Bypass Beats Band for Weight Loss

 

"Results of Roux-en-Y Gastric Bypass in Morbidly Obese vs Superobese Patients - Similar Body Weight Loss, Correction of Comorbidities, and Improvement of Quality of Life"
Michel Suter, MD, PD; Jean-Marie Calmes, MD; Alexandre Paroz, MD; Sébastien Romy, MD; Vittorio Giusti, MD, PD
Arch Surg. 2009;144(4):312-318.

NYT -  Bypass Beats Band for Weight Loss

A study of two popular surgical procedures to treat morbidly obese patients shows gastric bypass is associated with faster and more sustained weight loss than gastric banding.

Weight loss was faster, greater and remained "significantly better" six years after gastric bypass compared with patients *****ceived a gastric band, according to researchers.

The study, which involved more than 400 patients in Switzerland, is one of the longest studies of the two common procedures in the U.S. that limit the amount of food the stomach can hold. It was published online Monday in the Archives of Surgery.

Weight loss was measured by looking at group changes in body mass index at various times after surgery. BMI is a measure that estimates body fat by using a person's height and weight. People with BMIs of 30 or higher are considered obese.

Study participants started out with an average BMI of about 43. After a year, the average BMI in the bypass group fell below 30, while those receiving a gastric band had a BMI of about 34. Researchers said maximum weight loss was achieved after an average of three years for the gastric-band patients compared with 18 months for the bypass group.

Total cholesterol remained unchanged in patients who underwent gastric banding but decreased in patients who underwent gastric bypass.

The study looked at what are considered treatment failures, which was measured by a reversal of the procedures, or patients who had a BMI of 35 six years after surgery. The failure rate for gastric banding was 48.3% compared with 12.3% for bypass.

Gastric banding involves the placements of a band around the top part of the stomach to create a small pouch. In gastric-bypass surgery, surgeons reduce the size of the stomach and the smaller stomach is then attached to the middle of the small intestine, bypassing a section of the intestine and thereby limiting the absorption of calories. About 200,000 Americans undergo surgical procedures to shrink their stomachs each year.

The study involved 442 patients who were operated on between March 1998 and May 2005. Half of the patients received a gastric band while the other half underwent the Roux-en-Y procedure, a common gastric-bypass procedure in the U.S. Patients were matched according to sex, age and BMI. Patients had a BMI of more than 40, or more than 35 with at least one other disease such as diabetes, but didn't exceed a BMI of 50.

The gastric-bypass patients had a higher rate of complications immediately after surgery. The study showed the early complication rate for gastric bypass was 17.2% compared with 5.4% for banding. But in the long term, there were more complications and more follow-up operations after gastric banding.

Robin Blackstone, the president of the American Society for Metabolic and Bariatric Surgery who practices in Scottsdale, Ariz., explained that gastric banding initially seemed safer than gastric-bypass surgery in the first three months after the procedure. She says the long-term data involving both procedures will help doctors better determine treatment choices for obese patients. "What's important is how effective both procedures are," she says.

Dr. Blackstone said obese patients who don't have underlying diseases like Type 2 diabetes or high blood pressure can be good candidates for gastric-banding procedures while heavier and sicker patients are more likely to benefit from gastric bypass.

The article rings true in our program. We have patients for both and you can see the significant difference. There is now talk that banding will not be covered by our insurance any more because of the low success. I think it can still work with the right person, determination but for me would not have worked as well. Thank for sharing

I am actually shocked that the insurance companies have continued to cover the bands considering their high failrue rate.

Too bad they didn't also study the DS and sleeve. 

~Becky

True. It's obvious though that VSG and DS are MUCH more successful procedures than the band!

 "between March 1998 and May 2005."

I can't imagine there were that many DS or sleeves to study back then.  We were ALL given the option of RNY or Band.

Humm! it is a good news for those people who want to lose their weight instantly so the bypass is a good way for them to lose weight...

I don't consider the 13 months it took me to lose 125 pounds and reach goal an "instant."