Tag Archives: JAMA Surgery

Weight Loss Surgery Benefits May Diminish Over Time

Weight-loss surgeries for obesity are very popular, often producing dramatic fat loss and reducing type-2 diabetes, according a new study. The problem is that patients regain weight and health problems return in the long run.

Laparoscopic Sleeve Gastrectomy

Weight loss surgery benefits for obesity fade over time, according to new study. Photo by Daryl S. Marx M.D.

Diet and exercise are essential for any long term weight loss from my experience but I understand this is very difficult for anyone who is already obese.

A new study published in JAMA Surgery reviewed patients’ files between one and five years who underwent laparoscopic sleeve gastrectomy (LSG). It discovered that patients who had that kind of surgery encountered significant weight gain and a return of type 2 diabetes years later.

A sleeve gastrectomy is basically the removal of part of the stomach and creating a long, slim sleeve, or pouch, from the remaining section of the stomach, according to the U.S. National Institute of Diabetes and Digestive and Kidney Disease (NIDDK). When the size of the stomach is reduced it limits the amount of food you can consume. Also, it suppresses appetite, lowers blood sugar and changes gut hormones.

“Weight-loss surgery is not a panacea for weight loss over the long run,” said lead researcher Dr. Andrei Keidar, of the Beilinson Hospital in Petah Tikva, Israel.

Keidar says the main reason for weight regain is that the stomach dilates, which means you can eat more. The appetite returns so individuals can consume more and they desire to eat more (JAMA Surg.).

Data was collected on nearly 450 patients between April 2006 and February 2013. However, only 39 patients had a full follow-up by the fifth year after surgery. It seems patients either were ashamed or just became discouraged and did not want to report which could have ended in a biased study.

Patients lost 77 percent of their excess weight in the first year of surgery. Shockingly, they regained weight by the fifth year, resulting in only a 56 percent fat loss. Also, 51 percent of people eliminated type 2 diabetes in the first year. In the fifth year, only 20 percent were still clear of the disease, said researchers (JAMA Surg.).

I agree with Keidar that weight loss surgery is a “behavioral surgery”. If you do not switch up your lifestyle you will regain weight.

Even though patients may regain weight and develop diabetes again, I still believe weight-loss surgery is the best option for obese patients.

Leeman Taylor
Bachelor Degree in Criminal Justice
Real Estate Investor & Internet Marketer

Source: Golomb I, Ben David M, Glass A, Kolitz T, Keidar A. “Long-term Metabolic Effects of Laparoscopic Sleeve Gastrectomy” JAMA Surg. Published online August 05, 2015. doi:10.1001/jamasurg.2015.2202.

Less Common Obesity Surgery Better for Weight Loss

Gastric bypass and duodenal switch are two of the most common weight loss surgeries for treatment of severe obesity. A new study published in JAMA Surgery found that duodenal switch, the less common fat loss procedure, was shown to help individuals lose more weight and improve glycemic control (Risstad H, et al. 2015).

Duodenal Switch - Weight Loss

Duodenal switch has been linked to greater weight loss and decreased cholesterol and blood sugar levels. Photo: Bariatrics P.A.

Traditional diet and exercise have always been my choice of natural weight loss methods but I do understand the need for surgical procedures for severely obese individuals. The clinical trial included individuals with a BMI between 50 and 60, aged 20 to 50 years, and had prior fat loss attempts that did not enable sustained weight loss (Risstad H, et al. 2015).

Of the 60 included individuals, 31 underwent gastric bypass surgery and 29 underwent a duodenal switch. Fifty-five participants (92%) returned to the 5-year visit after an average follow-up of 61 months. The total body weight loss was 26.4% after gastric bypass and 40.3% after duodenal switch which is quite shocking to me. Also, cholesterol, triglyceride concentrations and blood pressure levels were significantly decreased after duodenal switch.

The only downfalls to duodenal switch are the more adverse events as compared to gastric bypass. Surgery to correct malnutrition or severe diarrhea was required in 10% of patients after duodenal switch so readmission rates were much higher.

The bottom line is that duodenal switch results in greater weight loss and good improvements in blood sugar and cholesterol levels over a 5-year period in patients with a BMI between 50 and 60. However, duodenal switch was linked to more long-term nutritional and surgical complications compared to gastric bypass surgery for weight loss.

Leeman Taylor
Senior Criminal Justice Major at Florida A&M University
Real Estate Investor & Internet Marketer

Source: Risstad H, Sovik TT, Engstrom M, et al. “Five-Year Outcomes after Laparoscopic Gastric Bypass and Laparoscopic Duodenal Switch in Patients with Body Mass Index of 50 to 60: A Randomized Clinical Trial. JAMA Surg. 4 February 2015