26 September 2014
Gastric bypass surgery could be the best option for obese patients as it not only helps them lose more weight, but can also help control other factors associated with being severely overweight, such as high blood pressure, according to a new study.
A new review conducted by surgeons at the University of Texas (UT) Southwestern Medical Center has found that undergoing gastric bypass surgery has better outcomes than gastric banding for long-term weight loss. It found that surgery is able to control type 2 diabetes and high blood pressure, as well as lowering cholesterol levels.
Around the world, gastric bypass accounts for nearly half (47 per cent) of weight loss procedures, while gastric bands represent less than a fifth (18 per cent). The team analysed 29 long-term studies comparing the two types of bariatric procedures and published their findings in the Journal of the American Medical Association.
Perhaps most importantly, it found that those having gastric bypass operations lost substantially more weight, shedding 66 per cent of their excess weight on average, compared to the 45 per cent of excess weight lost by those undergoing gastric banding procedures.
However, the figures highlight that there is also a significant difference in the procedures for controlling diabetes. Over two-thirds of gastric bypass patients with type 2 diabetes saw remission of the disease, compared to under a third of those that received a gastric band.
“We know gastric bypass brings more weight loss success and relief of commonly associated illness versus gastric band at one year after surgery. We now have the best evidence available telling us this outcome continues to be true even up to five years after surgery. We also know these procedures maintain their safety profile long-term,” said Dr Nancy Puzziferri, assistant professor of surgery and part of the bariatric surgery team at UT Southwestern.
The research found that patients that underwent gastric bypass surgery were also more likely to see an improvement in cardiovascular problems than those that had gastric banding. Nearly half of patients (48 per cent) with high blood pressure said they no longer had the condition two years after gastric bypass, while just 17 per cent of those that had gastric band procedures could say the same.
Gastric bypass also improved hyperlipidemia, characterised by high levels of cholesterol, triglycerides, and lipoproteins in the blood. More than half of gastric bypass patients reported remission in the studies, compared to around a quarter of gastric band patients.
“The review underscores the importance of thinking about durable treatments, as obesity, type 2 diabetes, hypertension, and elevated cholesterol are chronic illnesses, rather than focusing on short-term results,” Dr Puzziferri said.
Gastric bypass was also more favourable in terms of long-term complication rates, though they were low for both operations. Under three per cent of patients reported such issues after bypass surgery, while it was just under five per cent for banding procedures.
The vast majority (97 per cent) of weight-loss surgery studies track only a small per cent of patients and only for a year after the procedure. The researchers suggested that more research is needed to investigate the long-term outcomes for at least two years after the operation.
Posted by Edward Bartel
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