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A couple of new reports in JAMA Surgery shed some light on the impact of bariatric surgery on remission of Type 2 diabetes. One report focused on data from about 570 people who had undergone some type of bariatric surgery between 2005 and 2012, who also had Type 2 diabetes (T2DM). All had started with a BMI of 35 or more (morbid obesity — standard eligibility for such surgery). These folks were matched with diabetic patients who had not had surgery (1880 people), but were otherwise similar in terms of age when the operated people had surgery, sex and BMI. The main focus of the study was the extent to which T2DM remission occurred, and whether the level of hemoglobin A1c, or HbA1c, (a measure of long-term blood glucose control) decreased to less than 6.0 percent (any HbA1c over 6.5 percent is considered diabetes). The investigators, led by Dr. Jan Peter Yska from the Medical Centre Leeuwarden, Leeuwarden, the Netherlands reported that 95 (out of the 570) persons with T2DM who underwent surgery were in remission compared to only five patients in the non-surgical group (1880 total). The results also depended on the type of bariatric surgery involved. Gastric bypass surgery was the most effective, followed by sleeve gastrectomy and then by gastric banding (for more information on the types of bariatric surgery, read here). Thus, the researchers found, the positive effects of bariatric surgery could be seen for at least two years post operation. Although the standard cut point for bariatric surgery is usually a BMI of at least 35, some have queried whether or not such surgery would also benefit diabetes patients with lower BMIs. This question was investigated by Dr. Chih-Cheng Hsu from the China Medical University in Taiwan and colleagues. They examined records of 52 diabetic patients who received bariatric surgery — either sleeve gastrectomies or gastric bypass — and compared them to records of 299 T2DM patients whose conditions were managed medically. All patients had BMIs lower than 35. By five years post-surgery, the operated group had lost 21 percent of their initial body weight, bringing their BMIs down from about 31 to 24.5. In addition, their average HBA1c levels dropped from 9.1 percent to 6.3 percent over the same period. Thirty-six percent of this group had complete remission of their T2DM. In contrast, only one person in the medically-managed group, had a complete remission of their disease, and their HBA1c was, on average, 8 percent — still in the diabetic range. All differences between surgical and control groups were statistically significant. http://acsh.org/2015/12/bariatric-surgery-linked-to-diabetes-remission/ I suspect on the first study, the reason why the remission rate is so low is because they are lumping lap band patients in with RNY and sleeve patients.

Reading your queries sounded very familiar. You sound exactly like me! The more time I spend absorbing everything in the site and all information I can learn about the procedure, the more I'm sure it's right for me. I think Jachut summed it up well when she wrote that we'd all step right up to take care of any other body part. I wonder when our stomachs began producing shame and guilt. I'm sure that you will come to see yourself for who you truly are and realize you're completely worth it. You really are somethine else!!

ok .. just a query ... which type of band do u people have ... i just want to see if i have the same band because i havent had a fill but i still feel a lot of restriction ..so maybe just maybe i too have some fluid in my band

Hi Kylie! I must say that everyone's insurance policy is different, although the insurer may sound the same, insurance policies vary from state-to-state. The ensurer or surgeon may require a supervised visit, for example, as a prerequisite for WLS. Perhaps the employer excludes bariatric surgery, maybe not. I'm not trying to discourage you though - I hope you have a green light all the way. Having said that, my first consultation took place in LI, NY on 10/20/11. During that time, I had GHI PPO for med ins and they require one to attend a six month supervised visit. I made it priority to schedule all of my clearances appointments very close together (all within a two week gap) to speed things up. However, after three months of weight-ins, on Dec 31st I received new insurance cards from my husband's employer with Empire Bluecross Blueshield and I found myself switching plans with the Human Resources dept since my surgeon of choice is out-network for me. During this time, I receive a call from the surgeon's office that he will accept EBCBS fees, and I was so pleased. On 1/19/11, I got my surgery date for February 1st which was then rescheduled for the 31st - two days away. I am currently weighing 239 lbs, having lost two pounds. . Tips? I'd say, be very patient. Stay on top of the insurance company, don't be intimidated to call them to find out any questions that may surface. I have learned that ALL of my queries were answered whenever I called them to ask about specific questions. Find out from your medical Ins Co. all that is needed from you in order to get your process moving faster. Also, if you like, inquire if your employer excludes bariatric surgery or not. Finally, remain hopeful.

