A study recently published in the New England Journal of Medicine, showed that bariatric surgery improved glycemic control in patients with type 2 diabetes. We are a society that loves quick fixes, and this one seems magical in comparison to the dreaded lifestyle changes nurse practitioners always seem to be ranting about.
I know type 2 diabetes is a problem. I realize that diabetes increases the risk for coronary artery disease and myocardial infarction, as well as known long-term complications like kidney failure and vascular changes that can lead to limb loss. But bariatric surgery only treats the symptoms of diabetes and not the cause.
Let’s compare the outcomes from these recent studies to another study by Wroblewski et al published in The Physician and SportsMedicine that examined the outcomes of chronic exercise — training four to five times a week — in master athletes aged 40 to 81 years.
Chronic exercise preserves lean muscle and strength in older men and women, study data indicated. Master athletes in their 70s and 80s remained as strong as those in their 60s, who were nearly as strong as those in their 40s. In contrast we know that muscle mass and strength, as well as metabolism, begin to decline approximately 10% each decade after 50 years among the general population. Maybe the problem isn’t with aging, but with the lack of physical exercise and a sedentary lifestyle.
Multitudes of other studies have shown that exercise is clearly associated with weight loss, and that weight loss can lead to the improvement and even resolution of type 2 diabetes
When I consider the benefits of exercise, I always remember my times in Bangkok, Thailand. In the center of Bankok, there is an area known as Lumpini Park located in the center of the city. The park has approximately two miles of paved roadway and paths, and acres of grass and ponds. The park is open from 4:30 am to 10:30 pm each day, and the moment the sun rises crowds of people of all ages come here to walk, run and bike.
But these typical recreational activities are not all that the park offers. In one corner is a stage with an aerobics instructor. Music blares with a strong bass beat and a crowd of a few hundred can usually be found jazzercising away. When I was there, I couldn’t help stopping for a little dancing myself. Many of the grassy areas would fill up with groups of people practicing yoga, tai chi, ballroom dancing, fencing and other forms of exercise.
If we built more parks like Lumpini Park and made them safe and accessible, with supervised areas for children to play, I can’t help but think we’d be better off as a society in the long run than simply promoting bariatric surgery as a quick fix.
Julee B. Waldrop, DNP, FNP, PNP, is the Director of the MSN-DNP Program and an associate professor at the University of Central Florida. She provides health care to children at a local community health center.