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Primary and Revisional One Anastomosis Gastric Bypass: A Systematic Review and GRADE-Based IFSO Position Statement
Maurizio De Luca1, Amanda Belluzzi2, Matteo Monami3
1Department of Emergency, General and Bariatric Surgery, Rovigo Hospital, Rovigo, Italy, Rovigo, Italy. maurizio.deluca@aulss5.veneto.it.
Obesity Surgery
|December 9, 2025
Summary
One Anastomosis Gastric Bypass (OAGB) shows higher short-term excess weight loss than Roux-en-Y Gastric Bypass (RYGB). OAGB is comparable for long-term weight loss and type 2 diabetes resolution, with similar safety profiles.
Area of Science:
- Bariatric Surgery
- Metabolic Surgery
- Obesity Management
Background:
- Obesity is a chronic, systemic disease requiring professional intervention.
- Metabolic and Bariatric Surgery (MBS) are key treatments for obesity.
- Standardized methodologies are needed for developing clinical position statements.
Purpose of the Study:
- To evaluate the effectiveness and safety of One Anastomosis Gastric Bypass (OAGB) in primary and revisional settings.
- To provide evidence-based guidance for the use of OAGB within Metabolic and Bariatric Surgery (MBS).
Main Methods:
- A systematic review and meta-analysis following PRISMA guidelines.
- Inclusion of 14 Randomized Controlled Trials (RCTs) with 1288 patients.
- Comparison of OAGB outcomes against other MBS procedures, primarily RYGB.
Main Results:
- OAGB demonstrated significantly higher excess weight loss percentage (EWL%) in the short term compared to RYGB.
- OAGB showed comparable weight loss and type 2 diabetes (T2DM) resolution rates versus RYGB.
- No significant differences in safety profiles were reported between OAGB and other MBS procedures.
Conclusions:
- OAGB is effective for weight loss and metabolic improvement in both primary and revisional MBS.
- Further RCTs are necessary to establish definitive recommendations for OAGB in revisional surgery.
- The International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) recommends a GRADE-based methodology for future position statements.