Ok b*tches (and nice ladies), the 'doctor' is in!!! I'll address each of your queries in order... Unless there's an emergency or I get distracted or think your question is stupid ... Anyway, prepare to be learned some stuff!!!

There really isn't anything "off-topic" on this board :biggrin2:For me, no-bake cookies have cocoa, oats, milk, vanilla, splenda and some kind of binder (butter or crisco-ish.) I mix it all up in a bowl, do spoonful drops on waxed paper, and then let them "dry" either on the counter or in the fridge until they firm up a bit. There are some good recipes at cooks.com. Just query no-bake cookie.

This is by far the most common query that newbie bandsters have. I had it and didn't know the answer at the time. I've spent a lot of time thinking about it and asked my doctor about it, and I think this is a sound explanation for what is going on inside of you. Don't let it get to you - it IS temporary! Most of all, don't let it cause you to give up!! ****************************************** It is highly likely that you will hit a plateau or regain a few pounds in in the weeks after the op. My theory on this is: * In the pre-op weeks, we saw big numbers as weight loss because we had switched from a solid to a liquid diet and most of the loss was not fat but simply emptying the digestive system. At any point in time on a normal eating regime, an average person will have 10-15lb of food in various stages of digestion in their alimentary canal. Us fatties probably had 20+! Real fat loss at that stage is probably only 2-5lb, the rest is fluids and undigested food. However, we believe the big numbers and get disappointed when they don't continue. * During the operation, they put you on an IV saline drip, which boosts your Fluid levels and Water weighs MUCH more than fat. This can take several days to a couple of weeks to get out of your system (see next point). * The internal swelling from the operation all contributes to fluid retention, which is boosted by the IV drip. Until the swelling goes down, you're going to hold onto that fluid. * As the swelling goes down, you start to move from liquids to mushies to solids. You will probably notice that you don't poop for quite some time post-op, which is a combination of the constipation-causing painkillers, the fact that you are eating MUCH less in volume, and that you are now re-filling your digestive system from it's previously completely empty state. This means that as you lose fluid weight, you are regaining solid food weight, and all the actual fat loss is disguised by those two. Some people will retain more fluid, especially if they're eating salty canned Soups (I know I did!), so they will see a gain. Others will lose more fluid than they are gaining in food weight, so they will see a slight loss. For others it will be equal or will go up and down day by day. In the meantime, in the background, I believe that if we stick to the diet plans, we are still losing real fat at the steady rate of 2-3lb a week - we just can't see it and judge it accurately because there are too many other influences. Once you get back to solid foods, a "normally full" digestive tract and get rid of the extra fluids, your scales will be much more accurate and should be showing a steady loss of 1-2lb per week.

