For diabetes resolution, BPD/duodenal switch is most effective. Diabetes reversal: 76.8% of diabetic patients have resolution (Of 1000 …
Bariatric Surgery for Morbid Obesity
Summary of Findings
1 Who benefits most from bariatric surgery?
Carefully selected persons who have a BMI of 35 or more with a serious
comorbidity such as diabetes, or have a BMI of 40 or more Those
with diabetes may benefit most if they have mild diabetes, have had it
for a shorter period of time, and lose relatively a lot of weight
after surgery
2 Are some types of surgery more effective?
The National Institutes for Health endorse RYGB and VGB RYGB seems to
be more commonly performed Gastric bypass such as RYGB produces
more weight loss than gastroplasty such as VGB Different types of
surgery are more effective for different outcomes For diabetes
resolution, BPD/duodenal switch is most effective Hyperlipidemia:
BPD/duodenal switch Hypertension: RYGB Sleep apnea: RYGB RYGB had
twice as many deaths after surgery compared to BPD/duodenal switch in
the review that compared them
3 What are the main benefits of bariatric surgery?
Weight loss: Average of 44 lbs up to 8 years after surgery
Diabetes
reversal: 768 of diabetic patients have resolution Of 1000
patients, 190 will have diabetes and of these, 146 will be cured of
diabetes
Diabetes prevention: Reduced incidence of new diabetes Of 1000
patients, 40 will get diabetes after surgery compared to 190 of 1000
similar patients who did not have surgery
Hyperlipidemia: More than 70 improved Of 1000 patients, 356 will
have dyslipidemia and of these, 249 will be able to reduce or stop
medication
Hypertension: 617 of patients with hypertension have resolution Of
1000 patients, 354 will have hypertension and of these, 218 will be
cured of hypertension
Sleep apnea: 857 resolved Of 1000 patients, 196 will have sleep
apnea and of these, 168 will have resolution
Health care visits and hospitalizations: Decreased, according to a
recent cohort study
Mortality improvement: Fewer may die with surgery vs similar persons
without surgery
4 What are the risks of bariatric surgery?
Unclear Overall rate of death after surgery 0 - 5 Of 1000
patients, up to 50 may die, although most estimates are closer to 15
Complications
after surgery are common, probably occurring in 10 -
20 Of 1000 patients, up to 200 will have complications Most
complications are mild and respond to conservative treatment
5 What influences these risks?
Less chance of death if surgery is performed by a surgeon experienced
in bariatric surgery In 1000 patients, of those operated on by a
surgeon who performed 20 or fewer procedures, 50 will die In 1000 who
were operated on by a more experienced surgeon, 19 will die
Laparoscopic surgery may be less risky, but there is not yet enough
clear evidence to know with certainty if some types of surgery are
less risky than others
Source:vpqhc.org
