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Doctor: Bariatric Surgery Underused Tool to Prevent Severe Obesity

Carol Pearson

   WASHINGTON - Bariatric surgery shrinks the stomach so people battling
   obesity can lose weight and regain their health. It's a drastic,
   life-changing procedure, but some doctors think it should be done more
   often before patients become severely obese.

   Shaun Rogers struggled for more than 20 years to manage his weight even
   as his diabetes kept getting worse.

   "By just dieting and continuing the cycle with the insulin, I was never
   going to lose the amount of weight I needed to, to change the whole
   cycle and get the diabetes under really good control," he said.

   Insulin can make people feel hungry, making it even harder to lose
   weight.

   Expensive treatment

   Yet resorting to bariatric surgery is expensive. In the U.S., health
   insurance companies won't pay for the procedure unless a patient's body
   mass index, or BMI, is at least 35, even if a patient's diabetes is
   uncontrolled.

   BMI is a measure of body fat based on a person's height and weight. Dr.
   Stacy Brethauer at Ohio State University says BMI is not always an
   indication of how well a patient is responding to treatment for
   diabetes.

   "BMI is not really a fair or accurate representation of who should be
   getting therapy," he said.

   Brethauer says the criteria for the surgery is outdated.

   "The patient who doesn't get the operation, we know very well that
   their disease will progress, their lifespan will be shortened if they
   don't get effective treatment," he said.

   The American Medical Association classifies obesity as a complex,
   chronic disease that requires medical attention. If it's left
   untreated, obesity can lead to heart disease, cancer and diabetes.
   Brethauer advocates early treatment for both obesity and diabetes.

   Double standard?

   "No one asks somebody with cancer or heart disease to 'just do it
   themselves.' Patients have to participate in their care and do the
   right things, but there's also effective therapy being offered to those
   patients at the same time," he said.

   Since he had surgery to reduce the size of his stomach, Rogers has lost
   a significant amount of weight. His diabetes is also under control. He
   no longer needs oral medication, and has gone from nearly 500 units of
   insulin per day to about 10.

   "It's changed my life so much," he said, "I would tell anyone do it."

   Diabetes is a global health issue. More than 400 million, one in 11
   adults, have this disease. The World Health Organization estimates that
   number will rise significantly in the near future.

   If people with diabetes have bariatric surgery early on, their diabetes
   can be cured. For those who have had the disease for ten years or more,
   and need insulin shots, bariatric surgery won't reverse their diabetes,
   but Brethauer says it can greatly improve their health.