Our Summary

This paper is a review of existing research on two types of weight loss surgery: banded Roux-en-Y gastric bypass (BRYGB) and non-banded Roux-en-Y gastric bypass (NBRYGB). The researchers looked at studies from three different databases to compare the results and safety of the two procedures. They found eight studies that met their criteria, which included almost 4,000 patients.

The review found that both types of surgery had similar rates of complications, deaths, and improvement in conditions often linked to obesity, such as type 2 diabetes, high blood pressure, high cholesterol, acid reflux, and sleep apnea. Both surgeries also led to a similar percentage of excess weight loss one and two years after the surgery.

However, the review also found that the banded surgery might lead to more weight loss five years after the surgery. This conclusion should be taken with a grain of salt though because it was based on only two studies.

While this review provides the best evidence we have so far, the authors suggest that more well-designed studies, specifically randomized controlled trials, comparing the two surgeries are needed to better understand their effects.

FAQs

  1. What are the differences between banded (BRYGB) and non-banded Roux-en-Y gastric bypass (NBRYGB)?
  2. What kind of results can be expected from BRYGB and NBRYGB in terms of weight loss and improvement of health conditions?
  3. Are there more well-designed, randomized controlled studies needed to further assess the clinical outcomes of BRYGB and NBRYGB?

Doctor’s Tip

A doctor might tell a patient considering gastric bypass surgery that both banded and non-banded Roux-en-Y gastric bypass procedures have similar rates of complications and overall clinical outcomes. It is important for patients to discuss with their healthcare provider which procedure may be best for their individual needs and goals. Additionally, long-term follow-up studies are needed to fully assess the differences between the two procedures.

Suitable For

Patients with morbid obesity, typically defined as a body mass index (BMI) greater than 40 or a BMI greater than 35 with obesity-related comorbidities, are often recommended gastric bypass surgery. Additionally, patients who have not had success with other weight loss methods such as diet and exercise may also be considered for gastric bypass. Patients with obesity-related conditions such as type 2 diabetes, hypertension, dyslipidaemia, gastroesophageal reflux, and obstructive sleep apnoea may particularly benefit from gastric bypass surgery. However, it is important for patients to undergo a thorough evaluation by a multidisciplinary team of healthcare professionals to determine their suitability for surgery and to discuss the potential risks and benefits.

Timeline

  • Before gastric bypass:
  1. Patient undergoes initial consultation with a healthcare provider to discuss weight loss options.
  2. Patient undergoes extensive medical evaluation to determine candidacy for surgery, including physical exams, blood tests, and psychological evaluations.
  3. Patient attends educational sessions to learn about the risks and benefits of gastric bypass surgery.
  4. Patient follows a pre-operative diet and exercise plan to prepare for surgery.
  • After gastric bypass:
  1. Patient undergoes surgery to have the gastric bypass procedure performed.
  2. Patient stays in the hospital for a few days to recover and receive post-operative care.
  3. Patient follows a strict diet and exercise plan to aid in weight loss and promote healing.
  4. Patient attends regular follow-up appointments with healthcare providers to monitor progress and address any concerns.
  5. Patient experiences significant weight loss and improvement in obesity-related health conditions such as type 2 diabetes, hypertension, and sleep apnea.
  6. Patient continues to make lifestyle changes to maintain weight loss and overall health.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with gastric bypass surgery?
  2. How long is the recovery process after gastric bypass surgery?
  3. What dietary changes will I need to make after surgery?
  4. How much weight can I expect to lose after gastric bypass surgery?
  5. What type of follow-up care will be necessary after surgery?
  6. How will my medications need to be adjusted after surgery?
  7. Will I need to take any supplements or vitamins after surgery?
  8. What are the long-term effects of gastric bypass surgery on my overall health?
  9. How will gastric bypass surgery affect my ability to absorb nutrients?
  10. What support resources are available to help me before and after surgery?

Reference

Authors: Magouliotis DE, Tasiopoulou VS, Svokos KA, Svokos AA, Sioka E, Tzovaras G, Zacharoulis D. Journal: Clin Obes. 2018 Dec;8(6):424-433. doi: 10.1111/cob.12274. Epub 2018 Aug 24. PMID: 30144284