Roux-en-Y gastric bypass and sleeve gastrectomy more effective for achieving ≥50 percent excess weight loss
THURSDAY, April 10, 2025 (HealthDay News) — For adults with severe obesity, Roux-en-Y gastric bypass and sleeve gastrectomy are more effective than adjustable gastric banding, according to a study published online March 31 in The Lancet Diabetes & Endocrinology.
Sanjay Agrawal, M.B.B.S., from Homerton University Hospital in London, and colleagues conducted a pragmatic, randomized controlled trial in 12 U.K. hospitals involving adults meeting national criteria for metabolic and bariatric surgery. Initially, the trial included two arms: Roux-en-Y gastric bypass and adjustable gastric banding, and sleeve gastrectomy was added at 2.6 years after initiation when it became widely available in the United Kingdom.
The analyses included 1,346 participants: 34, 34, and 31 percent in the Roux-en-Y gastric bypass group, adjustable gastric banding group, and sleeve gastrectomy group, respectively. The researchers found that 68, 25, and 41 percent of participants in the Roux-en-Y gastric bypass, adjustable gastric banding, and sleeve gastrectomy groups, respectively, achieved at least 50 percent excess weight loss. The mean EuroQol 5-Dimension utility quality-of-life scores were 0.72 for Roux-en-Y gastric bypass, 0.62 for adjustable gastric banding, and 0.68 for sleeve gastrectomy. Following surgery, there were 1,651 adverse events (6.0, 4.6, and 5.7 per year after Roux-en-Y gastric bypass, adjustable gastric banding, and sleeve gastrectomy, respectively). From random assignment to three years, there were 11 deaths: one attributable to surgery in the adjustable gastric banding group and 10 not attributable to surgery. The most cost-effective approach was Roux-en-Y gastric bypass.
“Future research to understand longer-term outcomes and to compare metabolic and bariatric surgery with obesity management medications is needed to guide evidence-based practice in this rapidly evolving field,” the authors write.
Several authors disclosed ties to relevant organizations.
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