Debate regarding weight loss surgery as a primary treatment for patients who are not overtly obese but diabetes has become topical. The rationale for this arises from the success that weight loss surgery has had in leading to remission of diabetes in obese patients. In the most recent report from the National UK database of all bariatric operations, the remission rate of diabetes was found to be 85.2% in patients who had weight loss surgery.

Extension of conventional wisdom has introduced the concept of weight loss surgery for patients with a much lower BMI with diabetes. However this recent study has concluded that there is no evidence that surgery is beneficial in the long term. The study concluded that short term outcomes for weight loss and glycemic control were reasonable for individuals with a BMI of 30 to 35 following surgery.

There is insufficient evidence to support bariatric surgical procedures in patients with a BMI30-35, according to a paper entitled ‘Bariatric Surgery for Weight Loss and Glycemic Control in Nonmorbidly Obese Adults With Diabetes A Systematic Review’, published in Journal of the American Medical Association.
However, the authors do acknowledge that bariatric surgery does offer short terms benefits such as greater weight loss and better intermediate glucose outcomes, when compared with nonsurgical treatments.