In this episode of Longevity Roadmap, host Buck Joffrey speaks with Dr. Mitchell Roslin, Chief of Bariatric Surgery at Lenox Hill Hospital, New York, about how surgical approaches to obesity can also play a major role in treating type 2 diabetes and improving longevity. The discussion explores how obesity functions as a model of accelerated aging and how both surgery and new drug therapies can help restore metabolic balance.

Key Points:

Obesity isn’t just about weight—it’s a form of accelerated aging with complex metabolic roots. Dr. Mitchell Roslin highlights how surgical and hormonal insights are transforming obesity and diabetes care for better longevity outcomes.

• Obesity as Accelerated Aging: Dr. Roslin explains that obesity mirrors the biological processes of aging—such as inflammation, metabolic dysregulation, and organ stress—and should be treated as a serious, multifactorial disease rather than just the result of poor lifestyle choices.
• The GLP-1 Revolution: Drugs like semaglutide (Ozempic) and tirzepatide have transformed obesity care, but not everyone responds equally. People with severe insulin resistance or diabetes often show diminished weight loss, highlighting the complexity of metabolic pathways.
• Surgical Innovation and Hormonal Effects: Modern bariatric surgeries, such as the SIPS (Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy) developed by Dr. Roslin, modify not just stomach size but also how the intestine processes glucose and hormones like GLP-1, improving blood sugar control and satiety.
• Reducing Glucose Variability: Unlike traditional gastric bypass surgery, newer procedures aim to stabilize blood sugar fluctuations—reducing post-meal insulin spikes and crashes, which are linked to fatigue and weight regain.
• Treating Obesity as a Disease: Dr. Roslin advocates for obesity to be staged and treated like any other chronic condition, with objective testing and stratified care that includes medication, lifestyle changes, or surgery depending on severity.