https://www.nytimes.com/2019/09/02/...art-attack.html

I think it was in “The Diabetes Code” that Dr. Fung mentions that bariatric surgery resolves T2DM quickly, even before significant weight loss. He suspects it is due to the resultant fasting (or close to).

I feel sure he is correct!

Good observation of Fung's statement, and it was made to contrast the brute-force decision for a surgical procedure having many risks and complications with IF having far fewer risks to achieve the same results. This article reads like a promotional piece for bariatric surgery.

And also:

It's a wonderful world when humans can perform amazing feats of surgery to improve health, but the mystery is when no one communicates that a much less risky alternative is a simple lifestyle change that is far cheaper, safer, and more manageable than having a team of physicians cut open one's abdomen. Why don't they just state the tag line, "better living through bariatric surgery?"

The rates of complication and death for bariatric surgery would be criminal offered to different people for different conditions.

1-2% death rate

How is this level acceptable?? I bet it is sold based on risks of continuing an obese , diabetic lifestyle.

Only one case I knew personally. No change in her lifestyle in the years after sugergy. Filled up on rice based meal and junk food at lunch everyday.

I have seen two bariatric surgeons and because of conditions that I have I cannot have most of the bariatric surgeries. I have Hypothyroidism which I take Cortef for and they said I would have to go off that for 4 weeks before and 4 weeks after. Which is impossible. At first I really was upset about it, however, the doctors up here at WVU Ruby Memorial really do care about their patients. There is no easy way and I think GRB5111 makes a point. I think a change in lifestyle is the best route. After all, if you don't change your lifestyle even if you get the surgery you can return to the same size again.

serenityh - since you live in WV, and you are not already familiar with him, you should contact Dr. Mark Cucuzzella. He is a family physician, teaches at WVU, and who is very plugged in to lifestyle changes. He follows a low carb WOE, is well versed in low carb health, and has spoken at many low carb events in the past few years. Good guy! Here's the contact information. Good luck:

https://wvumedicine.org/find-a-doct...details/?id=760

My DH had gastric sleeve in Feb 2019 with no complications, despite my example of low carb and my exhortations to seriously do the dietary change first to see if it would work. He was pre-diabetic with high blood pressure and overweight.

The pre-surgery diet was specifically designed to reduce fat in the liver to get it of the way for surgery, the doctor specifically said that. So, basically, improving NAFLD. Post surgery, the food plan is almost all just liquid protein during the healing phase. Again LC, though also low fat.

DH's A1c went down as did his blood pressure and he lost weight, which us LC'ers would expect. However now 6 months post surgery, A1c is back up to pre-diabetes. Anyone here can guess why...DH did not continue strictly low carb. He is much better than SAD eating, but still will not give up tortillas, rice, noodles, etc which we only have around because for his mother.

His bariatric dietitian says to drop the fats, but I think that is more because he doesn't really tell her or even realize how many carbs he is having. The post surgery diet says: eat protein first, veg second and carbs last if you still have room. That is not the order he eats, but he is starting to accept that he needs to give up those last carbs.

I understand how anyone, having tried and failed with bad advice from the past, think this is their last best choice. I think as more people report success from ketogenic approaches, that will help people like Mycie14 's DH.

Dr fung brings another angle that seems to have merit. Fasting. 24 hr or 36 hr fasting can restore sensitivity to insulin which conventional T2D treament fails at. Im no longer convinced Low carb keto is enough to offset the hiccups in compliance.

Agreed. I’ve recently read all of Dr. Fung’s books, which is why the article caught my eye. I found myself creeping up in carbs, mostly with fruit, in the past year, and it showed with higher fasting glucose numbers.

I’ve been doing 23 hour fasts most days during the work week for the past month and it is helping. Another plus is I’ve busted through a long term set point and lost 10 pounds.

My A1c jumped up this last spring which scared the begeezes out of my because I was working harder than ever to be consistently keto.

My doc was no help as using diet as a management tool is not in her tool box. I was on my own.

Fortunately, I had encountered dr fung's fasting protocol last year and have been stewing it over; such that when I revisited his website recently, everything "clicked." As fasting is a differsnt method, getting used to the hiccups and learning tricks to overcome these, is a steep learning curve. Just like learning LCHF had been. Im confident fasting will work for me given some patience.

Reading his books is on my to-do list. Was it a good read??

I read The Complete Guide to Fasting” a while ago and never did anything with it. It was good, but I liked “The Obesity Code” and “Diabetes Code” better and got through each one in only a few days. Honestly, I’d already read much of the material included in them on his IDM blog, but the books were better organized, so worth the purchase for me.

Switching from lunch and dinner and too many keto snacks between to just dinner most days wasn’t too hard and now I don’t really get hungry and ifasting glucose is much lower before dinner. It’s good!

Yeah, The Obesity Code is my favorite. Dr. Fung is a concise and witty writer. As an example, when he talks about exercise as a way to lost weight as opposed or in conjunction with diet he says: "Diet is Batman, exercise is Robin".

I learned a lot from the IDM podcasts. I prefer that to Facebook groups anyway, and they are great for hikes.