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Effectively Maintained Weight-Loss

The success of an operation is gauged by how much weight is lost and how long the weight-loss lasts.

The amount of weight lost following surgery is most commonly reported in terms of Percent Excess Weight-Loss (%EWL). The table below shows the results for various types of operations.

Percent Excess Weight-Loss Table

Type of Operation	Years after surgery
Type of Operation	1	2	5	10
Open RYGB¹	70%	66%	55%	50%
Lap RYGB²	74%	80%	82%
Open BPD/DS³	64%	77%	78%	78%
Lap BPD/DS⁴	65%
Lap Band⁵	63%	63%	53%

It is important to note that most of the operations reflected in the table were performed on patients who have a BMI between 35 and 50. The studies that involved bariatric surgery on patients with a BMI > 50 showed that weight-loss after BPD/DS was greater than after Roux-en-Y gastric bypass [MacLean et al. Ann. Surg. 2000]. Therefore, gastric bypass provides substantial weight-loss with a chance for weight-regain after 2 years, but with a lower risk of long-term nutritional problems. Overall, the BPD/DS provides a greater overall weight-loss for people who are severely overweight, but at a slightly higher risk of nutritional problems. The lap adjustable gastric band provides slower but constant weight-loss that is comparable to the gastric bypass but is maintained after 2 years without any nutritional problems and is the least invasive operation offered.

¹Pories WJ et al. "Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus". Annals of Surgery. 1995;222:339. Brolin RE. "Gastrointestinal surgery for obesity". Semin. Gastointest. Dis. 1998;9:163.

²Wittgrove AC and Clark GW. "Laparoscopic gastric bypass, Roux-en-Y- 500 patients: technique and results, with 3-60 month follow-up". Obesity Surgery. 2000;10:233.

³Marceau P et al. "Biliopancreatic diversion with duodenal switch". World Journal of Surgery. 1998;22:947.Hess DS and Hess DW. "Biliopancreatic diversion with a duodenal switch". Obesity Surgery. 1998;8:267.

⁴Ren CJ, Patterson EJ and Gagner M. "Early results of laparoscopic biliopancreatic diversion with duodenal switch for morbid obesity: a case series of 40 consecutive patients". Obesity Surgery. 2000 [in press], oral presentation, ASBS 2000.

⁵O’Brien P and Dixon J. Archives of Surgery, in press.

Cadiere GB, Himpens J, Vertruyen M, et al. "Laparoscopic gastroplasty (Adjustable Silicone Gastric Banding)", Seminars in Laparoscopic Surgery. 2000; 7: 55-65

Higa KD et al. "Laparoscopic Roux-en-Y gastric bypass for morbid obesity". Archives of Surgery 2000;135:1029.

Schauer PR et al. "Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity". Annals of Surgery. 2000:4;515.

Fielding GA, Rhodes M and Nathanson LK. "Laparoscopic gastric banding for morbid obesity", Surgical Endoscopy. 1999; 13: 550-554.

Dargent J. "Laparoscopic adjustable gastric banding: lessons from the first 500 patients in a single institution", Obesity Surgery; 9: 446-452.

Belachew M, Legrand M, Vincent V, et al. "Laparoscopic adjustable gastric banding", World Journal of Surgery. 1998; 22: 955-963.

Rubinstein R. " Laparoscopic adjustable gastric banding at a U.S. center with up to 3-year follow-up"", Obesity Surgery, 2002;12:380-384.

Disclaimer: This site is an independent service offered by BCCI, Inc. It is meant to be an educational site that offers patients information to help them investigate weight loss surgery. Although the site has been reviewed for accuracy, BCCI, Inc. cannot be held liable for inaccurate data or conclusions drawn from the site. Neither information obtained from this site nor e-mailed correspondence or verbal communication from BCCI, Inc. constitutes a doctor/patient relationship. This web site cannot be considered a doctor's opinion for your situation and is not a substitute for medical evaluation and counsel. Featured surgeons are private, independent practitioners.