Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2018 Oct;164(4):774-783.
doi: 10.1016/j.surg.2018.06.008. Epub 2018 Aug 20.

Long-term weight change and health outcomes for sleeve gastrectomy (SG) and matched Roux-en-Y gastric bypass (RYGB) participants in the Longitudinal Assessment of Bariatric Surgery (LABS) study

Bestoun Ahmed  1 , Wendy C King  2 , William Gourash  3 , Steven H Belle  4 , Amanda Hinerman  2 , Alfons Pomp  5 , Greg Dakin  5 , Anita P Courcoulas  3
Affiliations
Observational Study

Long-term weight change and health outcomes for sleeve gastrectomy (SG) and matched Roux-en-Y gastric bypass (RYGB) participants in the Longitudinal Assessment of Bariatric Surgery (LABS) study

Bestoun Ahmed et al. Surgery. 2018 Oct.

Abstract

Background: Data from a US multicenter longitudinal study of bariatric surgery were used to compare weight change (primary outcome) and comorbidities (secondary outcome) in patients who underwent sleeve gastrectomy versus Roux-en-Y gastric bypass.

Methods: This study includes participants who underwent sleeve gastrectomy and matched participants who underwent Roux-en-Y gastric bypass from the Longitudinal Assessment of Bariatric Surgery-2 (LABS-2) study. Adults undergoing initial bariatric surgical procedures between 2006 and 2009 were enrolled. Participants who underwent sleeve gastrectomy were high-risk or superobese and intended to have a second-stage procedure. Mixed models were used to evaluate percent weight change from baseline through 7 years, and diabetes, dyslipidemia, and hypertension prevalence through 5 years.

Results: Fifty-seven of 59 participants who underwent sleeve gastrectomy were matched one to one. Most were female (68%) and white (81%), and had a median age of 49 (37-56) years and median body mass index of 56.4 (35.5-76.8) kg/m2 presurgery. Weight loss was significantly less 1 to 7 years after sleeve gastrectomy versus matched Roux-en-Y gastric bypass (eg, year 7 mean weight loss was 23.6% vs 30.4%, respectively; P = .001). For both surgical groups, prevalence of diabetes, low high-density lipoprotein, and hypertension were significantly (P < .05) lower 5 years postsurgery versus baseline.

Conclusion: Higher-risk or super-obese participants after sleeve gastrectomy lost less weight than did matched Roux-en-Y gastric bypass counterparts throughout 7 years. Both groups exhibited improvements in comorbidities from presurgery through 5 years.

PubMed Disclaimer

Conflict of interest statement

CONFLICT OF INTEREST

Dr. Pomp receives speaker honoraria form WL Gore & associates, Ethicon and Medtronics., Drs. King, Belle and Dakin and Ms. Hinerman have nothing to disclose.

Figures

Figure 1.
Figure 1.. Observed and Modeled Percent Weight Change Following Sleeve Gastrectomy and Roux-en-Y Gastric Bypass
Abbreviations: IQR, interquartile range. Lines indicate modeled weight change based on mixed models with the matched pair as random effects. Data markers, median values; bars, interquartile range=25th-75th percentile of observed data. Negative value indicates weight loss from baseline. The difference between procedures was calculated as SG minus RYGB. aData was censored during pregnancies and following a participants’ second stage bariatric procedure or the second state procedure of a participant’s match. Data collection ended before the 7-year assessment of 18 SG and 12 RYGB participants.
Figure 2.
Figure 2.. Modeled Prevalence of Comorbid Conditions by Time Point in Relation to Sleeve Gastrectomy and Roux-en-Y Gastric Bypass, Respectively.
Abbreviations: HDL, high-density lipoprotein cholesterol, LDL=Low-density lipoprotein. Lines indicate modeled prevalence, bars, 95% CI, based on mixed models.
See this image and copyright information in PMC

Comment in

  • Discussion.
    [No authors listed] [No authors listed] Surgery. 2018 Oct;164(4):782-783. doi: 10.1016/j.surg.2018.06.049. Surgery. 2018. PMID: 30244905 No abstract available.

References

    1. Mechanick JI, Youdim A, Jones DB, Garvey WT, Hurley DL, McMahon MM, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient−−2013 update: cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery. Obesity. 2013;21 Suppl 1:S1–27. - PMC - PubMed
    1. Brethauer SA, Kothari S, Sudan R, Williams B, English WJ, Bregman M, et al. Systematic review on reoperative bariatric surgery American Society for Metabolic and Bariatric Surgery Revision Task Force. SOARD. 2014. - PubMed
    1. Clinical Issues Committee of the American Society for M, Bariatric S. Updated position statement on sleeve gastrectomy as a bariatric procedure. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery. 2010;6(1):1–5. - PubMed
    1. Cottam D, Qureshi FG, Mattar SG, Sharma S, Holover S, Bonanomi G, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc. 2006;20(6):859–63. - PubMed
    1. Committee ACI. Updated position statement on sleeve gastrectomy as a bariatric procedure. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery. 2012;8(3):e21–6. - PubMed

Publication types