But, there is a procedure that reduces obesity and, with it, diabetes - and it may soon be offered to even more people.
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44-year-old Shiranda Jones of Northeast Philadelphia knew it was time for a change.
Excess pounds led to high blood pressure and diabetes.
But Shiranda had even more motivation:
"To cut my risk of cancer," she told us.
Shiranda lost her younger sister and aunt to breast cancer. Her mother and a grandmother have also had it.
There's also cancer among men in the family.
For years, she and her mother, calling themselves Pink Eagles, have raised funds and awareness.
She knew dramatically cutting her weight would also lower her cancer risk.
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"I had the sleeve surgery, the gastric sleeve surgery," she says.
Dr. Rohit Soans says Temple does both the gastric sleeve and Roux-en-Y bariatric procedures.
Both have good track records in re-setting a patient's weight, and...
"Not only reducing the number of medications people need for diabetes but actually curing diabetes," says Dr. Soans.
But success takes more than an operation.
Temple's program also involves psychological counseling.
"Make sure the timing of the operation is right, make sure that the patient is ready for the lifestyle changes," he says.
And nutrition:
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"Making sure the patient understands how to eat, how to modify their lifestyle," he adds.
Diabetes educator Casey Dascher guides patients through it.
"Our program has shown to lower A1C by 1.5 and also our program has shown within about two months a two percent body weight loss," Dascher told us.
Shiranda has already lost 50 pounds.
"I feel amazing. The only I regret is that I didn't do it sooner," she says.
The support starts three to six months before surgery, and continues for years afterward.
The team even helps patients living in food deserts find fresh produce.