Weight-loss surgery benefits add up

Bariatric surgery to treat obesity is gaining favour among doctors, but demand far outstrips supply, doctors say.

The surgery reduces the size of the stomach and limits the amount of food it will hold.

Since Jeff Payne, 48, had bariatric surgery seven months ago, his diet has changed and he's lost 200 pounds.

"I knew I had to go for it because I was on blood pressure medication, I was very close to having sugar diabetes, fluid in my legs and sleep apnea," Payne said. "Things were starting to add up."

Payne is now down to 275 pounds and moving around more, inspired to work harder at being physically active since he recognizes the surgery isn't a solution by itself. 

His surgeon in Halifax, Dr. James Ellsmere, has 2,000 people on his waiting list for the procedure.

"Our goal is to do 100 patients a year," Ellesmere said. "If you do the quick numbers, that would be a 20-year wait list."

There is a lot of evidence the surgery is effective and saves the health system a lot of other costs related to obesity, said Dr. Arya Sharma, scientific director of the Canadian Obesity Network.

But there is a lack of health-care resources for the procedure, partly because attitudes haven't kept pace with the science in obesity, Arya said.

"There is still that reluctance because obesity is still widely seen as a self-inflicted condition."

A study in this week's issue of the journal Science Translational Medicine suggests weight-loss surgery changes metabolism in a different way than dieting alone. The findings may explain why Type 2 diabetes often eases after the surgery, long before many pounds are shed.

Investigators at Columbia University in New York and Duke University in North Carolina looked at 10 severely obese diabetic patients who had a type of bariatric surgery known as gastric bypass and 11 who went on strict diets alone.

Levels of circulating amino acids — compounds linked with obesity, insulin resistance and diabetes — were significantly lowered in the surgical patients but not those in the diet group.

It is clear that bariatric surgery resulted in metabolic changes but no one knows how or why.