How Effective is Weight Loss Surgery?

Weight Loss surgery (also known as Bariatric surgery) covers a wide span of procedures in which a portion of the digestive tract is restricted in some way, causing a physical sensation of appetite satiety after smaller than normal amounts of food have been consumed.

Consequently, the patient consumes fewer calories and loses weight. The two most commonly performed and recognized surgical procedures are gastric bypass and gastric banding, often referred to as the Lap-Band®.

Initially in the United States, gastric bypass has been the more common procedure, but lately the Lap-Band® has started to overshadow the bypass as the more common surgery. While in the short run, both procedures often affect dramatic weight loss, as many as 30% of the patients regain some of the lost weight in as little as 18 to 24 months, usually as the result of not maintaining adherence to a regime of diet and exercise, or of the consumption of high-calorie foods that pass easily through the gastric stoma, or restriction caused by the Lap-Band®. Thus, to compare the real effectiveness rate of the procedures, a longer time period is required for comparison.


With this in mind, which is more effective over time, gastric bypass surgery or the Lap-Band®? The following statistics shed some light on the subject.

For gastric bypass surgery, the bariatric-surgery industry standard for measuring positive outcomes is a loss of 50% to 60% Excess Body Weight (EBW) lost and maintained for three to five years after the surgery. Some centers report success rates as high as 70% to 80% mostly because of an ongoing support system sponsored by the physician with constant follow up.

For the Lap-Band® procedure, a three-year study conducted by the American Obesity Association showed 62% of patients losing at least 25% of their EBW, with 52% losing at least 33%, another 22% losing at least 50%, and a final 10% losing at least 75% of their excess weight. Similarly, the American Society for Bariatric Surgery reports weight loss of 28% to 65% of EBW after two years, with 54% of patients maintaining their weight loss after five years.

While this comparison is not precisely apples-to-apples, it would appear that at the five-year milestone, the effectiveness of gastric bypass and the Lap-Band® is nearly equivalent. The less surgically invasive laparoscopic Lap-Band® is often the better choice for those patients who are morbidly obese in that it is less traumatic to the body as a whole, causes less patient discomfort, and has a shorter recovery time. Because of its more common use in the more obese patients who have more weight to lose, the EBW numbers appear to be lower forthe Lap-Band® than for gastric bypass, an important caveat when comparing the two procedures.