SAN ANTONIO — Roux-en-Y gastric bypass surgery resulted in significant weight loss for severely obese patients, and the weight loss was sustained for an average of six years after the surgery, according to a new study.

Patients who had the surgery also experienced frequent remission and lower incidence of diabetes, hypertension and abnormal cholesterol levels, compared with participants who did not have the surgery, according to the study published this fall in the Journal of the American Medical Association. JAMA’s theme issue on obesity was published to coincide with the Obesity Society’s Annual Scientific Meeting.1

Co-author Sheldon Litwin, MD, of the Charlie Norwood VA Medical Center in Augusta, GA, said the research could provide a solution to the overwhelming issue of obesity in the United States.

“The problem is of enormous magnitude. Everything from the heart disease process to its diagnosis and treatment are affected by obesity. We see it every day. This really is the No. 1 issue facing us,” said Litwin, who added that he is now “seeing 25-year-olds weighing 350 pounds who present with chest pain or shortness of breath.”

At a JAMA media briefing, co-author Ted D. Adams, PhD, MPH, of the University of Utah School of Medicine and Intermountain Healthcare, both in Salt Lake City, added, “The prevalence of extreme obesity in the United States is increasing at a rate greater than moderate obesity. Unfortunately, lifestyle therapy is generally insufficient as a weight-management intervention for patients who are extremely obese. To date, effective long-term weight loss through pharmacological therapy has been marginal, leaving bariatric surgery as the only medical intervention providing substantial, long-term weight loss for most patients who are severely obese.”

For the study, researchers examined the association of Roux-en-Y gastric bypass (RYGB) surgery with weight loss, diabetes mellitus, and other health risks six years after surgery. The study included 1,156 severely obese (body mass index [BMI] 35 or greater) participants, ages 18 to 72 years (82% women; average BMI, 46) who sought and received RYGB surgery (n = 418), sought but did not have surgery (n = 417; control group 1), or who were randomly selected from a population-based sample not seeking weight loss surgery (n = 321; control group 2).

Average unadjusted weight loss in the surgical group was 27.7% from the beginning of the study to Year Six.

“At two years, 99% of surgical patients had maintained more than 10% weight loss from baseline and 94% had maintained more than 20% weight loss,” the authors wrote. “At six years, 96% of surgical patients had maintained more than 10% weight loss from baseline, and 76% had maintained more than 20% weight loss.”

In addition, diabetes remission rates were significantly higher for the surgery group than the two control groups — 62% vs. 8% for Control Group 1; and 6% for Control Group 2. Diabetes incidence in the surgery group was significantly lower than in the two control groups, as well, 2% vs. 17% and 15%, respectively. Hypertension, triglyceride levels and cholesterolemia also improved.

During the study period, however, hospitalizations were higher for the patients who received bariatric surgery.

1. Adams TD, Davidson LE, Litwin SE, et. al. Health benefits of gastric bypass surgery after six years. JAMA. 2012 Sep 19;308(11):1122-31. PubMed PMID: 22990271.