Gastric bypass leads to long-term weight loss and diabetes remission
04 Dec 2017 - 11:30
A Weill Cornell Medicine-Qatar (WCM-Q) researcher has helped to demonstrate that gastric bypass operations lead to maintenance of weight loss as well as remission and prevention of type 2 diabetes, high blood pressure and high cholesterol, 12 years after the surgery.
Dr Steven Hunt (pictured), professor of genetic medicine, played a key role in a long-term research project that found that patients who underwent a type of gastric bypass operation called ‘Roux-en-Y’ had lost an average of 35kg (77lbs) of body weight 12 years after surgery.
Furthermore, 51 percent of patients who had type 2 diabetes at the time of surgery no longer had the disease 12 years after their gastric bypass procedure. Patients who had the surgery also had higher rates of remission and prevention of hypertension (high blood pressure) and dyslipidemia (high cholesterol) than those who did not have the surgery.
In a Roux-en-Y gastric bypass, a surgeon staples off a section of the upper stomach to form a small pouch about the size of an egg. This section is then attached to a part of the small intestine called the Roux limb, forming a Y-shape and bypassing the majority of the stomach. This severely limits the amount of food the patient can eat, which aids weight loss.
The observational study, entitled ‘Weight and Metabolic Outcomes 12 Years after Gastric Bypass’, has now been published in The New England Journal of Medicine, one of the world’s foremost medical journals.
The research, which drew upon the expertise of researchers at WCM-Q and a number of institutions in the US, analyzed data collected over a 12-year period from 1,156 patients with severe obesity who visited a bariatric surgical center at Rocky Mountain Associated Physicians or the University of Utah in Salt Lake City, Utah. Researchers compared the outcomes of patients in three groups: 418 patients who sought and underwent Roux-en-Y gastric bypass surgery; 417 patients who sought but did not undergo surgery, mainly for insurance reasons and 321 patients who did not seek surgery.
Dr Hunt said, “This is really the only long-term controlled study of Roux-en-Y gastric bypass outcomes and the results are encouraging. A lot of people are keeping a lot of weight off and new-onset type 2 diabetes was almost done away with. For those who did have type 2 diabetes at the start of the study, most went into remission, particularly if they had not yet started diabetes medication. Even those with type 2 diabetes who were already on medication went into remission, though they were at greater risk of the diabetes coming back. However, even when the diabetes came back, in many cases they were free of the disease for six to 12 years, which means they are more likely to have delayed onset of typical diabetes complications like neuropathy, impaired vision and amputations, which would be a very good outcome.
Other institutions involved in the research along with WCM-Q included the University of Utah, Brigham Young University, Duke University Health System and Intermountain Healthcare in Utah, among others. The study was supported by funds from WCM-Q’s Biomedical Research Program and grants from the US National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health, and the US National Center for Research Resources.