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 .
Clinical Improvement After Duodenojejunal Bypass for Nonobese Type 2 Diabetes Despite Minimal Improvement in Glycemic Homeostasis
Background Glycemic control of type 2 diabetes mellitus ( T2DM ) remains a dilemma to physicians . Although gastric bypass surgery undertaken for morbid obesity has been shown to resolve this disease well , data on the effectiveness of duodenojejunal bypass in improving or resolving T2DM and the metabolic syndrome ( MS ) , especially in nonobese patients are scarce . This study was intended to evaluate the clinical effects of laparoscopic duodenojejunal bypass ( LDJB ) in patients with T2DM and a body mass index of < 35 kg/m2 . Methods We conducted a 12-month prospect i ve study on the changes in glucose homeostasis and the MS in seven T2DM subjects undergoing LDJB with similar DM duration , type of DM treatment , and glycemic control . Laboratory values including glycosylated hemoglobin A ( HbA1c ) , fasting blood glucose , cholesterol , triglyceride , and C-peptide were followed throughout the 12 months .  Serum levels of gastric inhibitory peptide and ghrelin were followed for 1 month .  Serum levels of gastrin and glucagon-like peptide were followed for 3 months . Results At 12 months after surgery , all subjects consistently felt relief from fatigue , pain and /or numbness in the extremities , polyuria , and polydypsia . Clinical resolution was obtained for one patient , and the preoperative diabetic medication requirements decreased for most of the other patients . The subjects demonstrated an overall improved HbA1c ( from 9.4 % to 8.5 % ) and fasting blood glucose level ( from 209 to 154 mg/dl ) . Although the change in fasting blood glucose approached statistical significance , these measures of glucose homeostasis did not achieve significance . Cholesterol and triglycerides increased slightly , and C-peptide decreased slightly over 1 year . These changes were not statistically significant . Conclusions Although this is a small series , our data show that at 12 months after surgery , clinical improvement was obvious in all of our seven patients , but LDJB may not be effective at inducing remission of T2DM and the MS in certain patients undergoing this operation . This suggests that larger patient studies should be conducted , before concluding that surgery may offer clinical and biochemical resolution to a disease once treated only medically . Longer follow-up is required for better evaluation
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 .