Bariatric Surgery for Type 2 Diabetes Reversal: The Risks

The twin epidemics of obesity andtype 2 diabetes are on the rise. From1986 to 2000, the prevalence of BMI 30 kg/m2 doubled, whereas that of BMI.40 kg/m2 quadrupled, and even ex-treme obesity of BMI 50 kg/m2 increased fivefold (1). Of particular concern is the alarming increasing prevalence of obesity among children, suggesting that the epi-demic will worsen (2). The impact of obesity on longevity has been well docu-mented. In the world, over 2.5 million deaths annually can be attributed to obe-sity; in the U.S. alone over 400,000 deaths attributable to obesity occur per year— second only to those attributable to cigarette smoking. There is a direct re-lationship between increasing BMI and