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 .
Evaluating the cost-effectiveness of laparoscopic adjustable gastric banding versus standard medical management in obese patients with type 2 diabetes in the UK.
AIM To evaluate the cost-effectiveness of laparoscopic adjustable gastric b and ing ( LAGB ) versus st and ard medical management ( SMM ) in obese patients with type 2 diabetes from a UK healthcare payer perspective . METHODS A vali date d computer model of diabetes was used to project outcomes reported from a r and omized clinical trial of LAGB versus SMM in obese patients with type 2 diabetes . Two-year follow-up data from the trial were projected over a 40-year time horizon and cost-effectiveness was assessed from the perspective of the National Health Service . Future costs and clinical outcomes were discounted at 3.5 % annually and all costs were reported in 2010 pounds sterling . A series of sensitivity analyses were performed . RESULTS LAGB was associated with benefits in HbA1c , systolic blood pressure , body mass index and serum lipid concentrations , which led to significant increases in discounted life expectancy ( an increase of 0.64 years ) and quality -adjusted life expectancy ( an increase of 0.92 quality -adjusted life years , QALYs ) and reduced incidence of diabetes complications relative to SMM . Treatment costs in the LAGB arm increased by 4552 Great British Pounds ( GBP ) , but this was partially offset by cost savings result ing from a reduction in the incidence of all modelled diabetes complications . The incremental cost-effectiveness ratio of GBP 3602 per QALY in the base case fell well below commonly quoted willingness-to-pay thresholds in the UK setting . CONCLUSIONS On the basis of data from a recent r and omized controlled trial , LAGB is likely to be considered cost-effective from the healthcare payer perspective when compared with SMM of obesity in patients with type 2 diabetes in the UK setting
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 .