医生：手术减肥的工具未充分使用

Bariatric surgery helps people who are severely overweight. The surgery can help them lose weight and regain their health.

Doctors remove part of the stomach, so the patient is forced to eat less food. It is a difficult, life-changing operation. Yet some doctors think it should be done more often, before patients become severely obese.

Shaun Rogers struggled for more than 20 years to control his weight while he battled the disease diabetes.

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

Diabetes patients take insulin to get blood sugar, or glucose, into their cells. However, insulin can make people feel hungry, making it even harder to lose weight.

Costly treatment

Bariatric surgery is costly. In the United States, insurance companies will not always pay for the surgery. They require a patient's body mass index (BMI) to be at least 35, even if a patient's diabetes is uncontrolled. BMI is the measure of body fat based on the person's height and weight.

Stacy Brethauer is a surgeon at The Ohio State University Wexner Medical Center in Columbus, Ohio. He says the BMI number does not always show how a patient is reacting to treatment for diabetes.

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

Brethauer added that the rules for who gets bariatric surgery need to be changed.

"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 identifies obesity as a complex, chronic disease that requires medical attention. If it is not treated, obesity can lead to heart disease, cancer and diabetes. Brethauer believes early treatment is necessary for both obesity and diabetes.

Double standard?

"No one asks somebody with cancer or heart disease to ‘just do it themselves...' 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, Shaun Rogers has lost a lot of weight. His diabetes is also under control. Rogers no longer needs oral medication. And he has cut down on the use of insulin, going from nearly 500 units a day down to about 10.

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

Diabetes is a health issue worldwide. More than 400 million people have the disease. That number represents one in 11 adults. The World Health Organization estimates that number will rise sharply 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 10 years or more, and need insulin, bariatric surgery will not cure their diabetes. But as Stacy Brethauer notes, it can greatly improve their health.

I'm Susan Shand.

VOA's Carol Pearson reported this story. Susan Shand adapted it for VOA Learning English. George Grow was the editor.

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