Bariatric surgery appears efficacious compared to st and ard care in reducing BMI .
Weight losses are greatest with diversionary procedures , intermediate with diversionary/restrictive procedures , and lowest with those that are purely restrictive .
Compared with Roux-en-Y gastric bypass , adjustable gastric b and ing has lower weight loss efficacy , but also leads to fewer serious adverse effects
A prospective randomized comparison of gastric bypass and gastroplasty. Complications and early results.
Fifty-seven morbidly obese patients were r and omized to gastric bypass ( 29 ) or gastroplasty ( 28 ) and observed for 24 months postoperatively . Operating time and hospital stay were longer and peroperative and postoperative complications somewhat more common in the bypass than in the gastroplasty group . But weight loss at 1 year was significantly greater and failures significantly fewer after gastric bypass . Four gastroplasties were converted to bypass after 18 - 24 months because of failure to lose weight .  Gastric bypass was judged to be much the preferable of the two operations . Dumping occurred in some patients with bypass but not after gastroplasty .  Dumping was not associated with greater weight loss . Peroperatively measured pouch volume showed significant correlation with weight loss after gastroplasty , but not after bypass . Peroperative pouch volume and postoperatively measured stoma diameter were co-acting factors , which in multiple regression analysis could explain observed variance in weight loss to about 40 % after gastroplasty , but to a negligible degree after gastric bypass
Bariatric surgery appears efficacious compared to st and ard care in reducing BMI .
Weight losses are greatest with diversionary procedures , intermediate with diversionary/restrictive procedures , and lowest with those that are purely restrictive .
Compared with Roux-en-Y gastric bypass , adjustable gastric b and ing has lower weight loss efficacy , but also leads to fewer serious adverse effects