Gastric bypass surgery appears to provide longer-lasting weight loss than gastric banding, according to findings published earlier this week in Archives of Surgery. As USA Today reported, the study followed more than 400 patients in Switzerland for six years. Some of the participants underwent gastric bypass surgery while others had a band placed around part of their stomachs to reduce its size. Study results (subscription required) showed that bypass patients lost more weight faster, had consistently lower cholesterol levels and, in the long-term, had fewer complications.
Below John Morton, MD, MPH, associate professor of surgery and director of bariatric surgery at Stanford Hospital & Clinics, discusses the findings and what patients should consider when determining if such procedures are right for them.
From your perspective, what is the significance of these findings?
This study was not a randomized trial so you have to take that into account. The patients are self-selecting and they may choose to have the bypass because they know they won’t do well with the band, or vice-versa. So you have to take these findings with a grain of salt.
The study presents findings that we are already pretty familiar with, which is that bypass results in more effective weight loss and changes in cardiac risk factors such as lowering cholesterol. But, overall, the findings are still important because the study has good size numbers, was completed by an experienced group and supports past data showing bypass patients lose more weight.
My opinion is that we need to do a randomized trial comparing these two procedures to provide a clearer picture. I wish we could do such a study. But, unfortunately, the funding just isn’t available for such randomized surgical trials so we have to rely on comparative studies like these.
What should patients consider when contemplating having one of these surgical procedures?
For patients with a body mass index of 35 or greater, surgery can be a good option because once you get to a certain weight it can be very difficult to lose it on your own. I’d encourage people who fall into this category to do a couple of things. First, they should review Stanford's Bariatric and Metabolic Interdisciplinary Clinic website, which has information about treatment options, resources and patient stories.
Secondly, I'd encourage them to choose an institution that has been recognized as a Center of Excellence because that really is like the Good Housekeeping seal of approval. There are a lot of places advertising gastric banding procedures directly to consumers and these establishments may or may not have the best quality. The easiest way to figure out if they are a quality center is to determine if they are a Center of Excellence. Beyond selecting where to receive treatment, patients need to be motivated. Surgery is just a tool.
Previously: Study finds family members of weight-loss-surgery patients also shed pounds, Study hints at benefits of weight-loss surgery for less obese patients and Bariatric surgery may help protect teen patients’ hearts
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