Warmer questions
- Do you have a sweet tooth? How many cakes and sweets do you eat each week?
- What are the effects of eating too much sugar?
- How much physical activity do you do each week?
Reading section
The high cost of sugar
Diabetes affects more than 150 million people worldwide and that number is soon expected to increase. Over 90 per cent of people with the disease have Type 2 diabetes, which is characteristically associated with obesity and overweight, lack of physical activity, and family history. Unlike Type 1 diabetes −in which the pancreas fails to produce sufficient insulin− the pancreas in people with Type 2 diabetes produces enough insulin, but for unknown reasons, the body is incapable to use it. Diabetes can lead to amputations, heart, and blood vessel disease, blindness, strokes, kidney failure, and nerve damage. Existing therapies, which include exercise, diet, oral anti-diabetic drugs and insulin, do not always cure the disease.
Bariatric surgery, previously used for treating obesity only, is now being explored as a cure for type 2 diabetes. In the US, the Cleveland Clinic Bariatric and Metabolic Institute is presently conducting pioneering studies in this matter.
This procedure is not used in obese patients only but also in moderately overweight or normal weight people. There are 4 types of bariatric surgery procedures: laparoscopic sleeve gastrectomy (gastric sleeve), gastric bypass, gastric band, and duodenal switch. Top choices by patients looking to lose weight through surgery include a gastric sleeve and gastric bypass.
In England, the criteria for weight loss surgery on the National Health Service (NHS) can vary across the country. As a result, the cost of private weight loss procedures varies as well. Usual prices are:
• Gastric band surgery – £4,000 to £8,000
• Gastric bypass – £8,000 to £15,000
• Sleeve gastrectomy – £8,000 to £10,000
Questions to consider:
- Type 2 diabetes carries serious health-related complications. Does type 2 diabetes make weight loss surgery riskier?
- Most women are much more fertile after surgery. However, will the baby be healthy?
- Old habits die hard. What is really preventing more morbidly obese individuals from eating well? Is junk food industry to blame?
- Most patients are recommended to take an adequate intake of protein, vitamins, and minerals before the surgery. Will they lose their hair after bariatric surgery anyway?
- The largest part of bariatric specialists put their patients on a special pre-operative diet. Will patients have to go on a diet after they have their surgery as well?
Vocabulary matching
Match the vocab on the left with the correct definitions on the right.
| Vocabulary | Definitions |
| 1. Diabetes | a. controlled medical experiments to test newly developed medicines. |
| 2. Disease | b. a medical procedure conducted in an operating theatre to radically improve the quality of life of a patient. |
| 3. Invasive | c. illness or sickness. |
| 4. Surgery | d. a temporary recovery |
| 5. Gastric | e. an organ that is located behind the stomach. |
| 6. Bypass | f. some medical procedures create alternative paths/routes for blood vessels. |
| 7. Remission | g. a disease in which the body’s ability to produce or respond to the hormone insulin is impaired. |
| 8. Pancreas | h. a procedure where tools enter the body to perform a task. |
| 9. Insulin | i. Stomach. |
| 10. Epidemic | j. a hormone created by the pancreas that regulates the amount of sugar in the blood. |
| 11. Clinical trials | k. when many people are infected with the same disease or illness. |
Video: Can a cure for diabetes be found through surgery?
Diabetes is the fastest growing health crisis of our time. Could a common surgical procedure bolster hopes of finding a cure?
Watch the video and answer the questions below.
- What is diabetes?
- How much does the British National Health Service spend treating diabetes?
- How many people will develop diabetes by the year 2040?
- How many patients have type 2 diabetes?
- What’s happened in the past 4 decades?
- Who is Peter Hansell?
- What does diabetes type 2 mean?
- What is the message doctors have failed to pass on for the past 30 years?
- Who is Prof Francesco Rubino?
- What did Prof Rubino discover?
The advantages of bariatric surgery
- Long-term remission for type 2 diabetes. Recent studies suggest that bariatric surgery causes long-term remission of difficult-to-control type 2 diabetes.
- Improved cardiovascular health. Weight loss surgery reduces a person’s probability of stroke, coronary and peripheral heart disease.
- Relief of depression. Many obese people feel depressed because of poor body image and social stigma. Weight loss improves self-concept and self-esteem in most depressed patients.
- Relieve of other medical conditions. Bariatric surgery can alleviate pregnancy complications, metabolic syndrome, and gallbladder disease, among others.
- Improved quality of life. After weight loss surgery, most people say their quality of life is improved. Also, some studies suggest people live longer after bariatric surgery, compared to equally obese people who do not get surgery.
The disadvantages of bariatric surgery
- Malnutrition. Gastric bypass not only restrains the kinds of foods a person can eat but also the quantity of food. Also, it limits the nutrients that the body is able to absorb.
- Dumping syndrome. Dumping syndrome from eating foods high in sugar, calories and fat may cause discomfort, nausea, vomiting, diarrhea, and overall weakness.
- Stomal Stenosis. Stomal stenosis occurs when, after a Roux-en-Y (roo-en-wy) gastric bypass, there is a narrowing of the new opening between the stomach and the intestine. This tightening often causes vomiting after drinking or eating.
- Peritonitis. One of the most severe complications of gastric bypass is a stomach leakage that can cause peritonitis. Peritonitis is an inflammation of the peritoneum, the membrane lining the cavity of the abdomen and covering the abdominal organs.
Potential debating topics
- Rather than motivating people to lose weight, weight discrimination increases the risk of obesity. Sustained weight loss for patients who are morbidly obese is even harder to achieve.
- In the US, although discrimination based on race, age, religion, and sex is illegal, federal law does not make it illegal to discriminate against people based on their weight.
- No weight loss surgery should be needed. Healthier food choices and exercise are key to lose weight but obese patients are just lazy.
- The public holds extensive misconceptions that minimise the intricacies of obesity and how difficult it is to reverse. Overweight patients are not necessarily lazy.
- Our society views skinniness as a symbol of self-discipline, hard work and strength of will. People who are overweight are severely discriminated because they lack these qualities.
- Discrimination is over-rated. If individuals are so deeply disturbed by the stigma of being obese, why don’t they just lose weight?
Final thoughts
Some specialists are of the view that the risk of bariatric surgery is less than the risk of death from diabetes-related complications. Furthermore, the risks of bariatric procedures have decreased with increasing expertise and technical enhancements. Nonetheless, bariatric surgical procedure carries some risk. Some detractors argue that a significant number of patients too often experience post-surgery yo-yo dieting, among other side effects. However, despite its setbacks, benefits distinctly overcome possible problems. Considering the potential risk-to-reward available, bariatric surgery is exceptionally effective when compared to morbid obesity, illness or, ultimately, death.