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Monday, April 21, 2008

Gastric Bypass on CBS 60 Minutes

The CBS news magazine 60 Minutes aired a piece on gastric bypass on April 20. To date it is one of the most fair pieces I have seen, yet there was still the feel of "easy fix". Here is a summary:

(CBS) An operation performed primarily to reduce weight in the obese has some startlingly positive side effects. Gastric bypass surgery can send type 2 diabetes into complete remission, in some cases almost instantly. It can also alleviate sleep apnea, common among obese patients, which causes them to intermittently stop breathing in their sleep.

Studies also suggest gastric bypass patients greatly reduce their risks from certain obesity-related cancers, according to the American Cancer Society.

60 Minutes correspondent Lesley Stahl reports on the effects of gastric bypass surgery this Sunday, April 20, at 7 p.m. ET/PT.

Dr. Eugenia Calle, managing director of Analytical Epidemiology at the American Cancer Society, tells Stahl the incidence of many types of cancers increases with weight gain. "Our estimate is that 100,000 individuals in the U.S. a year…die of cancer because of their weight," she says. But, she tells Stahl, it's been hard to prove whether losing weight reduces the risk of cancer because most Americans will regain weight they lose. This makes gastric bypass patients interesting research subjects because they tend to keep off the weight they lose. "And in those populations, very interestingly, the…overall cancer risk is…cut in half," says Calle.

Another beneficial side effect of the procedure may have more to do with the surgery than the weight loss. Doctors noticed that bypass surgery can force type 2 diabetes into remission, sometimes right after surgery. Dr. Francesco Rubino, director of the Gastrointestinal Metabolic Surgery Program at New York Presbyterian/Weill Cornell, tells Stahl, "We thought it could have something to do with the small bowel." Operating on diabetic rats, he proved that eliminating the flow of food through the upper part of small intestine caused the remission. Rubino now hopes his findings will lead to a "diabetes surgery."

Currently, NIH Guidelines, established in 1991, recommend the bypass surgery only to the morbidly obese, or to those severely obese with a related health problem, like diabetes. Dr. Neil Hutcher, the former president of the American Society for Metabolic and Bariatric Surgery, says it's time to reevaluate the guidelines, and allow more diabetics access to surgery. "I think we have clear-cut evidence that we can do terrific things for diabetics," he says.

In reporting the story, Stahl met Dr. Bruce Miller, a family practitioner from Hopewell, Va. who also lost 120 pounds in a bypass operation. He says it affected all his health problems. "I don’t take any blood pressure pills anymore. I don't take any cholesterol pills anymore, as well as my diabetic medicine," he says. Miller is now recommending the surgery to many of his obese patients and says he no longer sees it as a last resort, as many doctors do. "They haven’t walked the walk," he tells Stahl.
Read our Neighborhood Discussion about this featured report.

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