Weight loss surgery is available on the NHS if: It can lead to significant weight loss and help improve many obesity-related conditions, such as type 2 diabetes or high blood pressure.īut it's a major operation and in most cases should only be considered after trying to lose weight through a healthy diet and exercise. doi: 10.1381/096089206776116543.Weight loss surgery, also called bariatric or metabolic surgery, is sometimes used as a treatment for people who are very obese. Weight reduction after an early version of the open gastric bypass for morbid obesity: results after 23 years. Günther K, Vollmuth J, Weißbach R, Hohenberger W, Husemann B, Horbach T. Long term outcomes after bariatric surgery: fifteen year follow up after gastric banding and a systematic review of the literature. O’Brien P, McDonald L, Anderson M, Brennan L, Brown WA. Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes. Wing RR, Bolin P, Brancati FL, Bray GA, Clark JM, Coday M, Crow RS, Curtis JM, Egan CM, Espeland MA, Evans M, Foreyt JP, Ghazarian S, Gregg EW, Harrison B, Hazuda HP, Hill JO, Horton ES, Hubbard VS, Jakicic JM, Jeffery RW, Johnson KC, Kahn SE, Kitabchi AE, Knowler WC, Lewis CE, Maschak-Carey BJ, Montez MG, Murillo A, Nathan DM, Patricio J, Peters A, Pi-Sunyer X, Pownall H, Reboussin D, Regensteiner JG, Rickman AD, Ryan DH, Safford M, Wadden TA, Wagenknecht LE, West DS, Williamson DF, Yanovski SZ. Why is it difficult to lose and maintain large amounts of weight with lifestyle and pharmacologic treatments? Obesity (Silver Spring) 2017 2017:25. Mechanisms, pathophysiology, and management of obesity. Reoperation is likely to remain common across all procedures.Ģ0-year follow-up Bariatric surgery Long term Meta-analysis Reoperation rates Weight loss. More long-term data are needed for one-anastomosis gastric bypass and sleeve gastrectomy. Reoperation rate was initially high but reduced markedly with improved band and surgical and aftercare techniques.Īll current procedures are associated with substantial and durable weight loss. Weight loss at 20 years (N = 35) was 30.1 kg, 48.9%EWL and 22.2% total weight loss (%TWL). At a single centre, 8378 LAGB patients were followed for up to 20 years with an overall follow-up rate of 54%. Meta-analyses of eligible studies demonstrated comparable results. Eighteen reports of gastric bypass showed a weighted mean of 56.7%EWL, 17 reports of LAGB showed 45.9%EWL, 9 reports of biliopancreatic bypass +/- duodenal switch showed 74.1%EWL and 2 reports of sleeve gastrectomy showed 58.3%EWL. Weighted means of the percentage of excess weight loss (%EWL) were calculated for all papers included in the systematic review. Systematic review identified 57 datasets of which 33 were eligible for meta-analysis. In addition, a prospective cohort study of LAGB patients measuring weight loss and reoperation at up to 20 years is presented. Systematic review with meta-analysis was performed on all eligble reports containing 10 or more years of follow-up data on weight loss after bariatric surgery. We report on durability at and beyond 10 years with a systematic review and meta-analysis of all reports providing data at 10 or more years and a single-centre study of laparoscopic adjustable gastric banding (LAGB) with 20 years of follow-up. Durability is a key requirement for the broad acceptance of bariatric surgery.
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