Greater weight loss with gastric bypass than other bariatric surgeries
(HealthDay)—Roux-en-Y gastric bypass (RYGB) is associated with greater weight loss at one, three, and five years than sleeve gastrectomy (SG) or adjustable gastric banding (AGB), though it also has the highest rate of 30-day adverse events, according to a study published Oct. 29 in the Annals of Internal Medicine.
David Arterburn, M.D., M.P.H., from Kaiser Permanente Washington Health Research Institute in Seattle, and colleagues performed a retrospective cohort study to compare weight loss and safety among bariatric procedures. The study included 65,093 patients aged 20 to 79 years with a body mass index (BMI) ≥35 kg/m2. The patients had undergone bariatric procedures at 41 health systems in the National Patient-Centered Clinical Research Network from January 2005 to September 2015. Follow-up data were available for 44,978 patients at one year, 20,783 at three years, and 7,159 at five years.
The researchers found that 30-day rates of major adverse events were 5 percent for RYGB, 2.6 percent for SG, and 2.9 percent for AGB. One-year mean total weight loss (TWL) was 31.2 percent for RYGB, 25.2 percent for SG, and 13.7 percent for AGB. At five years, the mean TWLs were 25.5 percent for RYGB, 18.8 percent for SG, and 11.7 percent for AGB. Less weight loss was seen among patients with diabetes, those with BMI <50 kg/m2, those aged ≥65 years, African-American patients, and Hispanic patients.
"Health care providers, patients, and policymakers can use these data to inform treatment and insurance coverage decisions," write the authors.
Several authors disclosed ties to pharmaceutical and medical device companies.
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