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NEW YORK - Obesity surgery can reverse diabetes in teens, just as it does in adults, according to a small study.

All but one of the 11 extremely obese teens studied saw their diabetes disappear within a year after weight-loss surgery, the researchers reported. The 11th patient still had diabetes, but needed much less insulin and stopped taking diabetes pills.

Previous studies have shown the diabetes benefits of obesity surgery for adults. Dr. Thomas Inge, a pediatric surgeon at Cincinnati Children's Hospital Medical Center, and his colleagues wanted to find out if the same was true for adolescents.

Although more research is needed, Inge said the study "opens the door" to weight-loss surgery as a treatment option for severely obese teens with Type 2 diabetes.

The results are in the January issue of Pediatrics and are being released Monday.

1 in 3 U.S. kids are overweight
About a third of U.S. youngsters are either overweight or obese. Increasing numbers of obese children are being diagnosed with Type 2 diabetes, the most common form of the disease and the one linked to obesity. It was seldom seen before in kids.

"It's marching south through the generations, which is very scary," said Dr. Larry Deeb, a former president of the American Diabetes Association and a spokesman for the group.

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How Fat Went Global

It's not just Americans anymore; the whole world is becoming obese, and we have more than just the advent of cheap cheeseburgers to blame.

Mary Carmichael

Newsweek Web Exclusive

Two years ago, when Barry Popkin announced that more than a billion people worldwide were overweight—easily outnumbering the 800 million who were malnourished—folks looked up from their Big Macs in shock. Then they went back to eating, pushing the number of overweight people to its current number, an astonishing 1.6 billion. And it's not just Americans, or even Western cultures; obesity has become a global problem. Popkin has a new book that goes a long way toward explaining why that happened. "The World Is Fat" (Avery) pins the blame for the ever-growing obesity crisis on some well-known villains: sugary drinks, couch-potato lifestyles and yes, cheeseburgers. But Popkin also reveals some less obvious culprits: evolutionary biology, for instance, and a host of other forces beyond any individual's control. A professor of global nutrition at the University of North Carolina at Chapel Hill, he spoke with NEWSWEEK's Mary Carmichael. Excerpts:

NEWSWEEK: Your thesis is that we're all getting fat because we're eating more and moving less. That makes sense for individuals: if I sit around eating donuts, I'll gain weight. But you're talking about whole countries--the whole world, really. So what is going on?
Barry Popkin: The constant thing we've heard in America for the last 20 years is "You fat, gluttonous Americans, you should feel guilty. You're overweight and it's your fault." But all of a sudden, we're seeing the same problems in places where 20 years ago all they worried about was hunger: in Egypt, and among blacks in South Africa, and in China, where a third of adults now are overweight and obese. In Mexico, nobody was overweight 15 years ago; now 71 percent of Mexican women and 66 percent of men are. When you get to this kind of point, you've got to step back and say, "Wait, what is going on?"

What's happened is that from 30 years ago to today, we've had an exponential explosion in what we can think of as the "obesogenic environment." You see food available everywhere. You can't move more than 100 feet without seeing a caloric beverage. In most of the world, it used to be that people mostly drank water, and today they're consuming more and more sweetened beverages. Fruit juice didn't even come into being until the late 1950s, except for what you squeezed at home, and milk—there was some, but people didn't drink so much of it. The average American has not changed the amount of water he consumes in the last 30 years or so. But he's added 22 ounces of caloric beverages to his diet, and that's 300 extra calories per day. Then you match that kind of diet with human biology. We naturally prefer sweet and fatty foods because of what those foods used to mean for survival when we were hunter-gatherers. They had the nutrients we needed, and they let us store more energy for the hungry season.

And now, for most people, there is no hungry season.
Right. But we're still eating the same kinds of foods. From the beginning of humanity, we've always wanted to have tastier food and less work to do. These are innate drives, and we can't change our biology.

It's not just about what we eat. People around the world are less active now, too.
When I started working in China in the '80s, everyone biked to work. Today it's dangerous to bike, so people take mass transit or cars or motorcycles, and kids under 12 are banned from biking because it's not safe. They don't walk, either.

How important a factor is globalization? Your title, a play on Thomas Friedman's book on the global economy, "The World Is Flat," suggests it's a big factor, that we created the obesity crisis in America, then exported it.
Well, let's take an example. Up until three years ago, there was no snacking in China. Now it's exploding. Why? Because all of a sudden, there are Chinese equivalents of Wal-Mart. A lot of people used to live in a subsistence world, a more primitive world, and they couldn't afford things like modern vegetable oil. But now we have supermarkets everywhere, and everybody sees the same TV we see and wants the same things we want.

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Diabetes could cost U.S. well over $218 billion

TRENTON, N.J. - As diabetes is rapidly becoming one of the world's most common diseases, its financial cost is mounting, too, to well over $200 billion a year in the U.S. alone.

A new study, released Tuesday exclusively to The Associated Press, puts the total at $218 billion last year — the first comprehensive estimate of the financial toll diabetes takes, according to Danish pharmaceutical company Novo Nordisk A/S, which paid for the study.

That figure includes direct medical care costs, from insulin and pills for controlling patients' blood sugar to amputations and hospitalizations, plus indirect costs such as lost productivity, disability and early retirement.

The study, conducted by the Lewin Group consultants, estimates costs to society for people known to have Type 1 or Type 2 diabetes at $174.4 billion combined, a total previously reported by Novo Nordisk, the world's top producer of insulin and the maker of diabetes pills such as NovoNorm and Prandin. That study was done with the American Diabetes Association.

The new study adds estimates for people who haven't been diagnosed yet ($18 billion), women who develop diabetes temporarily during pregnancy ($636 million) and those on track to develop diabetes, an increasingly common condition called pre-diabetes ($25 billion).

"Diabetes has not seen a decline or even a plateauing, and the death rate from diabetes continues to rise," said Dana Haza, senior director of the National Changing Diabetes Program, an effort Novo Nordisk began in 2005 to improve diabetes care and prevention in the U.S.

"The numbers just keep going higher and higher, and what we want to say is, 'It's time for government and businesses to focus on it,'" said Haza, who believes diabetes will be the country's biggest health problem in the future, worsened by the obesity epidemic.

Novo Nordisk is to present the data Tuesday at a health care conference for corporate executives and then plans to publish a full report in a professional journal. The calculations are based on numbers from sources including databases on treatment of people with commercial insurance, Medicare and Medicaid, federal public health surveys and other sources.

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