A study published Online First by Archives of Surgery compared the effectiveness of two common forms of treatment for excessive weight gain: Roux-en-Y gastric bypass (RYGBP) and gastric banding (GB). The researchers found that for more sustainable and rapid weight loss, RYGBP is the better form of treatment.
Sebastien Romy, M.D., of Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland, and colleagues, comment that although early morbidity is higher among patients receiving RYGBP, there were significantly fewer long-term complications and re-operations, compared to those receiving GB.
"At the present time, RYGBP seems clearly superior to GB when treating morbidly obese patients, who should be informed accordingly."
The percentage of people who are morbidly obese has shot up over the past two decades. A recent survey shows that the number of bariatric procedures has increased drastically, more than doubling between 2003 and 2008. Of these procedures, in the U.S there was a much greater increase for GB than RYGBP. This is likely due to marketing campaigns and the thought that GB is a "simple and safer" procedure.
The study observed 442 patients, half of whom received GB treatment, whilst the other half received RYGBP treatment. The two groups were balanced in accordance to age, sex, and body mass index (BMI). The study period was six years long and had a follow-up rate of 92.3 percent.
Results taken after the six years showed that the percentage of failures (BMI above 35 or reversal of the procedure/conversion) in the GB group was 48.3 percent, compared to only 12.3 percent in the RYGBP group. Those in the GB group were also more likely to face reoperations (26.7 percent compared to 12.7 percent) and long-term complications (41.6 percent compared to 19 percent).
In relation to the treatment of other comorbidities - other existing illnesses among the patients - RYBGP was also found to be more successful. Cholesterol levels in those who received GB remained unchanged, but those who received RYBGP saw a notable decrease. The lipid profile for those after RYGBP was "significantly better" after five years than for those in the GB group, as well as a lower mean fasting glucose level.
The researchers note:
"On the basis of our results and the analysis of the literature, we conclude that RYGBP provides better, more rapid, and more sustained weight loss, resulting in better correction of comorbidities than GB,"
They comment the need for there to be a larger study with a longer follow-up to confirm their findings.