Lesser Used Surgical Method Actually Results in More Weight Loss
Are you considering weight loss surgery to get your weight gain under control? If so, then you need to hear about this latest finding about a lesser used surgical method that actually results in more weight loss than standard gastric bypass surgery.
Your decision on which weight loss surgical option to choose could be one of the most important decisions of your life. This fact was recently pointed out in a recent U.S News & World Report article written by Alan Mozes about a new JAMA Surgery article that revealed that the duodenal switch surgical procedure results in more weight loss than several others―including the more-popular gastric bypass. However, there are trade-offs to consider.
According to article, one of the study’s co-authors - Dr. Torsten Olbers, an assistant professor of surgery at Sahlgrenska University Hospital in Gothenburg, Sweden―is quoted as stating that, “Five years after surgery, the average reductions in weight were 41 kilograms [90 pounds] after gastric bypass and 66 kilograms [145 pounds] after duodenal switch."
While this is a significant difference in weight loss results, Dr. Obers also added that, “…patients who underwent duodenal switch also had more subsequent surgical procedures related to the initial operation, and more hospital admissions for nutritional complications, compared to patients who underwent gastric bypass."
A gastric bypass involves dividing and reconnecting portions of both the stomach and the small intestine to create a smaller stomach pouch, while re-directing the food absorption pathway. The duodenal switch, however, is a more complicated and more invasive procedure that involves the removal of a portion of the stomach and bypassing a large portion of the small intestine.
In an effort to determine the benefits and complications between the two weight loss surgical methods, the authors of the paper made a comparison between two groups of patients who had either gastric bypass surgery or the duodenal switch. The patients ranged in age between 20 and 50 years and had an average weight of approximately 355 pounds―an average body mass index (BMI) of between 50 and 60.
Five years following their surgeries, the patients were compared and it turns out that the duodenal switch surgical method group experienced a BMI reduction of over 22 points; whereas, the gastric bypass group on average had less than a 14 point reduction in BMI.
Furthermore, the duodenal group showed greater reductions in cholesterol, triglycerides, and fasting blood sugar levels. However, blood pressure, lung function and the presence of type 2 diabetes were similar between both groups followed.
But when it comes to the cons between the two surgical procedures, the duodenal procedure resulted in:
• A much higher risk for nutritional complications, gastrointestinal problems and re-hospitalization.
• About 80 percent of the duodenal patients experiencing one or more complications during the post-surgery timeframe (68 percent in the gastric bypass group).
• Nearly 45 percent among the duodenal group having to undergo additional surgical procedures (less than 10 percent of the gastric bypass group).
The authors concluded that:
“In our study, duodenal switch resulted in greater weight loss and greater improvements in blood lipids and glucose compared with gastric bypass across 5 years in patients with baseline BMIs of 50 to 60. Improvements in HRQL were comparable. However, duodenal switch was associated with more long-term surgical and nutritional complications and more gastrointestinal adverse effects compared with gastric bypass.” However, they also recommend that the, "…duodenal switch should be used with caution."
The article from U.S. News & World Report also included a medical opinion outside of the study by Dr. Mitchell Roslin, chief of bariatric and metabolic surgery at Lenox Hill/North Shore-LIJ Health System Hospital in New York City, who made the argument that, "…gastric bypass is just not an adequate therapy for many patients,” says Dr. Roslin.
"I really believe that the conclusion this team draws is way too in favor of gastric bypass. Their thinking makes light of weight loss, which is the goal of any of these procedures. And more than half the gastric bypass patients remained morbidly obese at the five-year point, a figure that I guarantee would go precipitously higher if you take another look five years later."
"Now yes, it's true that you have to be concerned that duodenal switch [surgery] may be too powerful for some patients. But gastric bypass just doesn't work well. So the goal should be to try and find a balance by modifying the duodenal procedure to minimize the harsh effects and maximize outcomes, which is something I and others are working to do right now," adds Dr. Roslin.
As with any medical decision, patients are encouraged to do their own research and consult with their family doctor about the pluses and minuses of any procedure and how it can affect their quality of life as well as their health.
For more about bariatric surgical options for weight loss, here is a study that determined that the duodenal switch beats gastric bypass, and how two weight loss surgery procedures measured up 3 years following surgery.
U.S. News & World Report― “Less Commonly Used Obesity Surgery Tied to More Weight Loss”
JAMA Surgery― “Five-Year Outcomes After Laparoscopic Gastric Bypass and Laparoscopic Duodenal Switch in Patients With Body Mass Index of 50 to 60” Hilde Risstad, MD et al.