The Cleveland Clinic recently published its "Top 10 Medical Inventions for 2013" list 1. Doctors and researchers at the Clinic voted for what they thought were the most significant inventions out of 250 submitted ideas.
Noted medical inventions include an implantable neuromodulation device for the treatment of severe cluster headaches, a handheld melanoma detection device, a novel prostate cancer drug, and breast tomosynthesis (a.k.a 3D mammography).
But shockingly, and really almost unbelievably, topping the list at number one is using bariatric surgery for the treatment of type 2 diabetes.
According to the Cleveland Clinic:
"Surgery for obesity, often called bariatric surgery, shrinks the stomach into a small pouch and rearranges the digestive tract so that food enters the small intestine at a later point than usual.
Over the years, many doctors performing weight-loss operations found that the surgical procedure would rid patients of Type 2 diabetes, oftentimes before the patient left the hospital.
To explore this diabetes treatment hypothesis, 150 patients with Type 2 diabetes and obesity were enrolled in a study in 2007. 50 patients had gastric bypass surgery.
This is a procedure that reduces stomach volume from the size of an inflated football to a golf ball size; 50 had a sleeve gastrectomy surgery, which reduces the stomach from the size of a football to that of a banana; and 50 were offered counseling in nutrition and exercise while they continued taking their diabetes medication.
By closing off most of the stomach to food, people who received bariatric surgery ate less and, therefore, lost weight. Patients in the study lost about five times as much weight on average as those only taking bloodsugar-lowering medications.
The study results, published in the New England Journal of Medicine in 2012, astounded the medical world.
Compared with patients taking diabetes medication and receiving lifestyle counseling, those who had bariatric surgery were far more likely to be free of diabetes or to have reduced their dependence on diabetes medications for at least two years. The weight-loss surgery also helped many to lower their blood pressure and cholesterol. Most of the patients went from a dozen or more medications daily to none or just a few."
Dr. Michael Roizen, Cleveland Clinic Chief Wellness Officer, told Reuters 2 :
"Bariatric surgery has been around for a while. The reason it was chosen as the top innovation is because Medicare has broadened its indication for payment, and Medicaid in many states follows Medicare.
A lot of the other (private) insurance companies started covering it, so it's much more accessible. The criteria that insurers use to cover the surgery has been broadened because of its effectiveness in controlling Type 2 diabetes."
While this will probably sound wonderful to some, there's no doubt in my mind that this is absolutely the wrong treatment and not at all an appropriate solution for the vast majority of people, and that's what this list is all about — one of the primary criteria for making it
onto the list was the number of people the product or procedure can potentially help.
Bariatric surgery as a treatment for type 2 diabetes is a prescription for the most invasive and costly (not to mention risky) intervention possible for a problem that is firmly rooted in a faulty diet and lack of exercise. What makes this recommendations particularly troublesome is that virtually 100 percent of type 2 diabetes cases can be successfully treated and reversed through appropriate lifestyle changes!
It's also blatantly clear (they even state it outright) that it topped the list because Medicare (i.e. your tax dollars) will now pay for it. NOT because it's been proven safe and effective.
On the contrary, they appear to base their opinion on the results from a singular study. This is probably ill advised.
Dr. John Ioannidis of the Stanford School of Medicine in California warns against placing too much faith in singular medical studies showing large effects of medical treatment (benefits or harms). His massive analysis, recently published in JAMA, 3 tracked the fate of thousands of studies, from the effects demonstrated in the initial study, compared to the effects elucidated in subsequent trials.
Interestingly, in 90 percent of cases where "very large" effects were initially reported, such effects shrank or vanished altogether as subsequent studies were done to confirm the results. Dr. Ioannidis told Reuters 4 :
"Our analysis suggests it is better to wait to see if these very large effects get replicated or not. Keep some healthy skepticism about claims for silver bullets, perfect cures, and huge effects."
In the case of weight loss surgery, there are already a number of studies showing both bariatric surgery and gastric banding are very risky procedures that produce poor long-term outcomes! But of course, that only means the revenue stream from those suffering with type 2 diabetes will continue to flow, and apparently that's what really matters and drives medical recommendations in the US.
Nearly Half of Weight Loss Surgeries Result in Major Complications
All surgeries have inherent risks, but bariatric surgeries seem to have a much higher ratio of complications. Complications occur for both types of weight loss surgery, gastric banding and the more invasive gastric bypass.
For example, a study from 2004 5 reported that the risk of dying within 30 days of gastric bypass surgery was 1 in 50. And, within the surgeon's first 19 procedures, the odds of death within 30 days were 4.7 times higher, due to inexperience.
Gastric banding consists of surgically inserting a band around the top section of your stomach, and cinching it into a small pouch. This is often touted as a simpler, less invasive procedure to gastric bypass, and whereas gastric banding is at least reversible, while gastric bypass is not, the complications are often so debilitating that patients opt to have the bands removed completely. According to research 6 published last year, nearly 40 percent of patients who undergo gastric banding experience major complications, including: