Is Gastric Banding or Bypass Better?

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Gastric banding or bypass? A systematic review comparing the two most popular bariatric procedures, by Jeffrey A. Tice and colleagues. American Journal of Medicine 31121885–893, 2008

What is the problem and what is known about it so far?

Extreme obesity is on the rise and is linked to early death and a higher risk of many serious diseases, including diabetes. Weight loss improves the health and quality of life of people who are extremely obese, but it is very difficult to achieve. Because weight-loss diets, exercise plans, and medicines so often fail to control extreme obesity, several surgical options, including gastric banding and gastric bypass operations, have become popular. Gastric bypass has been the standard surgery for obesity, but recently, gastric banding has been promoted as a safer, possibly reversible, and effective alternative to bypass surgery.

Why did researchers do this particular study?

The researchers wanted to find out whether gastric banding was a better option than gastric bypass surgery for extremely obese patients.

Who was studied?

The study reviewed results of 14 previous studies that directly compared the banding and bypass operations.

How was the study done?

The researchers searched the medical literature for studies that directly compared the two procedures and included at least 1 year of follow-up data. They then analyzed the results of those studies to learn which operation did a better job of controlling obesity-related medical conditions, inducing weight loss, and improving quality of life, while causing the fewest serious complications.

What did the researchers find?

Weight loss and improvement in obesity-related medical problems were greater with the bypass operation. Operating room time and length of hospital stay were shorter for the banding procedure, but patients who had this operation were more likely to need another operation later. Patients were more satisfied with the bypass operation.

What were the limitations of the study?

Because this study relied on results of numerous earlier studies, some of the differences between the two operations may have been related to differences among the earlier studies in terms of their designs, populations, locations, or other factors. Also, most of the studies included lasted only a year or two. This is a fairly short time period to test the long-term benefits or drawbacks of operations that could last for 30 to 50 years.

What are the implications of the study?

Gastric bypass appears to be an overall better option than gastric banding for extreme obesity. However, both operations have some advantages and drawbacks. More studies are needed to help patients and surgeons choose the best option for specific circumstances.

FOR MORE INFORMATION

Are Your at Risk for Obesity?

Options for Losing Weight

Diabesity: The Obesity/Diabetes Epidemic