Weight Loss Maintained for 20 Years: Study Reveals Long-Term Effectiveness of Gastric Bypass

Gastric bypass keeps diabetes in remission for 15 years and weight loss maintained for 20 years, according to a large, long-term study.

Roux-en-Y gastric bypass, a type of weight-loss surgery, kept type 2 diabetes in remission for up to 15 years and most of the weight off for up to 20 years in one of the largest long-term studies of patients undergoing the procedure. The study “Long Term (> 15 Year) Outcomes Following Roux-en-Y Gastric Bypass” will be presented today (June 12) at the American Society for Metabolic and Bariatric Surgery (ASMBS) 2024 Annual Scientific Meeting.

Study Details and Initial Findings

Researchers from Geisinger Medical Center in Danville, Pennsylvania analyzed diabetes remission rates and weight-loss outcomes of 2,045 patients who had a gastric bypass at their center between 2001 and 2008 and followed them for up to 20 years. Patients, on average, were 46 years old with a body mass index (BMI) of 47.9, prior to surgery.

Of the 677 patients with pre-operative diabetes, remission rates were 54% at the three-year mark but dropped to 38% after 15 years. Only about 10% of patients with insulin-dependent diabetes had remission in the same timeframe and the rate of persistent diabetes was higher in patients who had insulin-treated diabetes before surgery.

About Weight-Loss Surgery

Metabolic, bariatric, or weight-loss surgery such as gastric bypass and sleeve gastrectomy has been shown to be the most effective and long-lasting treatment for severe obesity. The operations improve or resolve diseases including type 2 diabetes, heart disease and high blood pressure and leads to significant and durable weight loss. Its safety profile is comparable to some of the safest and most commonly performed surgeries in the U.S. including gallbladder surgery, appendectomy, and knee replacement.

Surgical Safety and Mortality Rates

Peak weight loss of 31.8% was achieved after 18 months and stabilized at 23% after 10 years and up to the 20-year mark. The overall 15-year mortality rate was 13.3%, which was 37.4% among patients with diabetes and older than 60. No deaths were related to the surgical procedure itself.

“With the availability of medical and endoscopic therapies, the demonstration of long-term effectiveness of gastric bypass that exceeds that of these alternatives is critical to providing the right intervention for the right patient at the right time,” said study author Anthony T. Petrick, MD, FACS, Director, Division of Bariatric and Foregut Surgery, Geisinger Health System.

Prevalence and Eligibility for Bariatric Procedures

The ASMBS reports that nearly 280,000 metabolic and bariatric procedures were performed in 2022, which represents only about 1% of those who meet eligibility requirements based on BMI.

“The study is an important contribution to the current understanding of long-term outcomes of gastric bypass because of the extremely high follow-up rates,” said Marina Kurian, MD, ASMBS President, who was not involved in the study.

According to the U.S. Centers for Disease Control and Prevention (CDC), obesity effects 42.4% of Americans. Studies show the disease can weaken or impair the body’s immune system and cause chronic inflammation and increase the risk of many other diseases and conditions including cardiovascular disease, stroke, type 2 diabetes, and certain cancers.

A447 — Long Term (> 15 Year) Outcomes Following Roux-en-Y Gastric Bypass

John Nguyen-Lee Danville PA, Michael Furey Dallas PA, Craig Wood Danville PA, Luis Pina Danville PA, Mark Mahan Danville PA1, Ryan Horsley Scranton PA, Benefsha Mohammad Danville PA, Alexandra Falvo Scranton PA, Christopher Still Danville PA, Peter Benotti Danville NY, David Parker Danville PA, Vladan Obradovic Manlius NY, Anthony Petrick Danville PA, Geisinger Medical Center