Developed about 40 years ago, weight-loss surgery has exploded in popularity in Philadelphia and across the nation, reflecting the obesity epidemic, surgical advances, and studies showing that the radical procedure extends lives.
The surprising thing is that for Type 2 diabetics, surgery confers benefits independent of weight loss, and that's especially true of gastric bypass, which bypasses part of the small intestine, as well as much of the stomach. Studies show about 84 percent of bypass patients have a total remission of diabetes, sometimes within days or weeks, just like Pezzano.
This is not to minimize the costs - $20,000 to $35,000 for the surgery - or the hazards of reducing the stomach to the size of an egg. Patients can develop infections, blood clots, ulcers, hernias and problems with excess skin. Adjustable gastric bands that shrink the stomach can slip, break or cut into the organ. Long-term risks include vitamin deficiencies, osteoporosis and the rare but severe problem of low blood sugar.
Nor does the weight-loss battle end. On average, patients shed 62 percent of their excess weight with bypass, 48 percent with banding - and most eventually regain some.
The ultimate peril - dying - has fallen to about 0.3 percent, but that's averaging all patients. For "super-obese" patients (more than 175 pounds overweight) and those with severe heart or lung disease, mortality rates were 6 percent and 10 percent respectively, in a study of veterans published last month.
Still, nothing has proved better than surgery at treating Type 2 diabetes, long viewed as chronic, progressive and incurable.