Long post alert.... I'm in Birmingham, had my operation in London, St Mary's, Paddington in Feb 2013. Started off at 20st got down to about 11st 8lb but looked too thin and always felt like I had a cold coming, weak and tired all the time. Am now just under 13st got my curves back, and don't feel shattered all the time, I'm in a happy place now. After the op I didn't feel that anything had been done as I had no pain, didn't need painkillers and everyone else that had the op in the ward was doubled up in pain and couldn't leave their beds. At St Mary's they had some funding as the offset was paying dividends due to me for example being on 5 types of blood pressure medication to now only being on 2.5mg water retention tablet every other day as still get slightly swollen ankles. In addition I have 30mg Lansoprazol antacid tablet every day also a centrum multi vitamin am lucky as my GP gives me them on prescription. What are you taking? The whole process for me was very quick was referred by my GP November 2012 got letter for a group presentation New Year Eve as all types of surgery are presented. Then I got an appointment for mid January 2013 where everything was done... X-rays, blood tests, talking to doctor and anethantist. That day was given my surgery date of 8th February. Had to do a pre-surgey diet I opted for low carbs. Loads of people did slim fast, I didn't want to feel deprived. I lost 15lbs in the 2 weeks. Food side was difficult to get my head around initially as someone​ loves food I totally skipped the purée stage and made lentil soups and blended down and had whenever I felt hungry and to keep my protein levels up. Can recommend a book called weight loss surgery for dummies Google it as there is a PDF copy online. I'm at the stage can eat most things but have to stop myself from overindulgence. Often said that your stomach is size of an egg. I queried this and was told for me was bigger as I didn't have as much to lose as some patients. Was glad was told this as I constantly kept seeing and egg and I are more than the size of an egg so thought I had an eating disorder! Over time my pouch has relaxed and stretched a bit, was told it would after your body repairs after the surgery. Meaning that now it has to act as a tool. I can have one food this week and next week can't stand smell. If I get a metallic taste in my mouth I have to get to a toilet... quickly! That's my trigger for throwing up. Has your hair thinned a bit, mine has but took a couple years to recover, I was told to have more protein. Often ask if I regret having done, for me I regret not having it sooner! Did look at having it done private at Dolan Park in Worcester had an appointment saw doctor etc but changed my mind after reading reviews online and getting a hard sales pitch from the assistant, I felt uncomfortable. So went back to see my GP and that time the funding had been approved. One tip though, hold off buying clothes...I found that I'd skip a size and got expensive. I would buy stuff from charity shops, jumble sales, hand me downs from friends etc. I went from size 22/24 have been down to size 10 M&S skirts but now a happy size 14 tend to wear slightly bigger top as don't like a snug fit. Hope info has been of help to you? It's a great journey and I'm learning every day.... Sent from my CUBOT MAX using BariatricPal mobile app

In Indiana, there is a center of excellence for weight loss surgery located in Indianapolis. That hospital not only has a complete staff of surgeons, nutritionists and other specialist. They also sponsor Bariatric Surgery Support Group meetings throughout the state. So you might touch base with the hospital where your surgery will be performed and query if they also sponsor or know of local area support groups meetings. Generally these meetings occur once per month and are free.

The reason the band is much tighter in the mornings is because of Fluid settling down around the band when we sleep, once we are awake and as the day progresses that fluid drains away hence the looser band at night time. I queried this with my doctor today when I went in for a fill and it makes sense. Kinda like if you wake up with swollen fingers or ankles in the mornings and the fluid drains throughout the day.

I think every woman on this website sighed a big *awww, he's adorable* on reading that. Careful there, fella. You'll end up getting yourself a cult following. Either that, or a load of stalkers Only kidding. All the advice you require is up there ^^^^^ if you have any further questions or queries, there's not a person on the planet who won't run to your aid. Well done, you. Your wife is a lucky lady

I am proud of my decision. This is not about pride. It's about privacy. I am a very private person and I'm tired of people offering unsolicited opinions about my weight and body. I find it exceedingly rude, and I suspect the changes that will come following WLS will result in additional queries.

@@Margie122 I think you've answered your query with the final two words of your post... No, I'm not judging or anything like that. My point is, you know yourself and your situation better than anyone else. If YOU are saying that you have no excuse then, well, you've no excuse... And by the way... Walking SUX!!! But it's gotta be done... Good luck with it all... Kinda...

Hey fellow Canucks! :canada: :canada: I thought I'd turn to ya for a question I have. This is mainly directed at those who are already banded and have been eating "regular food" for awhile now. So, here is the thing....I've noticed that every time (for the last couple of weeks) when I eat dinner (this doesn't happen at breaky or lunch; just dinner)....I get a headache when I'm about half way done. Just out of the blue...WHAM...headache. Nothing severe; just irritating. Doesn't matter what I have for dinner....it seems to happen. It goes away after a bit and it doesn't get bad enough to take something for it or anything. I just find it odd and am wondering if this has happened to anyone else. Comments? By the way...y'all are doing awesome!!! :clap2: :clap2:

