Surgery results in greater improvement in weight loss outcomes and weight associated comorbidities compared with non-surgical interventions , regardless of the type of procedures used .
When compared with each other , certain procedures result ed in greater weight loss and improvements in comorbidities than others .
Outcomes were similar between RYGB and sleeve gastrectomy , and both of these procedures had better outcomes than adjustable gastric b and ing .
For people with very high BMI , biliopancreatic diversion with duodenal switch result ed in greater weight loss than RYGB .
Isolated sleeve gastrectomy led to better weight-loss outcomes than adjustable gastric b and ing after three years follow-up .
BACKGROUND Bariatric ( weight loss ) surgery for obesity is considered when other treatments have failed .
The effects of the available bariatric procedures compared with medical management and with each other are uncertain .
This is an up date of a Cochrane review first published in 2003 and most recently up date d in 2009 .
OBJECTIVES To assess the effects of bariatric surgery for overweight and obesity , including the control of comorbidities .
Myocardial oxygen consumption change predicts left ventricular relaxation improvement in obese humans after weight loss.
Obesity adversely affects myocardial metabolism , efficiency , and diastolic function . Our objective was to determine whether weight loss can ameliorate obesity-related myocardial metabolism and efficiency derangements and that these improvements directly relate to improved diastolic function in humans . We studied 30 obese ( BMI > 30 kg/m2 ) subjects with positron emission tomography ( PET ) ( myocardial metabolism , blood flow ) and echocardiography ( structure , function ) before and after marked weight loss from gastric bypass surgery ( N = 10 ) or moderate weight loss from diet ( N = 20 ) .  Baseline BMI , insulin resistance , hemodynamics , left ventricular ( LV ) mass , systolic function , myocardial oxygen consumption ( MVO2 ) , and fatty acid ( FA ) metabolism were similar between the groups . MVO2/g decreased after diet-induced weight loss ( P = 0.009 ) . Total MVO2 decreased after dietary ( P = 0.02 ) and surgical weight loss ( P = 0.0006 ) and was related to decreased BMI ( P = 0.006 ) . Total myocardial FA utilization decreased ( P = 0.03 ) , and FA oxidation trended lower ( P = 0.06 ) only after surgery . FA esterification and LV efficiency were unchanged . After surgical weight loss , LV mass decreased by 23 % ( Doppler-derived ) E/E ' by 33 % , and relaxation increased ( improved ) by 28 % . Improved LV relaxation related significantly to decreased BMI , insulin resistance , total MVO2 , and LV mass but not FA utilization . Decreased total MVO(2 ) predicted LV relaxation improvement independent of BMI change ( P = 0.02 ) . Weight loss can ameliorate the obesity-related derangements in myocardial metabolism and LV structure and diastolic function . Decreased total MVO2 independently predicted improved LV relaxation , suggesting that myocardial oxygen metabolism may be mechanistically important in determining cardiac relaxation
Surgery results in greater improvement in weight loss outcomes and weight associated comorbidities compared with non-surgical interventions , regardless of the type of procedures used .
When compared with each other , certain procedures result ed in greater weight loss and improvements in comorbidities than others .
Outcomes were similar between RYGB and sleeve gastrectomy , and both of these procedures had better outcomes than adjustable gastric b and ing .
For people with very high BMI , biliopancreatic diversion with duodenal switch result ed in greater weight loss than RYGB .
Isolated sleeve gastrectomy led to better weight-loss outcomes than adjustable gastric b and ing after three years follow-up .
BACKGROUND Bariatric ( weight loss ) surgery for obesity is considered when other treatments have failed .
The effects of the available bariatric procedures compared with medical management and with each other are uncertain .
This is an up date of a Cochrane review first published in 2003 and most recently up date d in 2009 .
OBJECTIVES To assess the effects of bariatric surgery for overweight and obesity , including the control of comorbidities .