Comparing surgeries: The Official Conclusion
on 9/7/08 7:02 am
Everyone should look at these guidelines for their advice about nutrition and supplementation as well as post op testing. It's a little rough going if you don't know the medical language but it's worth wading through for the postop care stuff. Here's the link for the full text: http://www.aace.com/pub/pdf/guidelines/Bariatric.pdf
This is from table 4 on page 10. After 7-10 years, RNY excess weight loss ranges from 25% (!) to 68%, gastric banding from 14% (!!) to 60%, and DS from 60 to 80% (although we all know some people who are maintaining 100% excess weight loss at 7-10 years, they weren't part of these studies used to write the guidelines). So, if you had 100 pounds to lose, give the worst case scenario, you would still have 86 pounds left with the band, 75 with RNY and 40 with DS. The best of the band results is equivalent to the worst of the DS results at 7-10 years.
Reported Weight Loss as Percentage
of Excess Body Weight After Bariatric Surgery
Follow-up period (y) (the first number is 1-2 years, the second is 3-6 and the third is 7-10 (if data exist).
Procedure 1-2 3-6 7-10
Vertical banded gastroplasty 50-72 25-65 …
Gastric banding 29-87 45-72 14-60
Sleeve gastrectomy 33-58 66 …
Roux-en-Y gastric bypass 48-85 53-77 25-68
Banded Roux-en-Y gastric bypass 73-80 66-78 60-70
Long-limb Roux-en-Y gastric bypass 53-74 55-74 …
Biliopancreatic diversion ± DS 65-83 62-81 60-80
Elsewhere, I have a lot of problems with some of what the document states, since they threw BPD data with DS data in a kind of sloppy way. It's not a perfect document, but it shows you how far DS has come even in the competitive bariatric surgery world. It's important to note that no one has done a long-term study that head-to-head compares DS to RNY to Band (and that study will probably never be done). I hope this helps some pre-ops negotiate with their insurance companies.
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