Diabesity: How bariatric surgery is changing lives

Courtney Culbreath, MD, is a specialty care physician board certified in general surgery at Inova. She specializes in minimally invasive and robotic bariatric surgery, endobariatrics, and general surgery. Dr. Culbreath is committed to helping her patients achieve longer, healthier lives through long-term weight loss.

Type 2 diabetes affects 35 million Americans. Nearly 65% of these people also have obesity. These two conditions create a serious health concern doctors call “diabesity.” People with diabesity have a higher risk of other conditions including heart attack, stroke, blindness and kidney failure.

Bariatric surgery (weight loss surgery) is a safe, effective way to send diabesity into remission or prevent it altogether. Inova bariatric surgeon Courtney Culbreath, MD, explains why bariatric surgery works and who might benefit from it.

Why is weight loss so hard?

The first-line treatment for diabesity is diet, exercise and a diabetes control medication. But for many people, lifestyle changes don’t help them lose all the weight they need. Though they might drop a few pounds, the weight often comes back.

“As you eat less, certain hormones increase, making you hungrier,” explains Dr. Culbreath. “Your metabolism may also slow down, so it’s harder to keep the weight off. Many people become frustrated when they’re making healthy choices but not seeing the results they need.”

The power of bariatric surgery

All types of bariatric surgery help your body learn to eat less. But this surgery is not just about restricting food or “shrinking your stomach.”

“Bariatric surgery is also metabolic surgery,” says Dr. Culbreath. “The procedure changes your metabolism and hormones, so weight loss comes more easily. With the right bariatric procedure, people with diabesity can gain good blood sugar control and avoid dangerous complications of diabetes. And in some cases, weight loss surgery is a cure for type 2 diabetes.”

Which surgeries treat diabesity?

Gastric bypass and gastric sleeve surgery are the most common procedures for diabesity. Both change how much your stomach can hold and how your intestines absorb the food you eat.

“Gastric bypass and gastric sleeve are both good choices for people with diabesity,” says Dr. Culbreath. “A bariatric surgeon can explain each procedure to you so you can decide which will work best for you.”

The data shows just how powerful bariatric surgery is. An incredible 80% of people with diabesity experience remission (they no longer need diabetes medications) one year after gastric bypass. For gastric sleeve, the remission rate is 60%.

And those results last: Statistics show that 96% of obese people who had gastric bypass surgery do not have type 2 diabetes two years later. Fifteen years after bariatric surgery, that rate is 78%.

“Bariatric surgery is preventive medicine, not just a treatment,” says Dr. Culbreath, “You don’t have to have type 2 diabetes or other health conditions to be a candidate for the procedure.”

Who is eligible for bariatric surgery?

How do you know if bariatric surgery is an option for you? First, you have to know your body mass index (BMI). Find your BMI quickly and easily with Inova’s online BMI calculator.

You may be a candidate for bariatric surgery if you have a BMI of:

• 35 or greater and have type 2 diabetes
• 40 or greater, with or without other health problems

Choosing a bariatric surgeon

If you’re considering a bariatric procedure, finding the right surgeon is vital. Inova’s bariatric surgeons are expertly trained and highly experienced. We provide laparoscopic and robotic procedures, using tiny incisions for less pain and a faster recovery.

“Our techniques get patients back on their feet quickly,” says Dr. Culbreath. “Most of our patients go home the day after their surgery. After that, they usually go back to work after two weeks.”

The comprehensive team is the key to success in Inova’s Bariatric Surgery Program. “Our team includes every specialist you need, including educators, counselors, dietitians, exercise physiologists, bariatricians and surgeons,” says Dr. Culbreath. “And we support you every step of the way. We want you to meet your weight loss goals as much as you do.”

All of Inova’s bariatric procedures occur at Inova Fair Oaks Hospital, a Center of Excellence for Bariatric Surgery. “We earned the Center of Excellence designation because we have a cohesive team that provides the highest quality care,” says Dr. Culbreath.

Weighing the costs of surgery

If you’re a candidate for bariatric surgery, don’t let financial concerns hold you back. Inova accepts all major insurances for bariatric surgery, and many provide coverage for the procedure. Inova also offers flexible self-pay options to help make costs more manageable.  

What about weight loss medications?

Social media has been buzzing about the newest antidiabetic and weight loss medications, known as GLP-1 agonists, such as OzempicÒ and TrulicityÒ. These drugs are a significant medical breakthrough, but they are not a substitute for bariatric surgery. Rather, they can be used in combination with surgery for additional benefits.

“Weight loss and diabetes medications alone can be effective for people who don’t have diabesity or severe obesity,” says Dr. Culbreath. “We also combine medications with bariatric surgery when a patient needs that extra support. Studies show that most people who have bariatric surgery lose more weight and keep it off longer than those who take medications. Surgery is the gold standard of treatment for diabesity, and we can boost its effects with medications.”

Start your weight loss journey

Are you ready to look into weight loss options? Your primary care provider is a good place to start. You can also contact Inova Bariatric Surgery. We provide free consultations and weight loss surgery webinars, where you learn more about the procedures. We’ll help you make an informed decision about your care so you can get on the path to a healthier you.