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Cited by 674Bariatric Surgery and OutcomesMinimally Invasive Surgical TechniquesBody Contouring and Surgery

Health benefits of gastric bypass surgery after 6 years

Open access
Adams, Ted D., Davidson, Lance E., Litwin, Sheldon E., Kolotkin, Ronette L., LaMonte, Michael J., Pendleton, Robert C., Strong, Michael B., Vinik, Russell +13 more·2012·JAMA
DOI 10.1001/2012.jama.11164PMC PMC3744888
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Abstract

CONTEXT: Extreme obesity is associated with health and cardiovascular disease risks. Although gastric bypass surgery induces rapid weight loss and ameliorates many of these risks in the short term, long-term outcomes are uncertain. OBJECTIVE: To examine the association of Roux-en-Y gastric bypass (RYGB) surgery with weight loss, diabetes mellitus, and other health risks 6 years after surgery. DESIGN, SETTING, AND PARTICIPANTS: A prospective Utah-based study conducted between July 2000 and June 2011 of 1156 severely obese (body mass index [BMI] ≥ 35) participants aged 18 to 72 years (82% women; mean BMI, 45.9; 95% CI, 31.2-60.6) who sought and received RYGB surgery (n = 418), sought but did not have surgery (n = 417; control group 1), or who were randomly selected from a population-based sample not seeking weight loss surgery (n = 321; control group 2). MAIN OUTCOME MEASURES: Weight loss, diabetes, hypertension, dyslipidemia, and health-related quality of life were compared between participants having RYGB surgery and control participants using propensity score adjustment. RESULTS: Six years after surgery, patients who received RYGB surgery (with 92.6% follow-up) lost 27.7% (95% CI, 26.6%-28.9%) of their initial body weight compared with 0.2% (95% CI, -1.1% to 1.4%) gain in control group 1 and 0% (95% CI, -1.2% to 1.2%) in control group 2. Weight loss maintenance was superior in patients who received RYGB surgery, with 94% (95% CI, 92%-96%) and 76% (95% CI, 72%-81%) of patients receiving RYGB surgery maintaining at least 20% weight loss 2 and 6 years after surgery, respectively. Diabetes remission rates 6 years after surgery were 62% (95% CI, 49%-75%) in the RYGB surgery group, 8% (95% CI, 0%-16%) in control group 1, and 6% (95% CI, 0%-13%) in control group 2, with remission odds ratios (ORs) of 16.5 (95% CI, 4.7-57.6; P < .001) vs control group 1 and 21.5 (95% CI, 5.4-85.6; P < .001) vs control group 2. The incidence of diabetes throughout the course of the study was reduced after RYGB surgery (2%; 95% CI, 0%-4%; vs 17%; 95% CI, 10%-24%; OR, 0.11; 95% CI, 0.04-0.34 compared with control group 1 and 15%; 95% CI, 9%-21%; OR, 0.21; 95% CI, 0.06-0.67 compared with control group 2; both P < .001). The numbers of participants with bariatric surgery-related hospitalizations were 33 (7.9%), 13 (3.9%), and 6 (2.0%) for the RYGB surgery group and 2 control groups, respectively. CONCLUSION: Among severely obese patients, compared with nonsurgical control patients, the use of RYGB surgery was associated with higher rates of diabetes remission and lower risk of cardiovascular and other health outcomes over 6 years.

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  • Bariatric surgery is effective for sustained weight loss but remains inaccessible to many due to cost, procedural risks, and long-term nutritional deficiencies.

    “Bariatric surgery, while effective for sustained weight loss, remains inaccessible to many due to cost, procedural risks, and long-term nutritional deficiencies [5].”

    From Obesity: Clinical Impact, Pathophysiology, Complications, and Modern Innovations in Therapeutic Strategies (2025) · cites this paper as [5]

    The Discussion reports that patients who underwent Roux-en-Y gastric bypass sustained substantial weight loss over six years. The Results (Clinical Measures) report perioperative complications, but the paper does not say that procedural risks make surgery inaccessible. The passages examined do not support the claimed barriers of cost or long-term nutritional deficiencies. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Roux-en-Y gastric bypass remains the gold standard, with 25-30% sustained weight loss and remission of diabetes in 60-80% of patients.

