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 .
Beta cell function after weight loss: a clinical trial comparing gastric bypass surgery and intensive lifestyle intervention
Objective The effects of various weight loss strategies on pancreatic beta cell function remain unclear . We aim ed to compare the effect of intensive lifestyle intervention ( ILI ) and Roux-en-Y gastric bypass surgery ( RYGB ) on beta cell function . Design One year controlled clinical trial ( Clinical Trials.gov identifier NCT00273104 ) . Methods One hundred and nineteen morbidly obese participants without known diabetes from the MOBIL study ( mean ( s.d . ) age 43.6 ( 10.8 ) years , body mass index ( BMI ) 45.5 ( 5.6 ) kg/m2 , 84 women ) were allocated to RYGB ( n=64 ) or ILI ( n=55 ) . The patients underwent repeated oral glucose tolerance tests ( OGTTs ) and were categorised as having either normal ( NGT ) or abnormal glucose tolerance ( AGT ) . Twenty-nine normal-weight subjects with NGT ( age 42.6 ( 8.7 ) years , BMI 22.6 ( 1.5 ) kg/m2 , 19 women ) served as controls . OGTT-based indices of beta cell function were calculated . Results One year weight reduction was 30 % ( 8) after RYGB and 9 % ( 10 ) after ILI ( P<0.001 ) . Disposition index ( DI ) increased in all treatment groups ( all P<0.05 ) , although more in the surgery groups ( both P<0.001 ) . Stimulated proinsulin-to-insulin ( PI/I ) ratio decreased in both surgery groups ( both P<0.001 ) , but to a greater extent in the surgery group with AGT at baseline ( P<0.001 ) . Post surgery , patients with NGT at baseline had higher DI and lower stimulated PI/I ratio than controls ( both P<0.027 ) . Conclusions Gastric bypass surgery improved beta cell function to a significantly greater extent than ILI . Supra-physiological insulin secretion and proinsulin processing may indicate excessive beta cell function after gastric bypass surgery
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 .