Do You Recommend Bariatric Surgery to Your Obese Patients?

June 29, 2017

Bariatric surgery is one of the few antiobesity approaches that provide significant, sustained weight loss for morbidly obese patients (those with a body mass index of 40 kg/m2 or higher), with additional improvement in obesity-related comorbidities such as diabetes and heart disease.

The Roux-en-Y gastric bypass (RYGB) surgery, for example, yields greater, more sustained weight loss compared with no surgery. The results of a study published in JAMA Surgery last year found that, at a 10-year follow-up, more than 1500 patients who underwent RYGB lost an average 21% more of their baseline weight compared with nonsurgical matches.

Bariatric procedures do carry risks. Approximately 2% of gastric bypass procedures leak, with similar rates regardless of whether patients received RYGB or a gastric sleeve procedure. And the chances for mortality in the perioperative period are not inconsequential.

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