To be blunt and to not waste anyones time.. Asking a surgeon for a detailed response about the effects of bariatric surgery on an individuals metabolic rate (particularly as we're all different) is like asking a baker to fix a rare sports car. In short, you need an endocrinologist. As for the impeded weight loss. You sadly had a bit of a rough trot of it immediately after your surgery - so this would definitely have short-circuited the system - giving much credence to the points made by our learned friends on this site, that you may have to wait it out and see how your body normalises. As far as references for current academic research go, please see below. As you'll know, academic research is normally very narrow in its focus, so you'll have to go through quite a few of them in order to assimilate a potential 'ground truth' for yourself. However, there are some articles which offer the generic information you seek which might at least allay your current fears. Naturally, this comes with the caveat that without full knowledge of the endless subtleties and nuances the endocrine system plays on our bodies, it might appear attractive to propose one hypothesis for your current predicament, for it to then be incorrect because of a previously unidentified and unevaluated interaction. Consequently, if you want your rare sports car fixed? Go see a specialist mechanic Hope this helps. Any questions or queries, please do not hesitate to ask. Best of luck, Daydra x Bariatric surgery in obesity: Changes of glucose and lipid metabolism correlate with changes of fat mass Original Research Article Nutrition, Metabolism and Cardiovascular Diseases, Volume 19, Issue 3, March 2009, Pages 198-204 F. Frige', M. Laneri, A. Veronelli, F. Folli, M. Paganelli, P. Vedani, M. Marchi, D. Noe', P. Ventura, E. Opocher, A.E. Pontiroli Show preview | PDF (216 K) | Recommended articles | Related reference work articles 2 Effect of bariatric surgery on liver glucose metabolism in morbidly obese diabetic and non-diabetic patients Original Research Article Journal of Hepatology, In Press, Accepted Manuscript, Available online 20 September 2013 Heidi Immonen, Jarna C. Hannukainen, Patricia Iozzo, Minna Soinio, Paulina Salminen, Virva Lepomäki, Ronald Borra, Riitta Parkkola, Andrea Mari, Terho Lehtimäki, Tam Pham, Jukka Laine, Vesa Kärjä, Jussi Pihlajamäki, Lassi Nelimarkka, Pirjo Nuutila Show preview | PDF (808 K) | Recommended articles | Related reference work articles 3 Dramatic Reversal of Derangements in Muscle Metabolism and Left Ventricular Function After Bariatric Surgery Original Research Article The American Journal of Medicine, Volume 121, Issue 11, November 2008, Pages 966-973 Joshua G. Leichman, Erik B. Wilson, Terry Scarborough, David Aguilar, Charles C. Miller III, Sherman Yu, Mohamed F. Algahim, Manuel Reyes, Frank G. Moody, Heinrich Taegtmeyer Show preview | Purchase PDF | Recommended articles | Related reference work articles For purchase 4 Bariatric surgery and its impact on sleep architecture, sleep-disordered breathing, and metabolism Review Article Best Practice & Research Clinical Endocrinology & Metabolism, Volume 24, Issue 5, October 2010, Pages 745-761 Silvana Pannain, Babak Mokhlesi Show preview | PDF (355 K) | Recommended articles | Related reference work articles 5 Progressive Regression of Left Ventricular Hypertrophy Two Years after Bariatric Surgery Original Research Article The American Journal of Medicine, Volume 123, Issue 6, June 2010, Pages 549-555 Mohamed F. Algahim, Thomas R. Lux, Joshua G. Leichman, Anthony F. Boyer, Charles C. Miller III, Susan T. Laing, Erik B. Wilson, Terry Scarborough, Sherman Yu, Brad Snyder, Carol Wolin-Riklin, Ursula G. Kyle, Heinrich Taegtmeyer Show preview | Purchase PDF | Recommended articles | Related reference work articles For purchase 6 ESR1 gene and insulin resistance remission are associated with serum uric acid decline for severely obese patients undergoing bariatric surgery Original Research Article Surgery for Obesity and Related Diseases, In Press, Corrected Proof, Available online 14 November 2012 Weu Wang, Tsan-Hon Liou, Wei-Jei Lee, Chung-Tan Hsu, Ming-Fen Lee, Hsin-Hung Chen Show preview | Purchase PDF | Recommended articles | Related reference work articles