    “It remains the gold standard, with 25–30% sustained weight loss and remission of diabetes in 60–80% of patients.”

    From Obesity: Clinical Impact, Pathophysiology, Complications, and Modern Innovations in Therapeutic Strategies (2025) · cites this paper as [5]

    The Results report 27.7% weight loss and 62% diabetes remission six years after Roux-en-Y gastric bypass, supporting both numerical ranges. The cited paper does not establish that the procedure is the “gold standard” relative to other bariatric procedures. (LLM, conf=0.89)

    Experimental — accuracy not yet measured

  • Some patients experience weight gain after maximum weight loss.

    “The majority of patients reach maximum weight loss 1-2 years after surgery [1], but thereafter, some patients experience weight gain [2].”

    From Preoperative predictors of adherence to dietary and physical activity recommendations and weight loss one year after surgery (2016) · cites this paper as [2]

  • Expected weight loss after RYGB is 25-35% of initial body weight.

    “Expected weight loss after Roux-en-Y gastric bypass (RYGB) is 25-35% of initial body weight [1, 2], but weight loss and weight loss maintenance vary considerably between patients [1].”

    From Preoperative predictors of adherence to dietary and physical activity recommendations and weight loss one year after surgery (2016) · cites this paper as [2]

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Research works printed but not linked: 1

  1. [36]Adams TD Pendleton RC Strong MB Health outcomes of gastric bypass patients compared to nonsurgical, nonintervened severely obese Obesity (Silver Spring) 2010 18 1 121 130 19498344 PMC2864142

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Authors
Adams, T. D., Davidson, L. E., Litwin, S. E., Kolotkin, R. L., LaMonte, M. J., Pendleton, R. C., Strong, M. B., Vinik, R., Wanner, N. A., Hopkins, P. N., Gress, R. E., Walker, J. M., Cloward, T. V., Nuttall, R. T., Hammoud, A., Greenwood, J. L. J., Crosby, R. D., McKinlay, R., Simper, S. C., Smith, S. C., & Hunt, S. C.
Affiliations
  • University of Utah (US)
  • Intermountain Healthcare (US)
ORCID
Venue
JAMA
Publisher
American Medical Association (AMA)
Published
2012-09-19
Volume
308
Issue
11
Pages
1122
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/2012.jama.11164
PMC
PMC3744888
OpenAlex
W1996281935
Cited by
674
References
41
Citations by year
2026: 13 · 2025: 20 · 2024: 21 · 2023: 42 · 2022: 41 · 2021: 31 · 2020: 43 · 2019: 36 · 2018: 60 · 2017: 72 · 2016: 80 · 2015: 79 · 2014: 75 · 2013: 54 · 2012: 6
FWCI
69.70
Type
journal article
Language
en
Open access
Locations
  • JAMA (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (5ul1tr001067-05, KL2TR001065)
  • National Institute of Diabetes and Digestive and Kidney Diseases (Z01DK055006, R01DK055006)
  • National Center for Research Resources (M01-RR 00064, M01RR000064)
  • National Center for Advancing Translational Sciences (UL1-TR001067)
Topics
  • Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
  • Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
  • Health Sciences › Medicine › Surgery › Body Contouring and Surgery
Keywords
Roux-en-Y gastric bypass, bariatric surgery, morbid obesity, weight loss maintenance, diabetes remission, hypertension, dyslipidemia, health-related quality of life, long-term surgical outcomes
MeSH terms
Adolescent, Adult, Aged, Cardiovascular Diseases, Diabetes Mellitus, Female, Follow-Up Studies, Health Status, Humans, Male, Middle Aged, Obesity, Quality of Life, Risk, Risk Factors, Gastric Bypass, Weight Loss, Case-Control Studies, Young Adult

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