When endocrinologist Mary Elizabeth Patti looks at a patient with type 2 diabetes who could benefit from weight loss, she sees more than body mass index and blood glucose levels. She also recognizes the challenges of social vulnerability, understanding how low income, food insecurity, and limited access to health care might matter in treatment choice. After all, those factors are strongly linked to developing type 2 diabetes and obesity in the first place.
For more than a dozen years, Patti has been a leader of long-running randomized clinical trials conducted in four U.S. cities that compared bariatric surgery to medication and lifestyle management for type 2 diabetes. In 2024, one of those trials demonstrated the superiority of bariatric surgery for patients, measured by lower blood glucose levels, higher weight loss (28% vs. 10%), less use of diabetes medications, remission of diabetes to the point of no longer needing to inject insulin, and reduced risk factors for cardiovascular disease.
