A. A new study shows that Roux-en-Y gastric bypass surgery, a type of weight-loss procedure, can keep type 2 diabetes in remission for up to 15 years and maintain weight loss for up to 20 years. This finding is based on one of the largest long-term studies of patients who underwent this surgery. Today, the American Society for Metabolic and Bariatric Surgery (ASMBS) 2024 Annual Scientific Meeting presented the findings.

Researchers at Geisinger Medical Centre in Danville, PA, studied the diabetes remission rates and weight-loss outcomes of 2,045 patients who had gastric bypass surgery between 2001 and 2008, following them for up to 20 years. Geisinger Medical Centre conducted the study to determine the long-term efficacy of gastric bypass surgery in treating type 2 diabetes and obesity. Researchers followed the patients' health outcomes for two decades. 

Prior to surgery, patients had an average age of 46 and a body mass index (BMI) of 47.9. Before surgery, 54% of the 677 diabetic patients were in remission at three years, but this fell to 38% after 15 years. Notably, only 10% of patients who required insulin prior to surgery experienced remission. The peak weight loss of 31.8% occurred 18 months after surgery and stabilised at 23% after 10 to 20 years. The overall 15-year mortality rate was 13.3%, with diabetic patients over the age of 60 accounting for 37.4%. There were no deaths as a result of the surgery itself.

"With the availability of medical and endoscopic therapies, the demonstration of the long-term effectiveness of gastric bypass that exceeds these alternatives is critical to providing the right intervention for the right patient at the right time," said study author Dr. Anthony T. Petrick, Director of the Division of Bariatric and Foregut Surgery at Geisinger Health System. 

According to the ASMBS, nearly 280,000 metabolic and bariatric procedures were performed in 2022, accounting for approximately 1% of those eligible based on BMI. 

"The study is an important contribution to the current understanding of the long-term outcomes of gastric bypass because of the extremely high follow-up rates," said ASMBS President Dr. Marina Kurian, who was not involved in the study. 

According to the US Centres for Disease Control and Prevention (CDC), 42.4% of Americans are obese. Obesity can weaken the immune system, lead to chronic inflammation, and increase the risk of diseases like cardiovascular disease, stroke, type 2 diabetes, and certain cancers. 

Weight-loss surgery, also referred to as metabolic or bariatric surgery, includes procedures such as gastric bypass and sleeve gastrectomy. These surgeries are the most effective and long-lasting treatments for severe obesity, resulting in significant weight loss and the improvement or resolution of conditions such as type 2 diabetes, heart disease, and high blood pressure. These surgeries have a similar safety profile to some of the safest and most common procedures in the United States, such as gallbladder surgery, appendectomy, and knee replacement.