Why the study?
Although metabolic and bariatric surgery reduces the health risks of severe obesity, it was uncertain which operation is most effective or cost-effective.
Does Roux-en-Y gastric bypass or sleeve gastrectomy improve weight loss and quality of life compared to adjustable gastric banding in adults with severe obesity?
Population
1346 adults with severe obesity meeting national criteria for metabolic and bariatric surgery in the UK
Comparison
Roux-en-Y gastric bypass vs adjustable gastric banding vs sleeve gastrectomy
Design
Pragmatic, multicentre, open-label, three-group randomised controlled trial
Follow-up
3 years
Key result
Roux-en-Y gastric bypass and sleeve gastrectomy resulted in significantly greater weight loss and higher quality of life compared to adjustable gastric banding at 3 years in patients with severe obesity.
Authors
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RYGB should be first-line for severe obesity surgery; confirms its superiority to banding and sleeve in weight loss, QoL, and cost-effectiveness.
RCT (n=1,346)
Open-label
Cohort minimization
Yes
Does Roux-en-Y gastric bypass or sleeve gastrectomy improve weight loss and quality of life compared to adjustable gastric banding in adults with severe obesity?
Absolute Risk Reduction: 41 (95% CI 34–48)
Absolute Event Rate: 68% vs 25%
Absolute Risk Reduction: 41%
Roux-en-Y gastric bypass and sleeve gastrectomy are more effective than adjustable gastric banding for weight loss and quality of life at 3 years, with Roux-en-Y gastric bypass being superior to sleeve gastrectomy for weight loss.
Abbott et al. (2025) conducted an RCT in Severe obesity (n=1,346). Roux-en-Y gastric bypass vs. Adjustable gastric banding was evaluated on Proportion achieving ≥50% excess weight loss at 3 years (adjusted risk difference 41%, 95% CI 34 to 48). Roux-en-Y gastric bypass and sleeve gastrectomy resulted in significantly greater weight loss and higher quality of life compared to adjustable gastric banding at 3 years in patients with severe obesity.