Mixed
Biliopancreatic diversion with duodenal switch (BPD/DS) and its variants (SADI, TB) provide superior weight loss compared to Sleeve Gastrectomy (SG) and Roux-en-Y Gastric Bypass (RYGB) in extreme obesity, but at the cost of higher early complication rates and malnutrition risk.
For extreme obesity, malabsorptive surgeries like BPD/DS or SADI provide the best weight loss (38%+), significantly better than SG (23%) or RYGB (26%). However, these come with higher early complication rates (12.9% vs 4-8%). SG is safer but less effective for weight loss, making it a good option for older/younger patients or as a first step.
Notably, the 30-day complication rate was significantly higher in the BPD/DS group (12.9%) compared with the RYGB (4.7%) and SG (8.7%) groups... procedures with the greatest percentages of TWL were BPD/DS (38.4%), followed by RYGB (26.3%) and SG (23.6%)
Why this rating
Based on multiple retrospective studies and meta-analyses cited (references 35, 38, 48).
Source
Challenges in the care and treatment of patients with extreme obesity
Matheo Augusto Morandi Stumpf et al. · Archives of Endocrinology and Metabolism · 2024
DOI 10.20945/2359-4292-2023-0335
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Related findings · Mixed
- Bariatric surgery (VSG and RYGB) is the most effective and sustainable treatment for obesity, producing marked and sustained weight loss that non-surgical interventions cannot match.Strong
- Severely protein-deficient diets (2–3% energy) induce lean body mass loss and metabolic imbalance, whereas adequate protein intake (0.66 g/kg/d minimum) is a prerequisite for maintaining muscle, bone, and physiological function.Strong
- For patients with Class III obesity (BMI >39.9 kg/m2), metabolic bariatric surgery (MBS) is significantly more effective than any currently approved medication, with BilioPancreatic Diversion (BPD) showing the highest estimated weight loss.Strong
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