Weight-Loss Surgery May Help Moderately Obese, Too

It reduces symptoms of type 2 diabetes, studies found, but surgical risks exist

By Serena Gordon

HealthDay Reporter

TUESDAY, June 4 (HealthDay News) -- For the extremely obese, the benefits of weight-loss surgery generally outweigh the risks of the procedure. Now, new research suggests that the same might be true for less-obese people as well.

For those who are mildly or moderately obese, weight-loss surgery can improve type 2 diabetes, high blood pressure and high cholesterol more effectively than conventional diabetes management and lifestyle changes, new research suggests.

"We're seeing a pattern in these studies. There's a definite impact on the diabetes after surgery. Some people don't respond so well, but most do," said Dr. Bruce Wolfe, a professor of surgery and co-director of bariatric surgery at Oregon Health & Science University, in Portland.

But, he added, "We need longer-term studies to identify who's the right candidate for surgery, and we need a number of years of follow-up and a fairly large study population to see if the diabetes improvements after surgery prevent the heart disease, blindness and kidney disease associated with type 2 diabetes."

Results of the two new studies, as well as an accompanying editorial written by Wolfe and colleagues, are in the June 5 issue of the Journal of the American Medical Association.

Body mass index (BMI) is a measurement calculated with height and weight that's used to estimate the amount of body fat someone has. A BMI of 18 to 24.9 is considered normal weight while 25 to 29.9 is overweight, according to the U.S. Centers for Disease Control and Prevention. Mild to moderate obesity is between 30 and 39.9, and 40 and above is morbidly (or extremely) obese.

Normally, weight-loss surgeries are done on people who have a BMI of 40 or above. The surgery is also done on people who have a BMI of 35 or more if they have heart disease risk factors, such as type 2 diabetes, high blood pressure, high cholesterol or sleep apnea, according to Wolfe.

The first study was a review of previous research on non-morbidly obese people with type 2 diabetes. The authors searched the medical literature and among other related studies, found three randomized controlled clinical trials that compared weight-loss surgery (also known as bariatric surgery) to nonsurgical treatments, such as diabetes medications and lifestyle changes.

Weight-loss surgeries -- including gastric bypass and gastric banding -- were associated with a greater weight loss than nonsurgical treatments. Weight-loss surgeries led to as much as 32 to 53 pounds more weight loss and also to greater improvements in blood sugar levels.

"I think we found some promising results for the lower BMI patients with diabetes. There were better results in terms of controlling glucose [blood sugar] and weight loss over one to two years. That we have a way to provide some sort of successful treatment is exciting. But, we don't yet know how sustainable these changes are. We need longer and larger studies," said Dr. Melinda Maggard-Gibbons, lead review author, and an associate professor with RAND Health in Santa Monica, Calif.

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