For purchase 7 American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery Medical Guidelines for Clinical Practice for the Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery Patient Review Article Surgery for Obesity and Related Diseases, Volume 4, Issue 5, Supplement, September–October 2008, Pages S109-S184 Jeffrey I. Mechanick, Robert F. Kushner, Harvey J. Sugerman, J. Michael Gonzalez-Campoy, Maria L. Collazo-Clavell, Safak Guven, Adam F. Spitz, Caroline M. Apovian, Edward H. Livingston, Robert Brolin, David B. Sarwer, Wendy A. Anderson, John Dixon Show preview | PDF (1294 K) | Recommended articles | Related reference work articles 8 Clinical Practice Guidelines for the Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery Patient—2013 Update: Cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery Review Article Surgery for Obesity and Related Diseases, Volume 9, Issue 2, March–April 2013, Pages 159-191 Jeffrey I. Mechanick, Adrienne Youdim, Daniel B. Jones, W. Timothy Garvey, Daniel L. Hurley, M. Molly McMahon, Leslie J. Heinberg, Robert Kushner, Ted D. Adams, Scott Shikora, John B. Dixon, Stacy Brethauer Show preview | Purchase PDF | Recommended articles | Related reference work articles For purchase 9 Bariatric surgery and the gut-brain communication—The state of the art three years later Review Article Nutrition, Volume 26, Issue 10, October 2010, Pages 925-931 Maria de Fátima Haueisen S. Diniz, Valéria M. Azeredo Passos, Marco Túlio C. Diniz Show preview | PDF (156 K) | Recommended articles | Related reference work articles 10 Postoperative Metabolic and Nutritional Complications of Bariatric Surgery Review Article Gastroenterology Clinics of North America, Volume 39, Issue 1, March 2010, Pages 109-124 Timothy R. Koch, Frederick C. Finelli Show preview | Purchase PDF | Recommended articles | Related reference work articles For purchase 425] Bariatric surgery has become an increasingly important method for management of medically complicated obesity. In patients who have undergone bariatric surgery, up to 87% with type 2 diabetes mellitus develop improvement or resolution of their disease postoperatively. Bariatric surgery can reduce the number of absorbed calories through performance of either a restrictive or a malabsorptive procedure. Patients who have undergone bariatric surgery require indefinite, regular follow-up care by physicians who need to follow laboratory parameters of macronutrient as well as micronutrient malnutrition. Physicians who care for patients after bariatric surgery need to be familiar with common postoperative syndromes that result from specific nutrient deficiencies. 11 Update: Metabolic and Cardiovascular Consequences of Bariatric Surgery Review Article Endocrinology and Metabolism Clinics of North America, Volume 40, Issue 1, March 2011, Pages 81-96 Donald W. Richardson, Mary Elizabeth Mason, Aaron I. Vinik Show preview | Purchase PDF | Recommended articles | Related reference work articles For purchase 425] Obesity is a disease state with polygenic inheritance, the phenotypic penetrance of which has been greatly expanded by the attributes of modern civilization. More than two-thirds of obese persons have comorbidities, many of which are characteristic of cardiometabolic risk syndrome (CMRS) in addition to other life-quality–reducing complaints. The CMRS is associated with increased cardiovascular events and mortality. Individuals with a body mass index greater than 35 infrequently achieve or maintain weight loss adequate to resolve these metabolic and anatomic issues by lifestyle or pharmacologic strategies. Data suggest that some of these patients may be better served by bariatric surgery. 12 Secretion and Function of Gastrointestinal Hormones after Bariatric Surgery: Their Role in Type 2 Diabetes Review Article Canadian Journal of Diabetes, Volume 35, Issue 2, 2011, Pages 115-122 Alpana Shukla, Francesco Rubino Show preview | PDF (1234 K) | Recommended articles | Related reference work articles 13 Cirurgia bariátrica: como e por que suplementar Review Article Revista da Associação Médica Brasileira, Volume 57, Issue 1, January–February 2011, Pages 113-120 Livia Azevedo Bordalo, Tatiana Fiche Sales Teixeira, Josefina Bressan, Denise Machado Mourão

