Clinical Edge

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Efficacy of Bariatric Procedures for Weight Loss

Ann Intern Med; ePub 2018 Oct 30; Arterburn, et al

Compared with sleeve gastrectomy (SG) or adjustable gastric banding (AGB) procedures, adults lost more weight with Roux-en-Y gastric bypass (RYGB) at 1, 3, and 5 years; however, RYGB had the highest 30-day rate of major adverse events (AEs). This according to results from a retrospective cohort study that compared weight loss and safety among bariatric procedures. A total of 65,093 patients aged 20‒79 with body mass index (BMI) of ≥35 kg/m2 who had bariatric procedures were included. Researchers estimated total weight loss (TWL) at 1, 3, and 5 years and measured 30-day rates of major AEs. They found:

  • Total numbers of eligible patients with weight measures at 1, 3, and 5 years were 44,978 (84%), 20,783 (68%), and 7,159 (69%), respectively.
  • 30-day rates of major AEs were 5.0% for RYGB, 2.6% for SG, and 2.9% for AGB.
  • 1-year mean TWLs were 31.2% for RYGB, 25.2% for SG, and 13.7% for AGB.
  • 5-year TWLs were 25.5% for RYGB, 18.8% for SG, and 11.7% for AGB.
  • At 1 year, RYGB patients lost 5.9 percentage points more weight than SG patients and 17.7 percentage points more than AGB patients, while SG patients lost 12.0 percentage points more than AGB patients.


Arterburn D, Wellman R, Emiliano A, et al. Comparative effectiveness and safety of bariatric procedures for weight loss: A PCORnet Cohort Study. [Published online ahead of print October 30, 2018]. Ann Intern Med. doi:10.7326/M17-2786.

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