Stomach downsizing – obesity cure?

[attach id="255309" size="medium"]The modern way of life associates overeating and drinking with happiness and satisfaction.[/attach]

It may appear strange that currently, in the so-called developed world, one major medical problem is our inability to control the amount of food we eat, necessitating dependence on unusual and unnatural ways of reducing food intake.

‘Enforced’ control of food intake has been practised for years by reducing the stomach size through various surgical procedures such as gastric banding, removal of part of the stomach, or gastric bypass. This encourages early satiety, a natural signal to stop eating, and hence an effective means of weight control.

If ever there was a procedure that interferes with the natural way of things, this is surely it. It proclaims the fact that we have completely lost our ability to control our own physiological needs when we are surrounded by a cornucopia of food.

More recently, this technique has been applied to control food intake in type 2 diabetic patients. Diabetes thrives in condition where food is abundant. It has been shown to be much less prevalent in isolated places where people were long deprived of material goods, only to explode when economic conditions improve and food is abundant.

113,000

The number of people in the US undergoing this surgical procedure every year.

In a recent publication announcing the best medical innovations for 2013 at the Cleveland Clinic, the US, the prize went to stomach downsizing, which has now been reinvented from being a technique for obesity control, to being a very promising tool for controlling diabetes.

The results of surgical reduction of stomach volume in diabetic patients have been published recently in the eminent medical journal The New England Journal of Medicine. This procedure was chosen out of 250 ideas presented by doctors at the Cleveland Clinic as showing the most promise in having a significant effect on the population, particularly in view of the increasing prevalence of overweight and obese people in the population.

The operation is not without its side effects. While the mortality rate is very low, one must bear in mind issues relating to complications resulting from any surgery, as well as symptoms directly related to changes in physiology of digestion, including a feeling of bloating and diarrhoea, as well as long-term bone weakening from osteoporosis.

In spite of this there seems no end to the demand for this procedure for the control of overweight. In Australia alone, there are currently 17,000 undergoing this procedure every year. In the US, the figure is a mammoth 113,000 a year.

While this is certainly good news to surgeons and private hospitals, it is hoped it will be equally good news to diabetic patients, of whom Malta produces more than its fair share.

It is likely there will be an increasing demand for this operation to control the devastating long-term effects of obesity, and more specifically of diabetes, which has now practically reached epidemic proportions in Malta’s population.

Such a drastic measure to control dietary requirements might imply that as a society we have lost the ability to judge for ourselves the right amount of food we can consume. The developed world comsumes up to 10 times more calories than in underdeveloped countries.

One might also object that this invasive procedure really tackles only one aspect of the problem, namely the physical reduction of nutrients, without attacking the basic root of the problem, which seems to relate to complex psycho-social issues associated with the modern way of life, which associates overeating and drinking with happiness and satisfaction.

Hopefully, this technique might be of value to a selected number of patients. It is simplistic to expect that it is a panacea suitable for all diabetic people.