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Roux-en-Y Gastric Bypass, Sleeve Gastrectomy Beat Adjustable Gastric Banding for Severe Obesity

By Elana Gotkine HealthDay Reporter

Medically reviewed by Carmen Pope, BPharm. Last updated on April 10, 2025.

via HealthDay

THURSDAY, April 10, 2025 -- For adults with severe obesity, Roux-en-Y gastric bypass and sleeve gastrectomy are more effective than adjustable gastric banding, according to a study published online March 31 in The Lancet Diabetes & Endocrinology.

Sanjay Agrawal, M.B.B.S., from Homerton University Hospital in London, and colleagues conducted a pragmatic, randomized controlled trial in 12 U.K. hospitals involving adults meeting national criteria for metabolic and bariatric surgery. Initially, the trial included two arms: Roux-en-Y gastric bypass and adjustable gastric banding, and sleeve gastrectomy was added at 2.6 years after initiation when it became widely available in the United Kingdom.

The analyses included 1,346 participants: 34, 34, and 31 percent in the Roux-en-Y gastric bypass group, adjustable gastric banding group, and sleeve gastrectomy group, respectively. The researchers found that 68, 25, and 41 percent of participants in the Roux-en-Y gastric bypass, adjustable gastric banding, and sleeve gastrectomy groups, respectively, achieved at least 50 percent excess weight loss. The mean EuroQol 5-Dimension utility quality-of-life scores were 0.72 for Roux-en-Y gastric bypass, 0.62 for adjustable gastric banding, and 0.68 for sleeve gastrectomy. Following surgery, there were 1,651 adverse events (6.0, 4.6, and 5.7 per year after Roux-en-Y gastric bypass, adjustable gastric banding, and sleeve gastrectomy, respectively). From random assignment to three years, there were 11 deaths: one attributable to surgery in the adjustable gastric banding group and 10 not attributable to surgery. The most cost-effective approach was Roux-en-Y gastric bypass.

"Future research to understand longer-term outcomes and to compare metabolic and bariatric surgery with obesity management medications is needed to guide evidence-based practice in this rapidly evolving field," the authors write.

Several authors disclosed ties to relevant organizations.

Abstract/Full Text

Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.

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