Health benefits of gastric bypass surgery after 6 years

Ted D. Adams, Lance E. Davidson, Sheldon E. Litwin, Ronette L. Kolotkin, Michael J. LaMonte, Robert C. Pendleton, Michael B. Strong, Russell Vinik, Nathan A. Wanner, Paul N. Hopkins, Richard E. Gress, James M. Walker, Tom V. Cloward, R. Tom Nuttall, Ahmad Hammoud, Jessica L J Greenwood, Ross D. Crosby, Rodrick McKinlay, Steven C. Simper, Sherman C. SmithSteven Hunt

Research output: Contribution to journalArticle

361 Citations (Scopus)

Abstract

Context: Extreme obesity is associated with health and cardiovascular disease risks. Although gastric bypass surgery induces rapid weight loss and ameliorates many of these risks in the short term, long-term outcomes are uncertain. Objective: To examine the association of Roux-en-Y gastric bypass (RYGB) surgery with weight loss, diabetes mellitus, and other health risks 6 years after surgery. Design, Setting, and Participants: A prospective Utah-based study conducted between July 2000 and June 2011 of 1156 severely obese (body mass index [BMI] ≥35) participants aged 18 to 72 years (82% women; mean BMI, 45.9; 95% CI, 31.2-60.6) who sought and received RYGB surgery (n=418), sought but did not have surgery (n=417; control group 1), or who were randomly selected from a population-based sample not seeking weight loss surgery (n=321; control group 2). Main Outcome Measures: Weight loss, diabetes, hypertension, dyslipidemia, and health-related quality of life were compared between participants having RYGB surgery and control participants using propensity score adjustment. Results: Six years after surgery, patients who received RYGB surgery (with 92.6% follow-up) lost 27.7% (95% CI, 26.6%-28.9%) of their initial body weight compared with 0.2% (95% CI, -1.1% to 1.4%) gain in control group 1 and 0% (95% CI, -1.2% to 1.2%) in control group 2. Weight loss maintenance was superior in patients who received RYGB surgery, with 94% (95% CI, 92%-96%) and 76% (95% CI, 72%-81%) of patients receiving RYGB surgery maintaining at least 20% weight loss 2 and 6 years after surgery, respectively. Diabetes remission rates 6 years after surgery were 62% (95% CI, 49%-75%) in the RYGB surgery group, 8% (95% CI, 0%-16%) in control group 1, and 6% (95% CI, 0%-13%) in control group 2, with remission odds ratios (ORs) of 16.5 (95% CI, 4.7-57.6; P<.001) vs control group 1 and 21.5 (95% CI, 5.4-85.6; P<.001) vs control group 2. The incidence of diabetes throughout the course of the study was reduced after RYGB surgery (2%; 95% CI, 0%-4%; vs 17%; 95% CI, 10%-24%; OR, 0.11; 95% CI, 0.04-0.34 compared with control group 1 and 15%; 95% CI, 9%-21%; OR, 0.21; 95% CI, 0.06-0.67 compared with control group 2; both P<.001). The numbers of participants with bariatric surgery-related hospitalizations were 33 (7.9%), 13 (3.9%), and 6 (2.0%) for the RYGB surgery group and 2 control groups, respectively. Conclusion Among severely obese patients, compared with nonsurgical control patients, the use of RYGB surgery was associated with higher rates of diabetes remission and lower risk of cardiovascular and other health outcomes over 6 years.

Original languageEnglish
Pages (from-to)1122-1131
Number of pages10
JournalJAMA - Journal of the American Medical Association
Volume308
Issue number11
DOIs
Publication statusPublished - 12 Sep 2012
Externally publishedYes

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Gastric Bypass
Insurance Benefits
Control Groups
Weight Loss
Odds Ratio
Health
Body Mass Index
Propensity Score
Bariatric Surgery
Dyslipidemias

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Adams, T. D., Davidson, L. E., Litwin, S. E., Kolotkin, R. L., LaMonte, M. J., Pendleton, R. C., ... Hunt, S. (2012). Health benefits of gastric bypass surgery after 6 years. JAMA - Journal of the American Medical Association, 308(11), 1122-1131. https://doi.org/10.1001/2012.jama.11164

Health benefits of gastric bypass surgery after 6 years. / Adams, Ted D.; Davidson, Lance E.; Litwin, Sheldon E.; Kolotkin, Ronette L.; LaMonte, Michael J.; Pendleton, Robert C.; Strong, Michael B.; Vinik, Russell; Wanner, Nathan A.; Hopkins, Paul N.; Gress, Richard E.; Walker, James M.; Cloward, Tom V.; Nuttall, R. Tom; Hammoud, Ahmad; Greenwood, Jessica L J; Crosby, Ross D.; McKinlay, Rodrick; Simper, Steven C.; Smith, Sherman C.; Hunt, Steven.

