The U.S. National Institutes of Health recommends bariatric surgery for obese people with a body mass index (BMI) of at least 40, and for people with BMI 35 and serious coexisting medical conditions such as diabetes. While research indicates that bariatric surgery is an effective method for weight loss, the data are sparse regarding long term efficacy or sustainability of weight loss obtained through surgical means. Data released in the latest issue of JAMA Surgery, now provide evidence that Roux-en-Y gastric bypass (RYGB) is associated with significant and sustained long-term weight loss.
Researchers from the Durham Veterans Affairs (VA) Medical Center and Duke University, reviewed electronic medical records (EMR) from the VA database to evaluate 1787 veterans who had undergone bariatric surgery against 5303 severely obese veterans who didn’t have surgery. Ten year post op outcomes showed:
*Table adapted from Medscape
Additional results indicated:
- Only 3% of RYGB patients regained weight to within 5% of their baseline weight as compared to 55.5% of the nonsurgical cohort
- Patients who underwent RYGB lost significantly more of their baseline weight than did the nonsurgical patients (29% vs. 7%)
- RYGB was associated with the greatest percentage of weight loss 4 years’ post-op (28%), compared with 11% for adjustable gastric banding (AGB) and 18% for sleeve gastrectomy (SG)
- Though SG is now the most common bariatric surgery in the US, it is still a relatively new procedure and 10 year data are yet to be achieved
Why is this clinically significant?
With the obesity epidemic, bariatric surgery is an increasingly common intervention for weight loss. However the question often remained whether a surgical procedure could result in sustained outcomes. The results of this study strongly support the benefits of bariatric surgery as weight loss option for the obese patient and mitigate the commonly held belief that all bariatric surgery patients rapidly regain their weight.
 Robinson, MK. N Engl J Med. 2009 Jul 30;361(5):520-1
 Maciewjewski ML, Arterburn DE, Van Scovoc L et.al JAMA Surg. 2016 Aug 31. doi: 10.1001/jamasurg.2016.2317