More effective bariatric surgery for super obesity

Reported by Susan Aldridge, PhD, medical journalist

The duodenal switch is a better form of gastric surgery for super obesity.
Super obesity is defined as having a body mass index (BMI) of more than 50 - that is, carrying more than 150 pounds of your ideal weight. It used to be rare - affecting fewer than one in 2,000 people in the US in 1987 when the term super obesity was coined. Now it affects around one in 400. Super obesity can be dealt with by bariatric (weight loss) surgery - and a new study from the University of Chicago compares two different operations.

In the standard operation, the gastric bypass, the stomach is made smaller. In the newer duodenal switch operation, the reduction of the stomach is less but more drastic alterations are made to the intestines to limit the absorption of fat and sugar. In this study. 320 patients with super obesity underwent either gastric bypass or duodenal switch. The latter led to better long term weight loss - defined as a loss of more than half of the excess weight.

At one year, 84 per cent of those undergoing duodenal switch had lost more than half their excess weight compared to 70 per cent having a gastric bypass. At three years, the corresponding figures were 84 per cent and 60 per cent. Till now, doctors have been reluctant to choose duodenal switch as it is technically more demanding and there was no evidence of its clinical benefit over gastric bypass. Their views may change with the current findings. Research into how the long term benefit of duodenal switch compares to gastric bypass is ongoing.

Source
Annals of Surgery October 2006

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