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 .
A controlled clinical trial of the effect of gastric bypass surgery and intensive lifestyle intervention on nocturnal hypertension and the circadian blood pressure rhythm in patients with morbid obesity.
BACKGROUND Nocturnal hypertension , increased night-to-day systolic blood pressure ( BP ) ratio and nondipper status ( night-to-day systolic BP ratio > 0.9 ) are associated with an increased risk of cardiovascular disease . Our aim was to compare the 1-year effect of Roux-en-Y gastric bypass ( RYGB ) versus a program of intensive lifestyle intervention ( ILI ) only on nocturnal hypertension and circadian BP rhythm . METHODS The study participants were part of a 1-year , controlled clinical trial comparing the effect of RYGB or ILI on obesity-related comorbidities . Ninety participants ( 49 in the RYGB group ) successfully completed 24-hour ambulatory BP monitoring  at baseline and follow-up and were eligible subsequently for analysis . RESULTS A total of 71 subjects ( 79 % ) had nocturnal hypertension at baseline . The number of subjects with nocturnal hypertension decreased from 42 to 14 in the RYGB group ( P ≤ .001 ) and from 29 to 27 ( P = .791 ) in the ILI group . Subjects in the RYGB group had a lesser adjusted odds ratio ( OR ) of nocturnal hypertension at follow-up ( OR 0.15 ; 95 % confidence interval , 0.05 - 0.42 ; P ≤ .001 ) ; however , after further adjustment for weight loss , there was no additional beneficial effect of RYGB ( P = .674 ) . No differences between groups regarding improvement in the night-to-day systolic BP ratio were found after adjustment for 24-hour systolic pressure ( P = .107 ) . Both interventions showed a decrease in the proportion of subjects classified as nondippers , namely , 44 % ( P ≤ .001 ) and 28 % ( P = .002 ) in the RYGB and ILI groups , respectively . CONCLUSION Only RYGB was associated with a decrease in the prevalence of nocturnal hypertension . Both interventions showed an improvement in dipper status , although RYGB was more effective
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 .