OUTCOMES
The success of bariatric surgery is measured by weight loss maintained over time, improved health, and each patient's personal assessment of improved well being.

Weight Loss
Weight loss that is significant must be maintained. Yo-yoing is unfortunately all too common. Bariatric surgeons should follow their patients indefinitely, and report their patients' outcomes to their colleagues and in the medical literature. The ASBS considers reports of weight loss outcomes of patients less than five years post-operative, preliminary.

One of the first reports of longterm weight loss outcomes on VBG patients was Dr. Sweet's series, reported in the ASBS official journal, and presented at the ASBS annual meeting in 1994. That report of his patients five to twelve years out from VBG prompted Dr. Sweet, and others in the ASBS, to increasingly perform RYGB. Though the majority of his patients with VBG had done well, and had averaged 50% loss of their excess weight, maintained over five to twelve years, a significant minority had not done well, thus prompting use of a more effective procedure.

In a carefully followed group of patients operated on at East Carolina, now eighteen years post-operative, they have maintained an average excess weight loss of just over 50%. (see illustration of the operative technique then). With significantly smaller pouches, and longer "bypass" segments now commonly used by many members of the ASBS, long-term excess weight loss is expected to be even better, in the 60-70% range.

Ultimately individual weight loss is dependent on how well each person, carefully evaluated and counseled pre-operatively, utilizes his operative "tool." Patients with significant exercise impairment, those with diabetes, and often older patients, don't generally do as well long term. The truth is that it takes commitment, and generally lifestyle changes with regard to exercise, eating, and drinking, if one is to achieve and maintain significant weight loss.

Health Improvement

With weight loss come improvements in an individual's health.
Most significantly:

• two-thirds of gastric bypass (GB) patients who previously were treated for high blood pressure with medication no longer require any blood pressure medication;
• diabetics not on insulin but using other medications to regulate blood sugar show immediate and dramatic improvement in their blood sugar levels after GB, 80% of these patients return to normal blood sugar range without the need to take medication;
• people with asthma show marked improvement;
• problems with sleep apnea become less severe or disappear entirely;
• less joint pain and slower deterioration due to arthritis are other results of weight loss;
• one continuing European study indicates that severely obese patients who undergo bariatric surgery have fewer early deaths than those patients treated with diet and exercise.

Self Assessment

Feeling good about yourself is an important indicator of a successful outcome. In almost all cases, patients who undergo bariatric surgery report that they do feel better about themselves, and become more involved with family, friends, and work. These individuals consistently rate their experience as one of marked improvement.
For details about the risk and side effects of VBG and RYGB, please click on Risks and Side Effects.