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 .
Bariatric surgery versus conventional medical therapy for type 2 diabetes.
BACKGROUND Roux-en-Y gastric bypass and biliopancreatic diversion can markedly ameliorate diabetes in morbidly obese patients , often result ing in disease remission . Prospect i ve , r and omized trials comparing these procedures with medical therapy for the treatment of diabetes are needed . METHODS In this single-center , nonblinded , r and omized , controlled trial , 60 patients between the ages of 30 and 60 years with a body-mass index ( BMI , the weight in kilograms divided by the square of the height in meters ) of 35 or more , a history of at least 5 years of diabetes , and a glycated hemoglobin level of 7.0 % or more were r and omly assigned to receive conventional medical therapy or undergo either gastric bypass or biliopancreatic diversion . The primary end point was the rate of diabetes remission at 2 years ( defined as a fasting glucose level of < 100 mg per deciliter [ 5.6 mmol per liter ] and a glycated hemoglobin level of < 6.5 % in the absence of pharmacologic therapy ) . RESULTS At 2 years , diabetes remission had occurred in no patients in the medical-therapy group versus 75 % in the gastric-bypass group and 95 % in the biliopancreatic-diversion group ( P<0.001 for both comparisons ) . Age , sex , baseline BMI , duration of diabetes , and weight changes were not significant predictors of diabetes remission at 2 years or of improvement in glycemia at 1 and 3 months . At 2 years , the average baseline glycated hemoglobin level ( 8.65±1.45 % ) had decreased in all groups , but patients in the two surgical groups had the greatest degree of improvement ( average glycated hemoglobin levels , 7.69±0.57 % in the medical-therapy group , 6.35±1.42 % in the gastric-bypass group , and 4.95±0.49 % in the biliopancreatic-diversion group ) . CONCLUSIONS In severely obese patients with type 2 diabetes , bariatric surgery result ed in better glucose control  than did medical therapy . Preoperative BMI and weight loss did not predict the improvement in hyperglycemia after these procedures . ( Funded by Catholic University of Rome ; Clinical Trials.gov number , NCT00888836 . )
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 .