Long term weight loss and diabetes remission results

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The reason some doctors say Weight Loss surgery (WLS) is the only weight loss solution which works is because many patients do not gain all the weight back.  However, studies have suggested that the persistence of excess weight kept off after weight loss surgery is only slightly more than for dieters. 
  • The Hebrew University study found that only 7 percent of gastric bypass patients kept all the weight off and 25 percent of patients regained all. (Dept. of Surgery C, Soroka Medical Center, Beer Sheba (Israel study) Harefuah 1993 Feb 15;124(4):185-7, 248 (article is in Hebrew))
  • Another study found that in gastric bypass patients whose start BMI is higher than 49, 34% regain all or most of the weight within 10 years of surgery (Annals of Surgery. 244(5):734-740, November 2006. Christou, Nicolas V. MD, PhD; Look, Didier MD; MacLean, Lloyd D. MD, PhD )

Another reason some medical providers recommend weight loss surgery is to control diabetes but studies again suggest that on the long term, surgery does NOT control diabetes for most patients.

 
Here are some of the results of the only large long term clinical study of weight loss surgery that we know about. It's called the Swedish Obesity Study.  In the New England Journal of Medicine, some of the results were published.  This is a study of over 2500 WLS patients (mostly gastric bypass and gastric band patients) but at the 10 year point, only 641 patients were available to be contacted.
 
The weight loss results were:
 
at the 2 year point post op: the average loss was 23 percent of the patient's weight.
 
at the 10 year point post op, the average loss had dropped to 16 percent of the patient's weight.
 
Here is a projection of expected weights for the average weight loss surgery patient according to the Swedish Obesity study:
 
SOS weight results
start wt    2 years      10 years   
 300         231           252
 350         270          294
 400         308           336
 450         346.5         378
 500         385           420
 
As reference to diabetes:
 
At the two year point, 72 percent of the diabetics appeared to be in remission but at the 10 year point, only 36 percent of the diabetics were still "disease-free".
 
Although we certainly rejoice with those new ops who show amazing weight losses, the results of the only ongoing clinical long term study of WLS patients are a bit more sobering than the ads or seminars.  Remember those who hang out in ANY diet group, INCLUDING WLS support groups, are the small percentage who can keep all or most of their weight off - the average people who usually have more significant regains, are often made to feel ashamed and if they are members of an online group, they often stay silent.  At seminars, patients with significant regains are often not welcome to speak out. 
 
SOURCE: New England Journal of Medicine: Volume 351:2683-2693  December 23, 2004  Number 26
Lifestyle, Diabetes, and Cardiovascular Risk Factors 10 Years after Bariatric Surgery
Lars Sjostrom, M.D., Ph.D et al