In: JAMA - Journal of the American Medical Association, Vol. 308, No. 11, 12.09.2012, p. 1122-1131.

Research output: Contribution to journalArticle

Adams, TD, Davidson, LE, Litwin, SE, Kolotkin, RL, LaMonte, MJ, Pendleton, RC, Strong, MB, Vinik, R, Wanner, NA, Hopkins, PN, Gress, RE, Walker, JM, Cloward, TV, Nuttall, RT, Hammoud, A, Greenwood, JLJ, Crosby, RD, McKinlay, R, Simper, SC, Smith, SC & Hunt, S 2012, 'Health benefits of gastric bypass surgery after 6 years', JAMA - Journal of the American Medical Association, vol. 308, no. 11, pp. 1122-1131. https://doi.org/10.1001/2012.jama.11164
Adams TD, Davidson LE, Litwin SE, Kolotkin RL, LaMonte MJ, Pendleton RC et al. Health benefits of gastric bypass surgery after 6 years. JAMA - Journal of the American Medical Association. 2012 Sep 12;308(11):1122-1131. https://doi.org/10.1001/2012.jama.11164
Adams, Ted D. ; Davidson, Lance E. ; Litwin, Sheldon E. ; Kolotkin, Ronette L. ; LaMonte, Michael J. ; Pendleton, Robert C. ; Strong, Michael B. ; Vinik, Russell ; Wanner, Nathan A. ; Hopkins, Paul N. ; Gress, Richard E. ; Walker, James M. ; Cloward, Tom V. ; Nuttall, R. Tom ; Hammoud, Ahmad ; Greenwood, Jessica L J ; Crosby, Ross D. ; McKinlay, Rodrick ; Simper, Steven C. ; Smith, Sherman C. ; Hunt, Steven. / Health benefits of gastric bypass surgery after 6 years. In: JAMA - Journal of the American Medical Association. 2012 ; Vol. 308, No. 11. pp. 1122-1131.
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title = "Health benefits of gastric bypass surgery after 6 years",
abstract = "Context: Extreme obesity is associated with health and cardiovascular disease risks. Although gastric bypass surgery induces rapid weight loss and ameliorates many of these risks in the short term, long-term outcomes are uncertain. Objective: To examine the association of Roux-en-Y gastric bypass (RYGB) surgery with weight loss, diabetes mellitus, and other health risks 6 years after surgery. Design, Setting, and Participants: A prospective Utah-based study conducted between July 2000 and June 2011 of 1156 severely obese (body mass index [BMI] ≥35) participants aged 18 to 72 years (82{\%} women; mean BMI, 45.9; 95{\%} CI, 31.2-60.6) who sought and received RYGB surgery (n=418), sought but did not have surgery (n=417; control group 1), or who were randomly selected from a population-based sample not seeking weight loss surgery (n=321; control group 2). Main Outcome Measures: Weight loss, diabetes, hypertension, dyslipidemia, and health-related quality of life were compared between participants having RYGB surgery and control participants using propensity score adjustment. Results: Six years after surgery, patients who received RYGB surgery (with 92.6{\%} follow-up) lost 27.7{\%} (95{\%} CI, 26.6{\%}-28.9{\%}) of their initial body weight compared with 0.2{\%} (95{\%} CI, -1.1{\%} to 1.4{\%}) gain in control group 1 and 0{\%} (95{\%} CI, -1.2{\%} to 1.2{\%}) in control group 2. Weight loss maintenance was superior in patients who received RYGB surgery, with 94{\%} (95{\%} CI, 92{\%}-96{\%}) and 76{\%} (95{\%} CI, 72{\%}-81{\%}) of patients receiving RYGB surgery maintaining at least 20{\%} weight loss 2 and 6 years after surgery, respectively. Diabetes remission rates 6 years after surgery were 62{\%} (95{\%} CI, 49{\%}-75{\%}) in the RYGB surgery group, 8{\%} (95{\%} CI, 0{\%}-16{\%}) in control group 1, and 6{\%} (95{\%} CI, 0{\%}-13{\%}) in control group 2, with remission odds ratios (ORs) of 16.5 (95{\%} CI, 4.7-57.6; P<.001) vs control group 1 and 21.5 (95{\%} CI, 5.4-85.6; P<.001) vs control group 2. The incidence of diabetes throughout the course of the study was reduced after RYGB surgery (2{\%}; 95{\%} CI, 0{\%}-4{\%}; vs 17{\%}; 95{\%} CI, 10{\%}-24{\%}; OR, 0.11; 95{\%} CI, 0.04-0.34 compared with control group 1 and 15{\%}; 95{\%} CI, 9{\%}-21{\%}; OR, 0.21; 95{\%} CI, 0.06-0.67 compared with control group 2; both P<.001). The numbers of participants with bariatric surgery-related hospitalizations were 33 (7.9{\%}), 13 (3.9{\%}), and 6 (2.0{\%}) for the RYGB surgery group and 2 control groups, respectively. Conclusion Among severely obese patients, compared with nonsurgical control patients, the use of RYGB surgery was associated with higher rates of diabetes remission and lower risk of cardiovascular and other health outcomes over 6 years.",
author = "Adams, {Ted D.} and Davidson, {Lance E.} and Litwin, {Sheldon E.} and Kolotkin, {Ronette L.} and LaMonte, {Michael J.} and Pendleton, {Robert C.} and Strong, {Michael B.} and Russell Vinik and Wanner, {Nathan A.} and Hopkins, {Paul N.} and Gress, {Richard E.} and Walker, {James M.} and Cloward, {Tom V.} and Nuttall, {R. Tom} and Ahmad Hammoud and Greenwood, {Jessica L J} and Crosby, {Ross D.} and Rodrick McKinlay and Simper, {Steven C.} and Smith, {Sherman C.} and Steven Hunt",
year = "2012",
month = "9",
day = "12",
doi = "10.1001/2012.jama.11164",
language = "English",
volume = "308",
pages = "1122--1131",
journal = "JAMA - Journal of the American Medical Association",
issn = "0002-9955",
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TY - JOUR

