HealthDay News — Roux-en-Y gastric bypass (RYGB) is associated with greater weight loss at 1, 3, and 5 years than sleeve gastrectomy (SG) or adjustable gastric banding (AGB), though it also has the highest rate of 30-day adverse events, according to a study published Oct. 29 in the Annals of Internal Medicine.

David Arterburn, MD, MPH, from Kaiser Permanente Washington Health Research Institute in Seattle, and colleagues performed a retrospective cohort study to compare weight loss and safety among bariatric procedures. The study included 65,093 patients aged 20 to 79 years with a body mass index (BMI) ≥35 kg/m2. The patients had undergone bariatric procedures at 41 health systems in the National Patient-Centered Clinical Research Network from January 2005 to September 2015. Follow-up data were available for 44,978 patients at one year, 20,783 at three years, and 7159 at five years.

The researchers found that 30-day rates of major adverse events were 5% for RYGB, 2.6% for SG, and 2.9% for AGB. One-year mean total weight loss (TWL) was 31.2% for RYGB, 25.2% for SG, and 13.7% for AGB. At 5 years, the mean TWLs were 25.5% for RYGB, 18.8% for SG, and 11.7% for AGB. Less weight loss was seen among patients with diabetes, those with BMI <50 kg/m2, those aged ≥65 years, African-American patients, and Hispanic patients.

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“Health care providers, patients, and policymakers can use these data to inform treatment and insurance coverage decisions,” write the authors.

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Several authors disclosed ties to pharmaceutical and medical device companies.

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