. But it’s a shame more doctors aren’t taught how to prescribe dietary changes that can prevent many problems from arising in the first place.

  19. Rambodoc

    “Shhhh! If they hear that, they’ll start removing patients’ tongues.”
    Haven’t you heard of the tongue patch surgery:
    Tom, there IS a lot of unsavory hardsell for this big-ticket surgery (bariatric). This is both unfortunate and inescapable– the device companies want to meet their targets! At the same time that we realise this, we should not scorn the very real scientific reasons surgery for weight loss and diabetes and why surgeons and internists the world over are coming to rely on it.
    Also, don’t think doctors don’t try low carb– I for one certainly do. Many, if not most, patients, are culturally alarmed at not eating grains. And if they are vegans you can forget about it– they will never come back to you if you insist they eat bacon and beef!
    In short, medical practitioners have to deliver results to all comers– studies have clearly shown the success of supervised diet and exercise to be no more than 5%.

    Tongue patch? Further proof that just when I think I’ve exaggerated for comic effect, reality always catches up.

    Aren’t most of those supervised diets the standard-issue low-fat, low-calorie variety? I tried those (often on the advice of a doctor) and couldn’t stick to them either.

    I believe you’re a rare breed when it comes to understanding the true effects of fats and carbs in the diet. I had a doctor in California counsel me to go on a high-carb, low-fat diet because my cholesterol was (eek!) 203 … that’s with HDL of 64 and TG of 71. I’ve spoken with people who have type 2 diabetes or fatty liver, but were told to go on low-fat diets, not low-carb. I even watched a video, while sitting in a doctor’s office, on how to manage diabetes: be sure to fill one-fourth of your plate with a carbohydrate-dense food so you’ll have plenty of energy, etc.

    But yes, I know some people can’t imagine a life without bread and pasta. I’ve gotten the “My god, what do you eat?!” reaction a few times.

    It saddens me when I think of people like my friend who had bypass surgery and now regrets it. After she saw Fat Head, she finally understood about blood sugar. She’d never been told to try a low-carb diet for her diabetes. Maybe it wouldn’t have worked, but she wasn’t even told to try. It was just a case of “you’re obese and diabetic, you need this surgery.” Now she’s suffering the side-effects … vitamin defiencies, intestinal upsets, etc.

  20. Sylvie O

    I think the last sentence is really the most important out of the whole article:

    “But if we understood this mechanism and what are the molecules secreted by the intestines that cause diabetes, then we can cure it with a pill. I would not be surprised if, in the next five years, we have new medications.”

    There. Quick fix. Tons o’money. Eating well doesn’t put money in anyone’s pockets.

    You can’t patent a low-carb diet.

  21. Marielize

    Sooo depressing, I really find it hard to read articles like that to the end it hurts too much.

    Maybe we are busy looking at new type of evolution here. People who “get it” and do the trouble to understand then take the road less traveled, and the sheep who will only follow and resist independant thinking at all cost.
    The second group will just slowly but surely breed themselves out of the existence via the obesity/diabetic/heart disease route

  22. Marielize

    By the way what do you think of doc Carlson’s new show?

    Haven’t had a chance to catch it yet.

  23. Matt

    Wow, that LA Times article Diana posted. I love how it has three sections:
    1. Introduction
    2. Misinformation
    3. We’ve got a drug to fix the problem.

    In section 2, Misinformation, we get this gem:

    The fatty acids also cue the liver to make too much “bad” LDL cholesterol and too little “good” HDL cholesterol, said Dr. Daniel Rader, director of preventive cardiology at the University of Pennsylvania.

    and this:
    Also, LDL particles in most people are normally large and buoyant, but in diabetics, they are small, dense and harder to clear from the body.

    Right, so it’s the diabetes that causes the particles to become small, got it. Diet can’t change that, right?

    Yup, it’s a piece of work, all right. Even vegetarian researcher Chris Gardner said in that lecture I posted that carbohydrates produce small LDL.

  24. Holly

    What?! They can’t eat cereal? How are they going to keep their immune systems healthy so they stay away from H1N1?! 😀

    I’ve met a few people who have had the surgery. For some, I know that the feeling of being forced to vomit because they ate something they weren’t supposed to was negative reinforcement enough to stay on their LC diet. Some people push past the pain and continue to eat and drink things they aren’t supposed to (like you’ve pointed out). I personally know both types of people. I have another friend who had something similar to gastric bypass – but they just cut out most of her stomach instead of rerouting everything.

