Mixed
Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) are more effective than adjustable gastric banding (AGB) for weight loss and quality of life in severe obesity, with RYGB providing superior weight loss compared to SG.
If you have severe obesity and are considering surgery, Roux-en-Y gastric bypass offers the best chance for significant, lasting weight loss and improved quality of life. Sleeve gastrectomy is a good alternative if bypass is not possible, but expect less weight loss. Adjustable gastric banding is not recommended as it is significantly less effective. Discuss these options with a specialist bariatric team to determine the best fit for your health profile.
Roux-en-Y gastric bypass and sleeve gastrectomy are more effective than adjustable gastric banding. Sleeve gastrectomy has inferior weight loss and lower mean quality of life score compared with Roux-en-Y gastric bypass.
Why this rating
Multi-centre, randomised controlled trial with 1346 participants, long-term follow-up (3 years), and rigorous statistical analysis.
Source
Roux-en-Y gastric bypass, adjustable gastric banding, or sleeve gastrectomy for severe obesity (By-Band-Sleeve): a multicentre, open label, three-group, randomised controlled trial
Sally Abbott et al. · The Lancet Diabetes & Endocrinology · 2025
DOI 10.1016/s2213-8587(25)00025-7
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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