The objective of this study was to examine 10-year weight change in a large, multisite, clinical cohort of subjects who underwent Roux-en-Y gastric bypass (RYGB) compared with nonsurgical matches and the 4-year weight change in veterans who underwent RYGB, adjustable gastric banding (AGB), or sleeve gastrectomy (SG).
Differences in weight change up to 10 years after surgery were examined for 1787 subjects who underwent RYGB from January 1, 2000, and 5305 nonsurgical matches. Differences in weight change up to 4 years was also compared among subjects undergoing RYGB (n = 1785), SG (n = 379), and AGB (n = 246). Data analysis was performed from September 9, 2014, to February 12, 2016.
The 1787 patients undergoing RYGB had a mean (SD) age of 52.1 (8.5) years and 5305 nonsurgical matches had a mean (SD) age of 52.2 (8.4) years. Patients undergoing RYGB and nonsurgical matches had a mean body mass index of 47.7 and 47.1, respectively, and were predominantly male (1306 [73.1%] and 3911 [73.7%], respectively).
Patients undergoing RYGB lost 21% more of their baseline weight at 10 years than nonsurgical matches. A total of 405 of 564 patients undergoing RYGB (71.8%) had more than 20% estimated weight loss, and 224 of 564 (39.7%) had more than 30% estimated weight loss at 10 years compared with 134 of 1247 (10.8%) and 48 of 1247 (3.9%), respectively, of nonsurgical matches.Only 19 of 564 patients undergoing RYGB (3.4%) regained weight back to within an estimated 5% of their baseline weight by 10 years.
At 4 years, patients undergoing RYGB lost of their baseline weight, patients undergoing AGB lost 10.6%, and patients undergoing SG lost 17.8%. Patients undergoing RYGB lost 16.9% more of their baseline weight than patients undergoing AGB and 9.7% more than patients undergoing SG.
CONCLUSIONS AND RELEVANCE
Patients receiving bariatric surgery lost substantially more weight than nonsurgical matches and sustained most of this weight loss in the long term. Roux-en-Y gastric bypass induced significantly greater weight loss than SG or AGB at 4 years.