Roux-en-Y gastric bypass (RYGB) surgery leads to sub-stantial and sustained weight loss and improved cardio-metabolic parameters in obese people (1). Approximately 80 % of patients with type 2 diabetes (T2D) experience complete remission, defined as normoglycemia without medication, and another 15 % have improvement, albeit remaining on medication (2). These rates are superior to those seen with conventional medical management (3–5). Several lines of evidence suggest such glycemic improve-ments are beyond those anticipated by weight loss alone. For many, remission of diabetes occurs within days, be-fore significant weight loss (6,7). Moreover, diabetes re-mission does not occur with similar degrees of caloric reduction following other surgical procedures, nor with liposuction or surgical resection of omental fat (8). These
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Goldfine et al. (2014) studied this question.