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Severely Obese Patients Have More Weight Loss With Gastric Bypass Surgery

July 17, 2006 -- Gastric bypass may work better, with fewer complications, than gastric banding for severely obese patients, doctors report in the Archives of Surgery.

That finding comes from Wilbur Bowne, MD, and colleagues. Bowne works in the surgery department at The State University of New York's Health Science Center of Brooklyn, N.Y.

Bowne's team studied 106 people who either got gastric bypass or gastric banding surgery. Both procedures are designed to make people eat less by limiting the amount of food the stomach can hold.

All the patients were extremely obese. Their BMI (body mass index, which relates height to weight) was greater than 50. That's 20 points higher than the BMI cutoff for obesity.

About the Operations

Both operations were done through small abdominal incisions, a technique called laparoscopy.

During the gastric bypass operation, the surgeon creates a smaller stomach pouch that holds less food than a normal stomach. The food passes from the pouch, bypassing part of the small intestine, to the rest of the digestive system.

During the gastric banding procedure, the surgeon places an adjustable band around the stomach, creating two small compartments.

Before and After Surgery

Here are details on the patients before surgery:

  • Average age: about 42 years
  • Average BMI: about 56
  • Average weight before their procedure: 330-346 pounds
  • Average amount of excess weight: nearly 200 pounds

The patients, most of whom were women, had their choice of gastric bypass or gastric banding. They got presurgery checkups and counseling about each procedure's risks.

Sixty patients chose gastric banding; the other 46 chose gastric bypass. One surgeon performed all the operations.

The researchers tracked the patients for an average of 16 months.

The gastric bypass group showed several advantages:

  • Greater weight loss: BMI dropped by 26 with gastric bypass, 10 with gastric banding.
  • Bigger drop in cases of type 2 diabetesand sleep apnea-- two obesity-linked conditions.
  • Fewer postsurgery complications.
  • Greater patient satisfaction.

The study only included people who were extremely obese, so it's not clear if the results would apply to people who want to lose less weight.

And the results don't mean gastric banding is ineffective. In fact, the researchers write that both operations yielded "satisfactory" weight loss.

The study also doesn't mean gastric bypass is risk-free. Both procedures have serious risks. The study was too short to track longevity effects, the researchers note.

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