Weight and Metabolic Outcomes 12 Years after Gastric Bypass
Open accessAbstract
BACKGROUND: Few long-term or controlled studies of bariatric surgery have been conducted to date. We report the 12-year follow-up results of an observational, prospective study of Roux-en-Y gastric bypass that was conducted in the United States. METHODS: A total of 1156 patients with severe obesity comprised three groups: 418 patients who sought and underwent Roux-en-Y gastric bypass (surgery group), 417 patients who sought but did not undergo surgery (primarily for insurance reasons) (nonsurgery group 1), and 321 patients who did not seek surgery (nonsurgery group 2). We performed clinical examinations at baseline and at 2 years, 6 years, and 12 years to ascertain the presence of type 2 diabetes, hypertension, and dyslipidemia. RESULTS: The follow-up rate exceeded 90% at 12 years. The adjusted mean change from baseline in body weight in the surgery group was -45.0 kg (95% confidence interval [CI], -47.2 to -42.9; mean percent change, -35.0) at 2 years, -36.3 kg (95% CI, -39.0 to -33.5; mean percent change, -28.0) at 6 years, and -35.0 kg (95% CI, -38.4 to -31.7; mean percent change, -26.9) at 12 years; the mean change at 12 years in nonsurgery group 1 was -2.9 kg (95% CI, -6.9 to 1.0; mean percent change, -2.0), and the mean change at 12 years in nonsurgery group 2 was 0 kg (95% CI, -3.5 to 3.5; mean percent change, -0.9). Among the patients in the surgery group who had type 2 diabetes at baseline, type 2 diabetes remitted in 66 of 88 patients (75%) at 2 years, in 54 of 87 patients (62%) at 6 years, and in 43 of 84 patients (51%) at 12 years. The odds ratio for the incidence of type 2 diabetes at 12 years was 0.08 (95% CI, 0.03 to 0.24) for the surgery group versus nonsurgery group 1 and 0.09 (95% CI, 0.03 to 0.29) for the surgery group versus nonsurgery group 2 (P<0.001 for both comparisons). The surgery group had higher remission rates and lower incidence rates of hypertension and dyslipidemia than did nonsurgery group 1 (P<0.05 for all comparisons). CONCLUSIONS: This study showed long-term durability of weight loss and effective remission and prevention of type 2 diabetes, hypertension, and dyslipidemia after Roux-en-Y gastric bypass. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases and others.).
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Long-term results of metabolic and bariatric surgery consistently demonstrate safety and efficacy.
“Long-term results of MBS consistently demonstrate safety and efficacy.”
From 2022 American Society of Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) Indications for Metabolic and Bariatric Surgery (2023) · cites this paper as [10]
The Discussion reports durable weight loss and improved metabolic outcomes 12 years after Roux-en-Y gastric bypass, supporting long-term efficacy for that procedure. It does not establish long-term safety across metabolic and bariatric surgery: the Results report seven suicide deaths, all occurring after bariatric surgery, and the Discussion calls for better prevention of this serious potential sequela. The paper also notes gaps in understanding long-term risks. (LLM, conf=0.88)
Experimental — accuracy not yet measuredMBS produces superior weight loss outcomes compared with nonoperative treatments.
“Studies with long-term follow up, published in the decades following the 1991 NIH Consensus Statement, have consistently demonstrated that MBS produces superior weight loss outcomes compared with nonoperative treatments [9–14].”
About 20-25% of patients struggle with considerable weight regain after bariatric surgery.
“where about 20–25% of patients struggle with considerable WR after BS [1–5].”
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Incretin-based therapies for the treatment of obesity-related diseases
Caruso, I., Cignarelli, A., Sorice, G. P., Perrini, S., & Giorgino, F. (2024) · npj Metabolic Health and Disease · doi:10.1038/s44324-024-00030-5 · Cited by 48 · see citing works
Cracking the combination: Gut hormones for the treatment of obesity and diabetes
Alexiadou, K., Anyiam, O., & Tan, T. (2019) · Journal of Neuroendocrinology · doi:10.1111/jne.12664 · Cited by 34 · see citing works
Hunt, S. C., Davidson, L. E., Adams, T. D., Ranson, L., McKinlay, R. D., Simper, S. C., & Litwin, S. E. (2021) · Metabolic Syndrome and Related Disorders · doi:10.1089/met.2020.0008 · Cited by 35 · see citing works
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- Authors
- Adams, T. D., Davidson, L. E., Litwin, S. E., Kim, J., Kolotkin, R. L., Nanjee, M. N., Gutierrez, J. M., Frogley, S. J., Ibele, A. R., Brinton, E. A., Hopkins, P. N., McKinlay, R., Simper, S. C., & Hunt, S. C.
- Affiliations
- Brigham Young University (US)
- ORCID
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2017-09-21
- Volume
- 377
- Issue
- 12
- Pages
- 1143-1155
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- PMC
- PMC5737957
- OpenAlex
- W2754674511
- Cited by
- 956
- References
- 40
- Citations by year
- 2026: 91 · 2025: 111 · 2024: 91 · 2023: 96 · 2022: 97 · 2021: 116 · 2020: 121 · 2019: 117 · 2018: 99 · 2017: 14
- FWCI
- 98.28
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute of Diabetes and Digestive and Kidney Diseases (Z01DK055006, R01DK055006)
- National Center for Research Resources (M01RR000064)
- 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, long-term weight loss, type 2 diabetes remission, diabetes incidence, hypertension, dyslipidemia, metabolic outcomes
- MeSH terms
- Adult, Aged, Body Weight, Diabetes Mellitus, Type 2, Female, Follow-Up Studies, Humans, Hypertension, Male, Middle Aged, Obesity, Morbid, Remission Induction, Risk Factors, Suicide, Gastric Bypass, Weight Loss, Incidence, Dyslipidemias, Young Adult
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