In a pair of large and recently completed studies, sleeve gastrectomy earned more praise as the safest thing to do if you are battling obesity. In one study of over 117,000 individuals, sleeve gastrectomy was found to result in tremendous long-term weight loss compared to non-surgical treatment. In the 2020 publication by Arterburn and colleagues, medical weight loss without surgery resulted in a grand total of 0.2% total body weight loss (1) – which is not much. Sleeve gastrectomy resulted in 23% total body weight loss and RYGB had slightly more weight loss.
A Closer Look
A note of caution was that, although sleeve and gastric bypass patients did markedly better than those without any surgery, 10% of sleeve patients regained weight to within 5% of baseline at the 5-year mark. On a positive note, the simplicity and relatively non-invasive nature of the sleeve means that those patients are eligible for a very effective revision procedure.
The second study to come out in the same week compared the bone thinning due to aging among non-surgical patients and those who had undergone RYGB or sleeve gastrectomy. Over 80,000 patients from a French national database were analyzed, finding that while RYGB resulted in an increase in bone-thinning and osteoporotic fracture, the sleeve did not (2).
So, what do we take from these studies? They represent more among a very large number of “big data” type cohort analyses that show the sleeve gastrectomy to be a highly safe and effective treatment with few long-term side effects. And while up to 10% of patient may regain their weight over the years, the simplicity of the sleeve means that excellent options for successful surgical weight loss remain.
- 45-minute procedure with 4 Band-aids
- Long term weight loss
- Type 2 diabetes reversal in most cases
- Safer than appendectomy, hernia repair, or C section
- 0.0% leak/mortality in last 2,500 consecutive cases
1. Arterburn DE, Johnson E, Coleman KJ, et al. Weight Outcomes of Sleeve Gastrectomy and Gastric Bypass Compared to Nonsurgical Treatment. Annals of surgery. 2020.
2. Paccou J, Martignène N, Lespessailles E, et al. Gastric bypass but not sleeve gastrectomy increases risk of major osteoporotic fracture: French population-based cohort study: bariatric surgery and fracture. Journal of Bone and Mineral Research. 2020.