Summary:
In adults with severe obesity, Roux-en-Y gastric bypass (Bypass) significantly improved weight loss and quality of life compared to adjustable gastric banding (Band) and sleeve gastrectomy (Sleeve), though it was associated with a higher rate of adverse events than Sleeve.
| PICO | Description |
|---|---|
| Population | Adults with BMI ≥35 kg/m² with comorbidity or BMI ≥40 kg/m² without comorbidity who were eligible for bariatric surgery at 12 NHS hospitals in the UK. |
| Intervention | Roux-en-Y gastric bypass (462 participants), a form of bariatric surgery intended to reduce excess weight and improve quality of life. |
| Comparison | Adjustable gastric banding (464 participants) and sleeve gastrectomy (420 participants), alternative surgical options for managing severe obesity. |
| Outcome | At 3 years, Bypass resulted in the highest proportion achieving ≥50% excess weight loss (68.1%) vs Sleeve (41.5%) and Band (25.3%). Quality-of-life scores were also highest for Bypass (EQ-5D: 0.72) vs Sleeve (0.68) and Band (0.62). Sleeve had the lowest adverse events; Bypass was the most cost-effective overall. |
Source: Welbourn, Richard, et al. “Roux-en-Y gastric bypass, adjustable gastric banding or sleeve gastrectomy for severe obesity: The By-Band-Sleeve randomised controlled trial.” Read article here.
