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Gastric Bypass Surgery Provides Long-term Health Benefits

In one of the first of its kind, a long-term, observational study of outcomes from gastric bypass, a form of bariatric surgery, has shown durability of weight loss and effective remission and prevention of type 2 diabetes in U.S. adults for more than a decade. More than 800 participants with severe obesity who sought to undergo “Roux-en-Y” gastric bypass at a bariatric surgical center were studied. Of the participants who sought bariatric surgery, half of them proceeded with the operation, and half initially did not, although some of those individuals had surgery at a later time. The researchers also recruited a group of more than 300 people with severe obesity who were not seeking surgery, as another control group for the study. The study included women and men; a majority of the participants were women. The investigators conducted clinical examinations of participants upon enrollment, and 2, 6, and 12 years later to assess weight and to determine the presence of type 2 diabetes, high blood pressure, and a disorder marked by abnormal amounts of fat in the bloodstream called “dyslipidemia.” Remarkably, most of the participants took part in follow-up exams at the 12-year mark. Of these, 388 people had sought and undergone bariatric surgery. Their health outcomes were compared with data from participants who did not have surgery, including 217 individuals who originally sought but did not undergo surgery, and 262 who had not sought surgery.

Previously, the investigators reported that participants who underwent bariatric surgery lost significantly more weight than people who did not at the 2-year mark and at 6 years after surgery. Although the participants who had surgery, on average, gained back some of the weight, at 12 years after the surgery, more than 70 percent of these participants maintained greater than 20 percent of the weight loss, and 40 percent maintained greater than 30 percent weight loss. Additionally, on average, the surgery participants’ weight remained stable between the 6- and 12-year follow-up exams. Those who did not have bariatric surgery did not lose weight. Moreover, among participants who had type 2 diabetes at the study’s onset, those who had surgery were significantly more likely to experience remission than those who did not have surgery, especially if the diabetes had not progressed to the point of needing medication prior to the surgery. The investigators also observed a reduction--by more than 90 percent--of new-onset type 2 diabetes at 12 years among people who had the surgery.

Finally, when the researchers assessed other obesity-related conditions in the participants, they found a significant reduction in the occurrence of both high blood pressure and dyslipidemia in people who underwent bariatric surgery compared to those who sought out the surgery but did not receive it. Although the overall effects of the surgery were of strong benefit, there were 7 suicide deaths, all in people who had surgery; this finding highlights the need for greater attention to patients’ psychological health before and after surgery.

The results from this first U.S.-based, 12-year, observational study of bariatric surgery in adults indicate long-term durability of weight loss after “Roux-en-Y” gastric bypass. Moreover, the weight loss was associated with improvement and prevention of type 2 diabetes and obesity-related cardiovascular conditions.

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