T1 - Health benefits of gastric bypass surgery after 6 years

AU - Adams, Ted D.

AU - Davidson, Lance E.

AU - Litwin, Sheldon E.

AU - Kolotkin, Ronette L.

AU - LaMonte, Michael J.

AU - Pendleton, Robert C.

AU - Strong, Michael B.

AU - Vinik, Russell

AU - Wanner, Nathan A.

AU - Hopkins, Paul N.

AU - Gress, Richard E.

AU - Walker, James M.

AU - Cloward, Tom V.

AU - Nuttall, R. Tom

AU - Hammoud, Ahmad

AU - Greenwood, Jessica L J

AU - Crosby, Ross D.

AU - McKinlay, Rodrick

AU - Simper, Steven C.

AU - Smith, Sherman C.

AU - Hunt, Steven

PY - 2012/9/12

Y1 - 2012/9/12

N2 - Context: Extreme obesity is associated with health and cardiovascular disease risks. Although gastric bypass surgery induces rapid weight loss and ameliorates many of these risks in the short term, long-term outcomes are uncertain. Objective: To examine the association of Roux-en-Y gastric bypass (RYGB) surgery with weight loss, diabetes mellitus, and other health risks 6 years after surgery. Design, Setting, and Participants: A prospective Utah-based study conducted between July 2000 and June 2011 of 1156 severely obese (body mass index [BMI] ≥35) participants aged 18 to 72 years (82% women; mean BMI, 45.9; 95% CI, 31.2-60.6) who sought and received RYGB surgery (n=418), sought but did not have surgery (n=417; control group 1), or who were randomly selected from a population-based sample not seeking weight loss surgery (n=321; control group 2). Main Outcome Measures: Weight loss, diabetes, hypertension, dyslipidemia, and health-related quality of life were compared between participants having RYGB surgery and control participants using propensity score adjustment. Results: Six years after surgery, patients who received RYGB surgery (with 92.6% follow-up) lost 27.7% (95% CI, 26.6%-28.9%) of their initial body weight compared with 0.2% (95% CI, -1.1% to 1.4%) gain in control group 1 and 0% (95% CI, -1.2% to 1.2%) in control group 2. Weight loss maintenance was superior in patients who received RYGB surgery, with 94% (95% CI, 92%-96%) and 76% (95% CI, 72%-81%) of patients receiving RYGB surgery maintaining at least 20% weight loss 2 and 6 years after surgery, respectively. Diabetes remission rates 6 years after surgery were 62% (95% CI, 49%-75%) in the RYGB surgery group, 8% (95% CI, 0%-16%) in control group 1, and 6% (95% CI, 0%-13%) in control group 2, with remission odds ratios (ORs) of 16.5 (95% CI, 4.7-57.6; P<.001) vs control group 1 and 21.5 (95% CI, 5.4-85.6; P<.001) vs control group 2. The incidence of diabetes throughout the course of the study was reduced after RYGB surgery (2%; 95% CI, 0%-4%; vs 17%; 95% CI, 10%-24%; OR, 0.11; 95% CI, 0.04-0.34 compared with control group 1 and 15%; 95% CI, 9%-21%; OR, 0.21; 95% CI, 0.06-0.67 compared with control group 2; both P<.001). The numbers of participants with bariatric surgery-related hospitalizations were 33 (7.9%), 13 (3.9%), and 6 (2.0%) for the RYGB surgery group and 2 control groups, respectively. Conclusion Among severely obese patients, compared with nonsurgical control patients, the use of RYGB surgery was associated with higher rates of diabetes remission and lower risk of cardiovascular and other health outcomes over 6 years.

