I saw a patient in my office recently who has a very important concern: Nearly everyone in his family has diabetes. He himself is quite overweight and has not developed diabetes but is only in his 30s. He wants to have weight loss surgery to lose weight and feel better, but also to prevent diabetes.
Should he undergo weight loss surgery? Which procedure would be the best?
I think there is little question that the roux-en-Y gastric bypass operation has proven to be the most effective procedure at eliminating diabetes once it has been diagnosed. There is also very little question that weight reduction helps prevent the onset of type 2 diabetes. But in this particular man there is probably no clear-cut, single correct answer. Certainly if my patient succeeds and really puts his mind to it, he will have a high chance of preventing the development of diabetes with either procedure. I suspect the success rate may be even higher with gastric bypass surgery, the more invasive procedure. But whether a higher rate of prevention success warrants a more invasive procedure will not be decided in the same manner by each person.
In the future, better studies will help us quantify the risk of diabetes for individuals and provide more detailed answers about the best preventive strategies. But it is noteworthy that more and more people are thinking about prevention and taking a proactive stance against diabetes and other complications of obesity.