What does the surgery entail?
In the surgery, we staple the stomach to make it much smaller, and we reroute food so that it bypasses the first few feet of intestines. We actually rearrange the anatomy and the physiology of the intestinal tract.
And what does this do to the body?
Well in addition to dramatically reducing the size of the stomach, the surgery also changes the hormonal condition of the patient. You're changing their sensitivity to insulin, you're changing their metabolism of iron and calcium and other nutrients.
And a lot of things which would otherwise get absorbed don't get absorbed. There are hormonal changes induced which suppress appetite. There are hormonal changes induced which increase the body's sensitivity to insulin, because most severely obese patients are resistant to insulin, which is why so many of them are diabetic. So it's one operation that has manifold effects on body metabolism.
Does this surgery actually treat diabetes in some cases?
Absolutely. I hear stories of patients who are on three or four different medications for diabetes, and a hundred units of insulin -- which is a big daily dose of insulin -- and within a few weeks they're off. They're off the medications even before they've lost a significant amount of weight. Also, people who have very high cholesterols will often see their cholesterol dipping down to normal.
So these are some of the more dramatic effects of the operation.
