Clinically severe obesity is associated with premature death and disability from heart disease and cancer. Gastric bypass surgery is an effective tool to induce sustained weight loss and normalization of metabolic parameters.
Abstract
Objective
Bariatric surgery reverses obesity-related comorbidities, including type 2 diabetes mellitus. Several studies have already described differences in anthropometrics and body composition in patients undergoing Roux-en-Y gastric bypass compared with laparoscopic adjustable gastric banding, but the role of adipokines in the outcomes after the different types of surgery is not known. Differences in weight loss and reversal of insulin resistance exist between the 2 groups and correlate with changes in adipokines.
Methods
Fifteen severely obese women (mean body mass index [BMI]: 46.7 kg/m2) underwent 2 types of laparoscopic weight loss surgery (Roux-en-Y gastric bypass = 10, adjustable gastric banding = 5). Weight, waist and hip circumference, body composition, plasma metabolic markers, and lipids were measured at set intervals during a 24-month period after surgery.
Results
At 24 months, patients who underwent Roux-en-Y were overweight (BMI 29.7 kg/m2), whereas patients who underwent gastric banding remained obese (BMI 36.3 kg/m2). Patients who underwent Roux-en-Y lost significantly more fat mass than patients who underwent gastric banding.
Conclusion
After 2 years, weight loss and normalization of metabolic parameters were less pronounced in patients who underwent gastric banding compared with patients who underwent Roux-en-Y gastric bypass. Our findings require confirmation in a prospective randomized trial.
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— Michael A. Trakhtenbroit, BA, Joshua G. Leichman, MD, Mohamed F. Algahim, BS, Charles C. Miller III, PhD, Frank G. Moody, MD,Thomas R. Lux, MD, Heinrich Taegtmeyer, MD, DPhil
This article was originally published in the May 2009 issue of The American Journal of Medicine.
