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Weight Loss: Is Bypass Better Than Banding?

Very Obese Bypass Patients in Study Lost More Weight, Kept It Off Longer
WebMD Health News

Jan. 16, 2012 -- Gastric banding doesn’t work as well as gastric bypass surgery, according to a new study in the journal Archives of Surgery.

More than 200,000 weight loss surgeries are performed annually in the U.S. and more people are choosing banding procedures over gastric bypasses. Banding procedures are marketed as a safer and simpler alternative, but new research suggests that it may not achieve better and lasting results.

Over six years of follow-up, obese people who had Roux-en-Y gastric bypass surgeries lost more weight and kept it off longer than people who chose gastric banding.

Although the complication rate was higher in the bypass group immediately following surgery, banding patients had more long-term complications and more surgical failures.

Several surgeons who spoke to WebMD called the study long overdue, while another questioned the conclusion that bypass is the best choice for most patients.

“Bypass surgery is not a miracle treatment and many surgeons do not perform it well,” says Jacques Himpens, MD, of the European School of Laparoscopy in Brussels, Belgium. “Surgical competency is a big issue with Roux-en-Y gastric bypass.” Himpens wrote an editorial of the study.

Banding, Bypass, and Sleeve Gastrectomy

About 15 million Americans are morbidly obese, meaning that they are 50 to 100 pounds over their ideal body weight or have a body mass index (BMI) of 40 or greater.

Over the past two decades, the number of weight loss surgeries performed in the U.S. has increased more than tenfold.

With a Roux-en-Y gastric bypass surgery, the stomach is reduced in size by 90% to 95% -- from that of a football to a golf ball. The surgery also bypasses a section of the small intestine, which limits calorie absorption.

With a gastric banding procedure, the stomach size is restricted with an adjustable ring, or band.

A third type of weight loss surgery, known as a gastric sleeve procedure or sleeve gastrectomy, reduces the size of the stomach through surgery but does not bypass the small intestine.

Obesity and Weight Regain

The new study compared outcomes among severely obese patients who had gastric banding and gastric bypass surgeries.

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