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@jconforti, I was looking for a location to find you. Your point on "Am I the only one" is well-taken and well-stated. May I share what,happened to me once? Often if I feel I have an insight, I do post. Thought that was fine until one day I answered a query,only to be put down because I was pre-surgical, apparently this person felt only post-surgical persons should be permitted to answer. My response had been gauged on life experiences which I had felt had equal validity. Didn't post for awhile, my "newbie" feelings were wounded, and until she went,inactive I never posted again where she was at. Just wanted to share this with you, and until I upgraded to Beta app, my "trendings" never told what forum things originated from so once or twice I did post way back in the GuysRoom by accident, but not anymore. I respect the boundaries now.

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Hi Disneyfreak, I am presently going down the Lapband path and am planning on being banded this spring. I just recently found out about the VSG and would prefer this procedure, but there does not appear to be any surgeons in South Central PA that does them and when I queried my insurance (Capital Blue Cross - FEHB) they said that they currently consider VSG to be experimental. Although VSG a more extreme procedure (removal of ~3/4 of the stomach), it is a "restrictive" only WLS similar to the Lapband, which appeals to me. What I like about VSG over the Lapband is that there are no fills, no "getting stuck", sliming, PBing, slippage, erosion, etc. With the VSG, one can eat whatever they ate before, but only a lot less of it. Just like the with the band, however, eating the right foods and exercising is still vital for tool to work. Since it does not appear that neither my insurance will change their mind, nor my surgeons will learn this procedure anytime soon, I am very very happy to continue with my stroll down the Lapband path. __________________ Originally posted at www.lapbandtalk.com

Newbie Here so please take my obversations as more of a query.. I really love my new sleeve family and I am scheduled for surgery in March. After months, month and months of research (with the help of this forum), I am just curious as to why there are not commericals or informationals about the Sleeve to help more people.:confused1: This journey appears to be a "God send" for alot of us and I am just sooo thankful I found out about the sleeve by through word of mouth. Anyone curious as to why the Sleeve has not recieved more public advertising.. similiar to the Realize Band? No pun intended to my Band family, just curious and trying to understand why more people are really not aware of Sleeve.. :blushing:

Hi I don't think I'm her. but I might be because I'm a preRnY but I got accused of chiming in too much, I accidently responded to,a lady who took umbrage with me, felt she had extends her query to post surg people only and basically told me to jump in the lake when i only tried to help. [emoji8] Oh the world is full of all kinds, I still wished her well even if our paths never cross again.[emoji26] If you ever want my,opinions on anything I'm usually lurking somewhere on B.P. just pull my chain and I'll be there! Okay?[emoji13] P.s. I am 72, red headed and spunky! Hoping for my surgery yet this spring, had to change programs (long story) but,praying this one comes through for me! Sent from my VS880PP using BariatricPal mobile app

I like to say "Thank you- I'm just eating healthy and exercising." Which is true! If they query further I will tell them "lots of low fat protien and good carbs". Because if you say high protien/low carbs it usually leads to an Atkins diet debate...no thanks : )

This is along the same lines as a thread I started. It's called, "What is the real point of this surgery?" You can look it up on my activity feed if you want to see what people have to say to my query. I'm in pre-op and still pondering whether to have the surgery. Trying to think it all through exhaustively. I think what happens is that people do regain some amount of weight, but you really have to be going out of your way to TRY to gain back all of the weight. Whereas, conventional weight losers have almost a 100% chance of regaining all the weight they lost and then some.

Hi Everyone, I've seem a few queries about what's good to eat after surgery. Google has a wealth of ideas, just search for Lapband (or whatever) recipies. I was on Amazon yesterday and found a number of cookbooks that deal with WLS. I bought a used, good condition book for $4.00. Someone on one of the forums, said they put a meatball in a container with a little spagetti sauce and used an immersion blender to mix to the consistency they wanted. It really sounded great. The immersion blender is probably one of the best investments you can make. Its perfect for blending Protein shakes and will mix a little tuna with a little onion to any consistency you can tollerate. I'm not really a cook, but I do have a lot of experience eating and I refuse to give up good taste just because I need to loose weight. I get my Lapband next week and plan to, finally, attack this problem with all energy i can muster. Best of luck to everyone.

Complications from surgery and the band are very low. There are several medical publications that can give you numbers on lap-band complication rates. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed is one example. Query "lapband complication rates" or similar terms.