Recent Study shows long term (12 years out) benefit from WLS

https://resident360.nejm.org/content_items/weight-and-metabo lic-outcomes-12-years-after-gastric-bypass

Not that the nay-sayers will be swayed by, like data, but here is another study in support of WLS as an effective tool (but, as we know, you still have to work at it) Original New England Journal of Medicine article

http://www.nejm.org/doi/full/10.1056/NEJMoa1700459?utm_mediu m=referral&utm_source=r360

Here is the top line from the study

Clinical Pearls

Q: How durable is the postsurgical weight loss achieved with Roux-en-Y gastric bypass?

A: In the study by Adams et al., despite a wide variation in change in body weight across the sample, 360 of 387 patients (93%) in the surgery group maintained at least a 10% weight loss from baseline to year 12, 271 (70%) maintained at least a 20% weight loss, and 155 (40%) maintained at least a 30% weight loss. Only 4 of 387 patients (1%) in the surgery group had regained all their postsurgical weight loss.

Q: How effective is Roux-en-Y gastric bypass in reducing the likelihood of developing type 2 diabetes?

A: In the study by Adams et al., the 12-year incidence of type 2 diabetes was 3% (8 of 303 patients) in the surgery group, as compared with 26% (42 of 164 patients) in nonsurgery group 1 and 26% (47 of 184 patients) in nonsurgery group 2.

With the surgeons considering the surgery a success if the patient keeps 50% of their weight off, it's sobering to that statistic. To those who have been carrying the weight, it's still a positive.

I'm 12 yrs out from my DS as of Halloween and have maintained 85% of my weight loss and I'm not fretting one bit over it.

Valarie,

My surgery date anniversary date is also Halloween. This was encouraging to me.... I am 23 years out/ of a hybrid surgery including a RNY+ several other procedures, bandings, resections etc. . out of total weight loss of 144.5 lbs I have maintained all but 22. I have reduced my physical activity from very heavy during the time of most of my maintainence time.so a 22 lb weight gain during a high time of emotional and physcial stress would not be uncommon for almost anyone .Yes I am still rying to loose a few more pounds again,but am not frantic, just gradually making more slow changes to get back to where i'd really like to be.

Cortizol rules much of our body response and being aware of those other changes in our life that allow us to loose and maintain our weight and health are of the utmost importance. Knowing and being aware of the blood sugar changes that come as we age, trying to maintain a clean diet can minimize sugar issues, whether hypoglycemia or hyperglycemia. Natural means can help manage this as well.. which ones?.do your own research!

Each of us needs to keep in mind that with every study done, there is an agenda being persued and someone is paying for this study to prove or disprove some "ideal" . Yes, Ideal.. an ideal weight and ideal diet, an ideal response...

The diabetes statistic is positive. However the regain weight is staggering.

I think researching all surgical options and all regain statistics is really important. As has been said before, these surgeries are just tools for long term success. Before any surgery, you need to examine your ability to adhere to the diet that your surgery will require.

I had a frank "conversation" with myself when I chose to have the DS. I knew the disadvantages....but I knew the statistics about regain as well. I knew I couldn't diet, and had never been successful keeping up an exercise regime. I knew I needed to be able to eat. This DS worked for me because I can take vitamins but not diet long term.

I've maintained almost a 100 percent excess weight loss at almost 12 years out. I did have a small regain last year (about 20 lbs), but I took that off after a few months of low carbing.

It should be noted that these are just 1 set of statistics.....there are lots of variables. Did the people have a good education about what would be required long term? There are plenty of RNYers on here that have maintained long term, because they know what they are suppose to do, and how they need to eat to maintain. The people that come on with regain issues, typically are surprised and sometimes offended by the new/good advice of these vets.


Scott

It took me over two years to realize that the surgery was not magic and that the weight would not stay off effortlessly.

For the first 30 months. I th0ught I was cured.

Improved health related quality of life through reduction of comorbidities such as diabetes hardly says "ineffective" to me!

I wish these studies came with more information about treatments and combinations with behavioral modification.

My take away from this is "if all you do is have weight loss surgery, don't expect great long term results."

These studies are not using "excess weight" as their measure. They are using percent weight lost. For example, I have lost 200 pounds. I consider that losing 100% of my excess weight. But if I calculate my loss as a percentage of my original weight, I have lost 59% of my initial weight (200/340 x 100%).

For example, I believe another study said the average person in this study was 250 pounds. To lose 30% of their weight, they would have lost 75 pounds (250 x 0.3 = 75), putting them at 175. If their goal is 150, they have lost 75% of their excess weight (75/100 x 100%). 75% sounds better than 30% but they both describe the same amount lost, just in different terms.

Thanks for the careful reading and analysis. I also went back and read a few studies and stats and realize that it is not excess weight but overall weight that the majority measure. I would go through with the surgery anyways just for the health benefits but this has actually made me feel even more convinced that the surgery is a good tool for me.

The stats are sobering and a clear indication that WLS is not a perfect solution.

It is the best option, when compared to conventional dieting when the 5 year results are that only 3-5% of people who lose 50 pounds keep it off for 5 years.

The 50 pound target it used because, as I understand it, it usually gives a medical improvement - diabetes, high blood pressure, etc.

THis is why the vets say that they track what they eat daily, etc and that regain is a concern.