Roux-en-Y Gastric Bypass and Sleeve Gastrectomy Are Superior to Medical Management for Weight Loss and Diabetes Remission

Data on long-term outcomes of surgical management of obesity are becoming available. Five studies were published in a recent theme issue of the Journal of the American Medical Association.

Bariatric surgery, mostly Roux-en-Y gastric bypass, was assessed in two observational cohort studies. In a study from Norway, investigators followed 1888 morbidly obese adults (mean body-mass index [BMI], 44 kg/m²) for a median 6.5 years. About half of the patients voluntarily chose surgery (almost all gastric bypass), and the rest were managed medically. Surgical patients experienced significant reductions in prevalence of hypertension (from about 50% to 30%), diabetes (30% to 10%), and dyslipidemia (25% to 10%) compared with slight increases in all measu…