JAMA: The benefits and risks of adult bariatric surgery are all you need to know in this review.

Some time ago, a topic about "Yang naive to have gastric surgery" went on the microblogging hot search, which caused a lot of discussion among netizens.
is a well-known entertainment industry agent, because of the usual busy work business pressure, suffering from diabetes and obesity, she has not been able to achieve good diet control.
August 11, she posted a video on Weibo announcing that she would have gastric surgery, and many netizens expressed surprise and wonder: "Will this operation not cause harm to the body?" Not too risky? Isn't it worth it? "Does gastric resection really lose weight? Feel contrary to the normal physiological mechanism, or force their regular diet to strengthen exercise is better..." So, gastric excision surgery is what is the matter, in order to lose weight or cure? What are its adaptations and the risks? On September 1st JAMA published a review called Benefits and Risks of Bariatric Surgery in Adults, the benefits and risks of adult bariatric surgery, which may answer our questions.
, the most effective long-term treatment for severely obese patients with type 2 diabetes is bariatric surgery, said lead author Professor David E. Arterburn, who co-authored the paper.
but few clinicians talk to patients about this, mainly because they worry that the long/short-term risks of surgery outweigh the benefits.
history of bariatric surgery is quite tortuous.
empty intestine re-intestinal bypass, gastric band forming and laparoscopy adjustable gastric banding (AGB) due to adverse reactions unbearable, high re-surgery rate, or poor long-term efficacy, has been basically abandoned.
, the long-term evidence base for Roux-en-Y gastric bypass (RYGB) has improved significantly.
With regard to the adaptive effects of bariatric surgery, the 1991 National Institutes of Health guidelines recommend that patients with a body mass index (in kilograms divided by the square of height divided by meters) above 40 or 40, 35 or 35 and with severe obesity-related co-diseases should consider weight loss surgery.
These guidelines are still widely used; however, there is growing evidence that weight loss treatment should be considered for people with type 2 diabetes and people with a BMI between 30 and 35, even with the best type 2 diabetes medication, when high blood sugar is not fully controlled.
In this review, the researchers collected all relevant information about bariatric surgery, gastric bypass surgery, and gastric sleeve excision from pubMed until January 2020, sifting through high-level studies and analyzing, comparing and summarizing those findings.
answered the current common questions about bariatric surgery: 1. What are the most common bariatric surgery? Bariatric surgery has changed over the past few years, with an estimated 61 per cent of the 252,000 cases being sleeve gastric excisions, followed by Roux-en-Y gastric bypass surgery (RYGB), or 17 per cent.
adjustable gastric band (AGB) and bile pancreatic striatage surgery each accounted for less than 2%.
2. Which weight loss method is more effective for weight loss? The weight loss effect of bariatric surgery varies according to the procedure, the best method of weight loss is still uncertain.
randomized trial comparing the two surgical methods showed that patients who received RYGB and cuff gastomectomy had similar weight loss effects, while observational studies showed that RYGB patients had better weight loss than patients with cuff gastric excision.
3. Have any patients rebounded in weight after bariatric surgery? In general, over time, patients usually begin to experience weight recovery in the second year after surgery, but it is relatively rare to regain 5% or less of their preoperative weight.
4. Is bariatric surgery more effective than standard diabetes treatment? About the efficacy of bariatric surgery has been published in 12 randomized trials, a total of 874 patients, of which 11 trials through at least 5 years of follow-up showed that weight loss surgery in promoting blood sugar control and alleviating type 2 diabetes is better than drug treatment.
data are supported by long-term observational studies.
showed that bariatric surgery had a lower incidence and mortality of microvascular and large vascular complications than conventional diabetes treatment.
5. Which weight loss method is more effective for diabetes treatment? Randomized trials comparing the two surgical methods showed similar improvements in blood sugar control in patients receiving RYGB and sleeve gastomy, while observational studies usually showed that RYGB patients had greater improvements in blood sugar control and longer-lasting diabetes relief.
. What is the effect of bariatric surgery on other obesity-related co-diseases? Randomized trials and observational studies have generally shown that bariatric surgery can improve hypertension and blood lipid abnormalities and reduce drug use compared to non-surgical treatments.
observational studies have shown that bariatric surgery has a lower risk of cancer and a better prognostic prognostic period for sleep apnea, osteoarthritis and urinary incontinence than non-surgical treatments, but randomized trials are needed to confirm these findings.
7. Which weight loss method is the safest? Currently, the risk of major adverse events (including additional surgery, intervention, and hospitalization) after RYGB appears to be greater than after a sleeve gastric excision;
8. Which weight loss method is "best" for me? Given the trade-off between the risks, benefits and uncertainty of long-term effects of bariatric surgery, there is currently no best treatment for all patients.
therefore, the choice of surgery should be based on a shared decision-making process that prioritizes the patient's own values and preferences.
12 bariatric surgery and drug/lifestyle treatment of type 2 diabetes randomized clinical trials (n - 874) sleeve gastrectomy, is currently the world's most common bariatric surgery in general, modern bariatric surgery has strong efficacy and safety evidence.
All patients with severe obesity, especially those with type 2 diabetes, should have a common decision-making dialogue on the risks and benefits of surgery and ongoing routine medical and lifestyle treatment, and decisions about surgery should be primarily based on the patient's informed preferences.
From this point of view, Yang naive response to the gastric excision also reflects in some aspects of the patient's medical awareness of the progress, "I have no dissatisfaction with their own appearance, shape has never affected me like myself, the main purpose of surgery is to cure the disease."
" she also revealed that she has been diabetic for six years, has complications and other problems, and chronic disease treatment needs to do the law of rest she can not meet, the main purpose of the operation is to quickly lower blood sugar.
s physical and living conditions are different, I need external help to help my health, and I don't think we're all like me," she says.
what do you think of bariatric surgery? References: Arterburn, D. E., Telem, D.A., Kushner, R.F., samp; Courcoulas, A. P. (2020). Benefits and Risks of Bariatric Surgery in Adults. JAMA, 324 (9), 879. doi:10.1001/jama.2020.12567 Source: MedSci Originals !-- Content Presentation Ends -- !-- To Determine If Login Ends.