It causes fewer complications, results in more weight loss
Bloomberg News

NEW YORK – Doctors in New York compared two kinds of surgery to help severely obese people lose weight and found that the most common form used in the U.S. is superior.

Gastric bypass, which makes the stomach smaller and reduces the amount of food processed by the small intestine, causes fewer complications and results in more weight loss than lap band surgery, or laparoscopic adjustable gastric banding, researchers said Monday.

"What's important isn't what's the least invasive but what's the most effective procedure," said George Ferzli, head of surgery at Lutheran Medical Center in Brooklyn, co-author of the study, which appeared in the Archives of Surgery.

Weight-loss operations of all types will total an estimated 177,600 worldwide this year, according to the American Society for Bariatric Surgery, a professional group based in Gainesville, Fla. Banding, which involves only the stomach and requires less time in the hospital, has become fashionable in recent years.

"The [gastric] bypass is the operation that every other operation is trying to compare to," said Dr. Ferzli, who said he has performed hundreds of bariatric surgeries.

All of the patients in the study registered 50 or higher on an index of body mass. A person 5 feet, 8 inches tall would need to weigh 329 pounds to hit 50 on the index.

The BMI number is computed by taking weight in kilograms and dividing by the square of height in meters. The National Heart, Lung and Blood defines 25 as the lower limit of being "overweight," and 30 or higher as "obese."

Bariatric operations aren't ordinarily performed unless a person's BMI hits 40, in the absence of weight-related diseases, Dr. Ferzli said. The study looked at 106 consecutive patients. Sixty chose gastric banding, and 46 chose gastric bypass, also known as laparoscopic Roux-en-Y gastric bypass. Both types of operations are laparoscopic, meaning that doctors make only a small incision.

While banding requires shorter operations and hospital stays, patients receiving that procedure went on to lose, on average, only 31 percent of their excess weight, compared with 52 percent of the Roux-en-Y group, after a follow-up time of about 16 months, the doctors reported.