A recent article in the paper said that studies find stomach surgery more effective than medicine for diabetes. The piece caught my eye, tilted my head, and caused me to pensively utter the word, "interesting". Interesting is my word for a number of things, but I find it particularly useful when I am uncertain that I believe something. I have no doubt the referenced studies are valid. My concern is that their findings might become the battle cry for surgical interventions to be touted over medical and social solutions for obesity and type two diabetes.
The American Diabetes Association (ADA) has a mixed history when it comes to giving sound advice related to nutrition. You may recall their "American Diabetes Association Deals" where they partnered with a couple corporations to provide discounts on pizza and ice-cream. Then there was the almost famous statement from within their ranks that, "you can't just eat your way to type-2 diabetes" during the "Paula Deen's got diabetes" dialogue. These things make the ADA "interesting" to me, and they remain far from my number one source for good health advice. However, I do appreciate the fact that they do not list surgery as part of the diabetes treatment regimen.
Getting people to modify their diet and exercise plans sounds great, and it works. I have maintained 60-70 lbs of weight loss for the last 10 years sans surgery, but it's not easy, I get that. The article states only severe cases of type two diabetes will be eligible for the surgery, I get that too. I also understand that surgeons, while they want to do their part, are not expected to mitigate the myriad of health determinants that affect their patients every day. Issues such as access to food, stress management, economic development, education, etc. are not handled in the operating suite. We should not be surprised that they want to bring a knife to the food fight (even though mashed potatoes and cream-pies don't need cutting). We do what we know.
Perhaps for some it is time for the knife, and should policy-makers decide that this $20K procedure warrant mass adoption, the surgery will be more widely available. When that day comes (and presuming we are still concerning ourselves with medical cost containment), I hope said policy-makers consider some balance to their approach. Promote the surgical intervention and: promote policies to improve access to good food options so that post-operative patients (and their communities) can eat healthier meals. Ensure the food options available in all communities are varied (like that color-block plate HHS launched last year). Push planners and developers to incorporate elements into their community design schemes that help sustain inhabitants as well as the environment, promoting activity by default by improving walk-ability for example.
Getting people to modify their diet and exercise plans sounds great, and it works. I have maintained 60-70 lbs of weight loss for the last 10 years sans surgery, but it's not easy, I get that. The article states only severe cases of type two diabetes will be eligible for the surgery, I get that too. I also understand that surgeons, while they want to do their part, are not expected to mitigate the myriad of health determinants that affect their patients every day. Issues such as access to food, stress management, economic development, education, etc. are not handled in the operating suite. We should not be surprised that they want to bring a knife to the food fight (even though mashed potatoes and cream-pies don't need cutting). We do what we know.Perhaps for some it is time for the knife, and should policy-makers decide that this $20K procedure warrant mass adoption, the surgery will be more widely available. When that day comes (and presuming we are still concerning ourselves with medical cost containment), I hope said policy-makers consider some balance to their approach. Promote the surgical intervention and: promote policies to improve access to good food options so that post-operative patients (and their communities) can eat healthier meals. Ensure the food options available in all communities are varied (like that color-block plate HHS launched last year). Push planners and developers to incorporate elements into their community design schemes that help sustain inhabitants as well as the environment, promoting activity by default by improving walk-ability for example.
We have been on a slippery slope for a while with this health thing. Its easy to slide, and hard to stop once you've started. The right balance gets us to the bottom of the slope on both feet with the least damage done. Clearing the way is what will cost us, and the political will to do that is yet to be seen.
Studies find stomach surgery more effective than medicine for diabetes.
Studies find stomach surgery more effective than medicine for diabetes.
No comments:
Post a Comment