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 .
The By-Band study: gastric bypass or adjustable gastric band surgery to treat morbid obesity: study protocol for a multi-centre randomised controlled trial with an internal pilot phase
Background The prevalence of severe and complex obesity is increasing worldwide and surgery may offer an effective and lasting treatment . Laparoscopic adjustable gastric b and and Roux-en-Y gastric bypass surgery are the two main surgical procedures performed . Design This open parallel-group r and omised controlled trial will compare the effectiveness , cost-effectiveness and acceptability of gastric b and ( B and ) versus gastric bypass ( Bypass ) in adults with severe and complex obesity . It has an internal pilot phase ( in two centres ) with integrated qualitative research to establish effective and optimal methods for recruitment . Adults with a body mass index ( BMI ) of 40 kg/m2 or more , or a BMI of 35 kg/m2 or more and other co-morbidities will be recruited . At the end of the internal pilot the study will exp and into more centres if the pre-set progression criteria of numbers and rates of eligible patients screened and r and omised are met and if the expected rates of retention and adherence to treatment allocation are achieved . The trial will test the joint hypotheses that Bypass is non-inferior to B and with respect to more than 50 % excess weight loss and that Bypass is superior to B and with respect to health related quality of life ( HRQOL , EQ-5D ) at three years . Secondary outcomes include other weight loss measures , waist circumference and remission/resolution of co-morbidities ; generic and symptom-specific HRQOL ; nutritional blood test results ; re source use ; eating behaviours and adverse events . A core outcome set for reporting the results of obesity surgery will be developed and a systematic review of the evidence for sleeve gastrectomy undertaken to inform the main study design . Discussion By-B and is the first pragmatic study to compare the two most commonly performed bariatric surgical procedures for severe and complex obesity . The design will enable and empower surgeons to learn to recruit and participate in a r and omised study . Early evidence shows that timely recruitment is possible . Trial registration Current Controlled Trials IS RCT N00786323
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 .