Gastric Bypass or Sleeve Gastrectomy: Which Has Better Outcomes?

Gastric bypass is better for controlling diabetes and losing weight; hepatic effects are similar.

Benefits of bariatric surgery (e.g., longer life expectancy, diabetes remission) have been well documented (NEJM JW Gen Med Jul 1 2021 and Lancet 2021; 397:1830; NEJM JW Gen Med Mar 15 2021 and Lancet 2021; 397:293), but whether any particular bariatric procedure is most beneficial has not been established. Norwegian investigators randomized 109 patients with obesity (average body-mass index, 42 kg/m²) and type 2 diabetes to receive either Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG).

At 1 year, diabetes remission (glycosylated hemoglobin [HbA_1c] ≤6% without glucose-lowering medications) was significantly more common in patients who received RYGB than SG (74% vs. 47%; number needed to treat, 4), and antidiabetes medication use …

Reviewing Author

Daniel D. Dressler, MD, MSc, MHM, FACP

Disclosures

RoyaltiesMcGraw-Hill; Elsevier

Editorial BoardsMedical Clinics of North America; Caribbean Medical Journal International Advisory Panel (2021–2026)

Daniel D. Dressler, MD, MSc, MHM, FACP

Disclosures

RoyaltiesMcGraw-Hill; Elsevier

Editorial BoardsMedical Clinics of North America; Caribbean Medical Journal International Advisory Panel (2021–2026)

Gastric Bypass or Sleeve Gastrectomy: Which Has Better Outcomes?

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Reviewing Author