Long-term weight-loss seen with gastric bypass
Benefits of Roux-en-Y procedure persist for 12 years, on average, study shows
12 years – that’s how long benefits persist from the Roux-en-Y gastric-bypass weight-loss surgery, according to results of a multi-site U.S. study published recently in the New England Journal of Medicine.
The procedure reduced diabetes, lowered blood pressure and cholesterol levels, and, most importantly, helped patients keep the weight off: 27 percent, on average.
“It doesn’t surprise me because gastric bypass is the gold-standard in weight-loss surgery,” said Dr. Judy Chen, a UW Medicine general surgeon fellowship-trained in minimally invasive and bariatric surgery, and board-certified in obesity medicine.
Practically speaking, people who want to lose weight via surgery have two options: gastric bypass and the sleeve gastrectomy. A third option, adjustable gastric banding, has fallen out of favor in the past decade, Chen said, marked by less-favorable outcomes.
Between the two more viable options, physicians make recommendations based on a patient’s health and goals. Bypass results in the loss of one-third of total body weight, on average. With sleeve gastrectomy, it’s one-fourth, on average, she said.
Patient comorbidities also can indicate the better approach. For instance, when Crohn’s disease is involved, sleeve gastrectomy is better to minimize the risk of fistulas and strictures, Chen said. But gastric bypass better serves a patient who has significant reflux because the surgery removes the potential for acid and bile to travel upward.
A bypass usually takes a bit over two hours, whereas a sleeve operation can be done in less than an hour – and because it involves no reconnecting of structures (as with bypass), there is less risk of complication for the patient. Both procedures are done via minimally invasive laparoscopic surgery.
Email Brian Donohue to interview Dr. Chen or her colleague Dr. Saurabh Khandelwal about bariatric surgery.