Health Benefits of Gastric Bypass Surgery After 6 Years

Adams TD, Davidson LE, Litwin SE, et al
JAMA. 2012;308:1122-1131


What are the long-term health benefits of Roux-en-Y gastric bypass (RYGB) surgery in severely obese patients? The authors compared results from more than 400 patients who received surgery (body mass index > 35 kg/m2) with 2 groups of similar patients who either sought surgery but did not have the operation (control group 1) or were randomly selected severely obese patients in the population (control group 2). At 6 years, patients who received RYGB lost about a quarter of their body weight compared with essentially no weight change in the control groups. With respect to diabetes, 66% of operated patients had a remission of diabetes compared with about 6%-8% of the control groups (P < .001). In the surgery group, 2% of patients developed new-onset diabetes compared with 15%-17% of nonoperated patients (P < .001).


This report shows that the reduction of diabetes noted soon after RYGB is sustained for at least 6 years, as is the reduced frequency of new-onset diabetes. A similar beneficial effect on hypertension and blood lipids was also found. Overall mortality rates after 6 years were similar in the operated and nonoperated groups, but a significant increase in the number of suicides was found in the surgical group (n = 4) compared with none in the control groups (P = .02). These data give us a long-term perspective on the surgical outcome after RYGB for the treatment of severe morbid obesity.