Type 2 Diabetes and Weight Loss Surgery
The health benefits of weight loss surgery have been understood for many years. One area where these benefits are particularly significant is in the treatment of Type 2 Diabetes. Obesity is a risk factor for type 2 Diabetes and with obesity rates increasing across the world, in parallel we are seeing an increase in the prevalence of Type 2 Diabetes.
The scale of the increased risk obese patients are exposed to was highlighted in a 1995 study based on a population of nurses (3). This Nurses Health Study demonstrated an increased risk of diabetes with obesity in women with a relative risk of 93.2 at BMI 35 when compared with normal weight. In simple terms, this means that the risk of an obese woman with a BMI of 35 is 93.2 times the risk of diabetes in a woman with an ideal BMI (22 kg/m2). For a man its 42 times as likely.
For people wanting to learn more about Diabetes, including symptoms and treatment options, the Diabetes UK website is an excellent resource.
The benefits of weight loss surgery in the treatment of Type 2 Diabetes in the obese population have been reported in many studies over the last 20 years or so. These studies indicate that the gastric bypass procedure (both the mini and Roux en Y gastric bypass) is the most powerful. Studies show that patients can expect to lose 60-70% (2) of their excess weight and remission rates for Type 2 Diabetes are about 80%.(1)
It’s important to say that although weight loss surgery is not a permanent cure for Type 2 Diabetes, most patients are able to stop taking their blood sugar medications and/or place their diabetes in remission. Moreover, most patients are able to stop taking their medication immediately after surgery (when having gastric bypass).
Diabetes UK is supportive of weight loss surgery as an active treatment for Type 2 Diabetes, alongside the established methods of treatment, e.g. following a healthy lifestyle and medications to lower blood glucose levels. You can visit the Diabetes UK to read more. They have a specific page that addresses weight loss surgery.
Are You Eligible for Weight Loss Surgery With Type 2 Diabetes?

Our eligibility criteria are those applied by NICE and supported by Diabetes UK. We consider Type 2 Diabetic patients eligible for surgery if they have a BMI above 35. This BMI threshold drops to a BMI of 30 if your blood sugar levels are not well managed by a healthy lifestyle and medication. You might also be considered for surgery at a lower BMI if you are from an ethnic group more prone to Type 2 Diabetes, for example, those from an Asian background.
Weight Loss Surgery Options With Type 2 Diabetes
In most cases, our preference for patients with Type 2 Diabetes is gastric bypass. This procedure shows excellent results and over a long period of time. The gastric sleeve is also powerful and offers benefits that are similar. The gastric band is another option although the benefits take longer to come through as they go hand in hand with weight loss. With the bypass, there is an immediate metabolic benefit that is derived from the changes in gut hormones caused by the procedure itself.
"Excess weight is one of the major risk factors for developing Type 2 diabetes and cardiovascular disease, with the vast majority of patients with Type 2 diabetes having excess weight. All the national and international guidelines put a lot of emphasis on weight loss as the cornerstone of the management of patients with Type 2 diabetes. Weight loss from as little as 5% of total body weight can lower glucose levels significantly, with a greater amount of weight loss producing a more significant impact on glucose levels in patients with Type 2 diabetes as well as lowering their risk of cardiovascular disease. All methods of weight loss including lifestyle intervention, pharmacotherapy and bariatric surgery have been shown to have a favourable impact on Type 2 diabetes, with bariatric surgery being the most powerful to date."
Dr Abd A Tahrani Tweet
Based on the published data we consider Type 2 Diabetes remission rates by type of procedure to be:
- Gastric Band: 40-75% resolution
- Gastric Sleeve: 80-85% resolution
- Gastric Bypass: 85-95% resolution
With the bypass, there is an immediate metabolic benefit that is derived from the changes in gut hormones caused by the procedure itself. The changes in gut hormones, including ghrelin, impact on glucose regulation. There are still gaps in our understanding of precisely how the procedure delivers the metabolic changes we observe, but what we do know is that the changes have a dramatic and positive effect on Type 2 Diabetes.
During your consultation with our surgeon, we will discuss all of your options and help you come to a decision on what procedure will be best for you taking into account your diabetes, wider health considerations, weight loss objectives, wider diet and lifestyle considerations.
If you believe you are experiencing the symptoms of Diabetes you should contact your GP. If you have been diagnosed and want to explore surgery as a treatment option, please call us on 0121 720 9437 make an enquiry below.
Useful Links:
Weight Loss Surgery
Gastric Bypass
Gastric Sleeve
Gastric Band
- JAMA. 2012 Jan 4;307(1):56-65. doi: 10.1001/jama.2011.1914. Bariatric surgery and long-term cardiovascular events
- Buchwald H et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004 Oct 13;292(14):1724-37
- Colditz GA, Willett WC, Rotnitzky A, et al. Ann Intern Med 1995;122:481 96486