The Center for Medical Weight debates if Bariatric Surgery is really the best treatment option for Uncontrolled Type 2 Diabetes

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Dr. Michael Kaplan provides another perspective on the April 2012 New England Journal of Medicine Studies claiming surgery is best for those with Uncontrolled Type 2 Diabetes.

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The majority of people in this situation do not need bariatric surgery,” says Dr. Michael Kaplan. “It should not be considered the first line of treatment.

Two April 2012 studies published in the New England Journal of Medicine that say Type 2 diabetics who were also obese and had out of control blood sugar fared better after bariatric surgery than those on the typical regimen of drugs, diet and exercise is making waves. But is bariatric surgery really the best treatment option for uncontrolled Type 2 (or adult onset) diabetes?

Not necessarily, says Dr. Michael Kaplan, Chief Medical Officer and founder of The Center for Medical Weight Loss, (CMWL), the largest network of non-surgical medical weight loss providers in the US. .

“The majority of people in this situation do not need bariatric surgery,” says Kaplan. “It should not be considered the first line of treatment.”

In fact, Kaplan says a comprehensive medically managed weight loss program overseen by a physician trained in the complex issues involved in weight loss like CMWL would likely work just as well. CMWL programs work just as quickly to get uncontrolled Type 2 diabetes under control and eliminate the need for medications for as many as 80 percent of people with Type 2 diabetes, obesity, and uncontrolled blood sugar.

Add in the very real risks of bariatric surgery for someone who is 100 pounds or more overweight and also has uncontrolled Type 2 diabetes on top of the lifelong impact of this surgery, and the risk to benefits ratio of opting for surgery before trying a medically managed approach to weight loss overseen by a trained physician first becomes even less appealing, Kaplan says.

“The risks of this surgery should not be overlooked or minimized,” Kaplan says. “The very real risks including death, pulmonary embolism, wound infections, nutritional deficiencies, the possible need for additional follow up surgeries, and more need to be considered.”

In addition, Kaplan points out that as many as 1 in 4 patients involved in the study who underwent surgery did not have their Type 2 diabetes go into remission.

Kaplan recommends those with Type 2 diabetes who are obese and also have uncontrolled blood sugar levels enroll in a proven physician managed weight loss program such as the one offered at CMWL first. If they then find themselves in the 20 percent group whose Type 2 diabetes remains out of control after 12 weeks, considering undergoing bariatric surgery would be a logical next step.

Preliminary results of an ongoing randomized study of patients enrolled in a CMWL program, participants have reduced their excess body weight by as much as 11 percent in 12 weeks, Kaplan adds. Considering that even a 5 percent reduction in excess weight has been shown to dramatically improve control of Type 2 diabetes, the odds are high that following such a program could be as effective for obese patients with Type 2 diabetes and uncontrolled blood sugar levels as bariatric surgery, without any of the associated risks or life-long side effects.

“It's a much smarter option,” Kaplan says.

CMWL offers individuals who have previously had trouble losing weight in a proven, evidence-based alternative, providing a physician-supervised program and focusing on a comprehensive, holistic approach that includes diet, exercise and behavioral modification.

About Center for Medical Weight Loss
The Center for Medical Weight Loss (CMWL) programs provide an approach to long-term weight loss and maintenance under the care and support of trained physicians. Each fully individualized program is customized to the patient, taking into account his or her medical history, body composition, and personal goals. This individual care is supported with on-going one-on-one counseling by the physician on important topics including nutrition, fitness, behavioral modification, motivation, and, where necessary, prescribed medications. Physicians in The Center for Medical Weight Loss network are all certified professionals specially trained in non-surgical bariatric medicine who have access to the latest techniques and medical data, including high-quality nutritional products and FDA-approved weight loss medications only available to medical doctors. The CMWL programs are clinically proven and evidence-based. For more information, visit

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Marian Coletti

Victoria Grantham
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