    I guess I feel lucky – I don’t need to feel like I’m going to throw up to stay LC… and I can still eat as much as I want, keep my blood sugar in check, (and not have weird mood swings) and still lose weight; all without surgery. That’s quite the bargain for me I think.

    Holy moly, that’s right … no Cocoa Krispies!

    Actually what would worry me the most is the chronic deficiency in vitamin D, now that we’re learning it’s crucial for immune functions.

  25. CindyD

    I was at a wake once after a funeral, and my overweight cousin was bragging that she was about to get lap band surgery. Someone asked her how much it was costing; she said it didn’t matter because Medicaid was paying for it. I would have torn into her about abusing taxpayers’ money and not taking responsibility for what she put into her mouth. A wake is not the venue for that, however.

    During this conversation, she was eating a really big piece of chocolate cake with lots of frosting. I chose the egg salad finger sandwiches. We are responsible for what goes in our mouths. If someone wants bariatric surgery, and it’s diet related, pay for it yourself.

    Choosing surgery over diet, plus taking advantage of “free” medical care. Two of my favorites. Glad I wasn’t there to witness that one.

  26. TonyNZ

    “my overweight cousin was bragging that she was about to get lap band surgery.”

    Are you sure she doesn’t have munchousens[sp?]?

  27. shel

    tonight i’ll be dreaming about sodas, corn chips, bread, Cocoa Puffs, mashed potatoes, pancakes, cookies, bagels, french fries, snickerdoodles, Little Debbie Snack Cakes, Twinkies, and Chunky Monkey ice cream.

    We may be having the same dream … but I usually wake up in a cold sweat from that one.

  28. Tinamemphis5

    OMG, how awful. I went to the Endo dr this week for a thyroid check. His primary patients are diabetics. They had a great big bowl of Halloween candy at the desk. This stuff is boggling my mind!

    Smart move on his part. It’s cheap job security.

  29. Jillian

    ” They keep us fragile to sell us relief” Dr Bruce Lipton, The Biology of Belief.
    Says it all for me. I keep this quote uppermost in my mind and use it to screen out what is glaringly WRONG….It works every time.Stunning stupidity is getting easier to recognise. 🙂

    I believe most doctors genuinely want to help, but man, some of them are working with some very bad information.

  30. Matt R.

    Before I met her, my wife underwent gastric bypass surgery when she was about 100 pounds overweight. She did great for a while, including when she was pregnant with our daughter. Now, though, she continues to skip too many meals and eat too many carbs and the weight is creeping back. But don’t tell her I said that.

    Mum’s the word.

  31. Alex

    I am doing a university course in nutrition (now THAT’ll make you bang your head on the wall!).
    Excerpt from course text:
    “There is no clear link between the intake of either sugar or starch and obesity. Carbohydrates are not normally converted to fat. Excess carbohydrates are normally used for energy. Overweight individuals are more likely to develop diabetes, but there is no link with carbohydrate consumption.”
    Then in the summary on the very next page:
    “There are numerous links between carbohydrates and impaired health, including tooth decay and diabetes.”

    That makes me want to cry into my glass of whole milk.

    Indeed. The sad part is that a lot of students probably read both pages and don’t see the contradiction.

  32. TonyNZ

    “Indeed. The sad part is that a lot of students probably read both pages and don’t see the contradiction.”

    Trouble is they don’t need to. I once had a lecturer that would put little bits of “incorrect and contradictory information” into lectures to see if people were awake and called him out on it. It was really rather effective.

    By and large though, when they are never taught to think like that, they don’t. And they can still get good grades ’cause the lecturers don’t think like that.

    Sounds like a good teacher. Many don’t like to be called on their contradictions.

  33. Ashley

    What’s really sad about all of this is that, even physicians who DO get extensive nutrition and biochemistry training are fed the same politically-correct BS. I’m attending naturopathic medical school, and nutrition is one of our core disease prevention and treatment tools. I can’t even begin to describe how frustrated I am sitting in class listening to the professors go on and on about “healthy whole grains” and “artery-clogging saturated fat.” One day I got into a friendly debate with a professor, challenging the notion that we need fiber in our diets. She was clueless. I finally realized I was wasting my breath, and possibly hurting my grades. I just tell myself to shut up, play their silly little game called “school”, and give them the politically-correct answers they want. Then, once I finish my ND and establish my own practice, I will treat my patients the RIGHT way. But, it is frustrating to know that my classmates – future holistic practitioners – are getting sucked into the lies.

