Wednesday, May 22, 2013

Pure Nonsense

Bariatric surgery is becoming a pretty big deal in the mainstream media lately.  Everyone's all in a tizzy over the findings that OMG GASTRIC BYPASS CAN CURE DIABETES!  Quickly, everyone!  Let's cut open every diabetic within reach!

I'll admit that it's pretty exciting news that scientists have said out loud that you can cure diabetes.  It seems like almost every doctor and every nutritionist is determined to make diabetics believe that diabetes is something you have to fight tooth and nail  every day of your life until it kills you, and that there's no such thing as a cure for diabetes.  So to actually hear someone say, hey guys, I think we can cure this thing...  That's pretty cool.  But then all the smart people in the room start talking about the possible ways it's happening.  The surgery must alter your hormones!  It makes it so you can't absorb all that harmful glucose!  It changes your whole system so you can work more properly!!!  But no one in the spotlight was asking, what about the diet?

Gastric bypass surgery has been kind of a miracle procedure since they first started reporting on it, really.  Can't lose weight?  Well, let me rip you open and connect this thingy to that thingy, and voila!  You're now 100 pounds lighter!  No need to diet, or cut out junk food, or try  to lose weight.  Except, yeah, after surgery you can only eat tiny portions and you have to cut out all junk or else you'll throw up all over the place.  I know that it's really hard for very fat people to lose weight with the carb-heavy calorie restricted diets they're recommended by, well, everyone, but I also know that bariatric surgery is the easy way out for a lot of people.  I've personally known a handful of people who have the attitude of , hey, I'm going to eat all the cake I want because if I get really fat, I'll just get that newfangled surgery and I'll get skinny in no time. 

But what's really bothered me about gastric bypass surgery is that it seems like no one is asking the most obvious question.  What happens when you just eat the diet recommended to surgery patients?

It's not a fun diet, let me tell you that.  The Mayo clinic website has a pretty good description of what you eat after gastric bypass.  It comes in phases, depending on where you are in the healing process, but in every phase, they emphasize eating high quality protein foods along with vegetables and fruit.  So meat, eggs, dairy, vegetables, and fruit.  Gosh, that sounds like a low carb diet.

Let's do a little math for fun (oh god, I'm turning into Chad...)  It's hard to pin this information down on the internet, but I found that the calorie goal of patients is no more than 1000 calories a day (many people say it's hard to eat more than 700 calories), and the recommended protein intake is about 75g a day, though some doctors recommend up to 100 g.  But for this thought experiment, we'll stick with 1000 calories and 75 g of protein.  On this page, I found that patients are told to keep their fat intake below 30 g a day.  We'll say the patient was behaving themselves and ate only 20g of fat.  So let's see what this looks like so far.

75 g of protein = 300 calories
20 g of fat = 180

300 + 180 = 480

1000 calories - 480 calories = 520 calories from carbs

520 / 4 = 130 g of carbs

That's not a super low carb diet, but you know what?  That's still pretty darn low.  Especially considering gastric bypass patients don't absorb all the food that they eat.  Now for fun, let's calculate out what I found on the internet most people end up eating (I looked through some diet journals on of surgery patients who are successfully losing weight), which is about 700 calories, 80 g of protein, and 35 g of fat.

700 calories a day - 320 calories of protein - 315 calories of fat = 65 calories of carbs.

65 calories of carbs = 16.25 g of carbs a day.

16 carbs a day?!  That's what I would call a VERY LOW CARB DIET. 

So why haven't scientists tried studying the diet alone to see if it's just as effective as the surgery?  Well, as it turns out, they have done just that recently.  Someone finally thought to themselves, hey guys, maybe we should, you know, see if it's the food or the horrible gut slicing that's helping these people.  And you know what they found out?  It's the food.

At least when it comes to diabetes control.  I'll admit that this is a pretty small study group (n=10), but it's still really promising.  They took ten people and had them eat the post-surgery diet for ten days, then several months later those same ten people had gastric bypass surgery and ate the exact same diet.  Both times the patients had improved fasting glucose, but the diet-only part of the experiment showed the best improvements.

So now we have a pretty good clue.  The next time you hear someone saying that bariatric surgery is the cure for diabetes, slap them with a clue-stick and tell them, no, idiot, it's the diet.

The worst part of this study, though, is one of the researches ended up saying,"Unfortunately, such a restrictive diet is nearly impossible to adhere to long-term in the absence of bariatric surgery."  Dude, what?  Are you dumb?  Have you no clue?  DO I NEED TO GET MY CLUE-STICK?!  Yes, it's true that it's going to be nearly impossible for most sane people to eat 700 calories a day, but why can't we combine what we learned with this study with what we've learned from low carb studies and say, hey guys, low carb helps you lose lots of weight and also helps you control your diabetes.  There's no need for bariatric surgery.  It's a waste of money, a waste of time, and it's a waste of a perfectly healthy body that, given the right food, can heal and lose the weight all by itself. 


  1. I've come to your blog via Tom Naughton - you and me both have a lot to thank him for!! I also agree about the surgery and probably about most everything else you are writing!!

  2. Add to that, any surgery can potentially have serious (even fatal) outcomes, particularly intrusive surgery such as cutting out or binding part of the gastric system. Is it really worth the risk, if you can get the results from diet alone? HELL NO!!!

  3. You said it! But wait! The surgeons and hospitals will lose all their revenue! Shhhh better hush this up, peoples livelihoods at stake! The economy would crash!