Gastric sleeve and gastric bypass: changes in weight after two-year follow-up - which is more effective?

Bariatric surgery is currently the gold standard for the treatment of obesity. However, weight recurrence varies among the different surgical methods.

To compare changes in weight one and two years after bariatric surgery considering the gastric bypass and gastric sleeve methods.

A cross-sectional study was conducted at a hospital with adults of both sexes followed up for two years after surgery. Anthropometric, sociodemographic, clinical, and lifestyle characteristics were analyzed.

A total of 184 patients, predominantly women (82.1%), were assessed (136 submitted to gastric sleeve and 48 to gastric bypass). Good adherence to the multivitamin, but not to diet or physical activity, was verified in both groups. The percentages of weight loss and excess weight loss were higher in the gastric bypass group (one year after surgery: p<0.001 and p=0.010, respectively; two years after surgery: p<0.001 and p<0.001, respectively). Average weight gain was 2.37 kg and higher after gastric sleeve (p=0.042), whereas no difference between methods was found for the percentage of weight recurrence. Weight loss and recurrence at the two-year follow-up were influenced by diet in both groups. The percentage of weight loss was higher after gastric bypass one and two years after surgery. Weight recurrence was higher after the gastric sleeve method, without interfering with the surgical success of the technique.

We verified greater efficacy in the gastric bypass technique in terms of weight loss at 12 and 24 months postoperatively. Weight recurrence was found 24 months after both methods, especially in the gastric sleeve group, without constituting surgical failure.