bariatric surgery and diabetes

For patients who are obese and struggling to lose weight, one potential treatment option is bariatric surgery.

About 198,000 Americans had bariatric surgery in 2020, according to the American Society for Bariatric and Metabolic Surgery.

Still, many people who could benefit from bariatric surgery do not undergo the procedure. People who could benefit include those who suffer from obesity-related conditions like type 2 diabetes.

A 2020 study in the Journal of the American Medical Association (JAMA) analyzed the benefits and risks of bariatric surgery. Anita Courcoulas, MD, chief of the Division of Minimally Invasive Bariatric and General Surgery at the University of Pittsburgh School of Medicine, co-authored the study.

Here is what you need to know about bariatric surgery benefits and risks.

Benefits of Bariatric Surgery

The two major types of bariatric surgery are gastric bypass and gastric sleeve procedures. Both procedures have shown benefits for people with obesity compared to other nonsurgical treatments.

Bariatric surgery and long-term weight loss

The JAMA study, co-authored by Dr. Courcoulas, reported that bariatric procedures resulted in greater long-term weight loss than nonsurgical obesity treatments.

The total amount of weight loss varies by patient and by the procedure. But most patients who undergo bariatric surgery can expect to see significant weight loss in the long term.

Most patients can expect to regain some weight over time. However, most will maintain at least some level of weight loss compared to their preoperative weight.

Bariatric surgery and other health conditions

Obesity is often associated with other health conditions. The JAMA study showed bariatric surgery could help lessen the risk and burdens of several obesity-related conditions, including:

  • Type 2 diabetes.
  • Dyslipidemia (imbalance of lipids like cholesterol, low-density lipoprotein cholesterol, triglycerides, and high-density lipoprotein).
  • High blood pressure.
  • Sleep apnea.
  • Osteoarthritis.
  • Urinary incontinence.
  • Cancer.

Future studies evaluating these benefits 10 years and beyond surgery will show the life-long effects of bariatric surgery on lessening these obesity-related conditions.

Risks of Bariatric Surgery

Bariatric surgery has become much safer since the early 2000s and has a low risk of reoperation.

According to the JAMA study, some other studies have suggested that gastric bypass has a slightly higher risk of reoperation compared to the gastric sleeve procedure. However, both gastric bypass and gastric sleeve procedures could have short-term (up to 30 days after the procedure) and long-term (30 days or more after the procedure) complications.

Gastric bypass complications

Short-term complications of gastric bypass surgery include:

  • Bowel obstruction.
  • Venous thromboembolism.
  • Wound infection.
  • Gastrointestinal or intra-abdominal bleeding.
  • Anastomotic leak.
  • Internal hernia.

Long-term complications included:

  • Anastomotic stricture.
  • Bowel obstruction.
  • Marginal ulceration.
  • Cholelithiasis.
  • Incisional hernia.
  • Nutritional and vitamin deficiencies.
  • Dumping syndrome.
  • Malabsorption.
  • Gastrogastric fistula.
  • Internal hernia.

Gastric sleeve complications

Short-term complications of gastric sleeve procedures include:

  • Venous thromboembolism.
  • Gastrointestinal or intra-abdominal bleeding.
  • Staple line leak.
  • Wound infection.

Long-term complications include:

  • Sleeve stricture.
  • Gastroesophageal reflux disease.
  • Cholelithiasis.
  • Incisional hernia.
  • Nutritional and vitamin deficiencies.

Should I Get Bariatric Surgery?

Although there are some potential risks and complications of bariatric surgery, the risks for many people struggling with obesity may be greater without surgery. The potential benefits outweigh the risks.

The JAMA study concludes that modern bariatric procedures have strong safety and effectiveness records. Patients who have severe obesity — especially those who also have type 2 diabetes — should talk about the risks and benefits of bariatric surgery with their doctor to decide if surgery is right for them.

UPMC Bariatric Services

At UPMC Bariatric Services, we offer support for people on their weight-loss journey through both surgery and lifestyle changes.

We have locations throughout Pennsylvania and New York. To schedule an appointment at a location near you, visit our website for more information.

Editor's Note: This gallery was originally published on , and was last reviewed on .