Bariatric surgery appears efficacious compared to st and ard care in reducing BMI .
Weight losses are greatest with diversionary procedures , intermediate with diversionary/restrictive procedures , and lowest with those that are purely restrictive .
Compared with Roux-en-Y gastric bypass , adjustable gastric b and ing has lower weight loss efficacy , but also leads to fewer serious adverse effects
Vertical banded gastroplasty or gastric banding for morbid obesity: effects on gastro-oesophageal reflux.
OBJECTIVE To assess the effect of vertical b and ed gastroplasty and gastric b and ing on the development of  gastro-oesophageal reflux  using both subjective and objective methods . DESIGN Prospect i ve , r and omised study . SETTING Teaching hospital , Sweden . SUBJECTS 50 consecutive , morbidly obese patients ( mean ( SD ) body mass index ( BMI ) 42.5 ( 5 ) , 27 women and 23 men ; mean age 48 years , range 38 - 57 years ) . INTERVENTIONS Vertical b and ed gastroplasty ( n = 24 ) or gastric b and ing ( n = 26 ) . MAIN OUTCOME MEASURES Results of evaluation by st and ardised question naire , 24-hour ambulatory pH-metry , and endoscopy . RESULTS After six months the mean ( SD ) BMI had decreased to 34.4 ( 5.7 ) , with no differences between the groups . Mild dysphagia was somewhat more common ( 13 compared with 1 ) but the incidence of heartburn ( 8 compared with 17 ) , and acid regurgitation ( 12 compared with 14 ) were less after the operation ; 3 patients developed erosive oesophagitis , two in the vertical b and ed group and one in the b and ing group . Ambulatory pH-metry readings did not change significantly from preoperatively and there were no differences between the two operations . One patient developed pathological reflux , and in three the values returned to the normal range . CONCLUSION Gastric restriction operations including those with a narrow stoma that causes outflow obstruction do not seem to increase the incidence of reflux in patients with functioning antireflux barriers
Bariatric surgery appears efficacious compared to st and ard care in reducing BMI .
Weight losses are greatest with diversionary procedures , intermediate with diversionary/restrictive procedures , and lowest with those that are purely restrictive .
Compared with Roux-en-Y gastric bypass , adjustable gastric b and ing has lower weight loss efficacy , but also leads to fewer serious adverse effects