AB - Context: Extreme obesity is associated with health and cardiovascular disease risks. Although gastric bypass surgery induces rapid weight loss and ameliorates many of these risks in the short term, long-term outcomes are uncertain. Objective: To examine the association of Roux-en-Y gastric bypass (RYGB) surgery with weight loss, diabetes mellitus, and other health risks 6 years after surgery. Design, Setting, and Participants: A prospective Utah-based study conducted between July 2000 and June 2011 of 1156 severely obese (body mass index [BMI] ≥35) participants aged 18 to 72 years (82% women; mean BMI, 45.9; 95% CI, 31.2-60.6) who sought and received RYGB surgery (n=418), sought but did not have surgery (n=417; control group 1), or who were randomly selected from a population-based sample not seeking weight loss surgery (n=321; control group 2). Main Outcome Measures: Weight loss, diabetes, hypertension, dyslipidemia, and health-related quality of life were compared between participants having RYGB surgery and control participants using propensity score adjustment. Results: Six years after surgery, patients who received RYGB surgery (with 92.6% follow-up) lost 27.7% (95% CI, 26.6%-28.9%) of their initial body weight compared with 0.2% (95% CI, -1.1% to 1.4%) gain in control group 1 and 0% (95% CI, -1.2% to 1.2%) in control group 2. Weight loss maintenance was superior in patients who received RYGB surgery, with 94% (95% CI, 92%-96%) and 76% (95% CI, 72%-81%) of patients receiving RYGB surgery maintaining at least 20% weight loss 2 and 6 years after surgery, respectively. Diabetes remission rates 6 years after surgery were 62% (95% CI, 49%-75%) in the RYGB surgery group, 8% (95% CI, 0%-16%) in control group 1, and 6% (95% CI, 0%-13%) in control group 2, with remission odds ratios (ORs) of 16.5 (95% CI, 4.7-57.6; P<.001) vs control group 1 and 21.5 (95% CI, 5.4-85.6; P<.001) vs control group 2. The incidence of diabetes throughout the course of the study was reduced after RYGB surgery (2%; 95% CI, 0%-4%; vs 17%; 95% CI, 10%-24%; OR, 0.11; 95% CI, 0.04-0.34 compared with control group 1 and 15%; 95% CI, 9%-21%; OR, 0.21; 95% CI, 0.06-0.67 compared with control group 2; both P<.001). The numbers of participants with bariatric surgery-related hospitalizations were 33 (7.9%), 13 (3.9%), and 6 (2.0%) for the RYGB surgery group and 2 control groups, respectively. Conclusion Among severely obese patients, compared with nonsurgical control patients, the use of RYGB surgery was associated with higher rates of diabetes remission and lower risk of cardiovascular and other health outcomes over 6 years.

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