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
Randomized trial of diet and gastroplasty compared with diet alone in morbid obesity.
We compared the weight-reducing effect of diet and gastroplasty with that of diet alone in a r and omized trial in 60 morbidly obese patients followed for two years . Initial median body weight was 120 kg in patients r and omly assigned to gastroplasty plus diet and 115 kg in those assigned to diet alone .  Maximum weight losses did not differ significantly between the groups ( 26.1 kg in the gastroplasty group and 22.0 kg in the group treated with diet alone , P greater than 0.05 ) . The risk of a Type II error with a true difference larger than 9.5 kg was less than 5 per cent . However , the group treated with diet alone  regained significantly more weight after maximum weight loss had been achieved , so that the gastroplasty group had a more favorable net outcome at two years ( P less than 0.05 )
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