    Sorry to hear even naturopathic schools teach the same old nonsense. I know at least one doesn’t, because a professor there assigned watching Fat Head as homework.

  34. Sheila G.

    re: Ashley’s comment, I am an acupuncturist and am horrified at how Asian Medicine schools have jumped on the bandwagon, promoting vegetarianism and red rice yeast extract. In China there are many researchers studying the efficacy of Chinese herbs and acupuncture in “treating” blood lipids. When folks bring up the China Study or the “healthy Asian diet of rice and veggies” I am quick to remind them that in most of China in the not too distant past (and still in rural areas) everyone raised pigs and ducks in the yard. Question: what are the two fattiest and most efficient livestock animals you can think of? Pigs and ducks! Do folks really believe that the frugal Chinese peasant threw away all the lard from these animals in favor of purchased rapeseed/canola and peanut oil? The absolute lack of critical thinking in contemporary people is quite a bummer.

  35. Carmen

    What a negative analysis of the article/talk on the possible positive effect of obesity surgery on diabetes.
    I do not eat any of the above mentioned treats and goodies. I follow fairly strictly a low glycemic diet. I exercise regularly.
    Except for the stress trying to get my sugars down causes in my life it is a life of productivity, joy, and am surrounded by family and friends who adore me.
    I have tried to get the sugars down using diet, metformin, a variety of other diabetic meds that have since been taken off the market, Byetta, Januvai, Novolyn, Levemir, and now Lantus and the effect has been to only shave off one or two points off my regular sugar count.

    I have however gained some fifteen pounds which now puts me in the sights of being “obese”. I hope you all see the irony in this!

    I have a disease of insulin resistance.

    I don’t know if that is what other Type 2’s have but I would suspect so.
    Therefore I think my condition should be called “Insulin resistance”.

    I am ready to try the lap band surgery. I’ve had it with everything else.

    Do yourself a favor: read up on the post-surgery diet. Then follow it. If your problems go away, you know it’s the diet, not something magical about the surgery itself.

  36. Tracee

    Wow, I wonder if this surgery would have worked for my child’s autism? Maybe ditching grains and junk food was the hard way out. I wonder how many other conditions could be helped by this surgery…beats giving up bread and cheerios, right?

    Of course. Cutting out your intestines makes life easy.

  37. Elmer fittery

    Dr. Rubino showed the following:

    1. take 100s of mice that are genetically engineered to be diabetic.
    2. surgically by-pass their dueodenum

    Now the mice no longer have diabetes.

    3. re-connect the duodenum

    Now the mice again have diabetes.

    The gastric by-pass includes by-passing the duodenum and as a result cures diabetes in about 80% of gastric-by-pass patients.

    Hopefully, this research results done by Dr. Rubino will lead to medications that will have the same effect. I suggest you watch the 60-minute episode about bariactric surgery. To find this video, just google “60 minute” and bariactric.

    By the way, statistically morbidly obese people getting the gastric-by-pass live 12 to 14 years longer than those not getting gastric-by-pass surgery.

    I’m not surprised by the morbidity figures; we’re comparing people forced onto very low-carbohydrate diets to people who continue eating junk. The true comparison would be to people who adopt the diet without having surgery.

  38. Caramoan

    Diabetes can be prevented by just having a physically active lifestyle. Just exercise everyday and avoid eating too much. Avoid sweets and high carb foods too.

  39. Melissa

    I had diabetes hypertension sleep apnea and atrial fib prior to having gastric sleeve surgery. I know longer have any of those medical problem. The gastric sleeve and other bariatric surgery can actually cure diabetes. I am so glad that I had this surgical procedure. It has truly saved my life and totally changed my life.

  40. Rhonda Gonzales

    You seem to not understand that some people this is do or die.sime people can eat all the good stuff and diabetes doesn’t affect them there are those like myself who have tried so many times. Over eating is emotional dude.this surgery gives us a tool to deal lose weight

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