Distal gastric bypass produced greater weight loss, with nutritional trade-offs
Long-term randomized-trial follow-up found more weight loss after distal bypass, alongside more vitamin D deficiency and no clear quality-of-life advantage.
Based on the published abstract. The full paper may contain additional methods, results and limitations.
The 30-second takeaway
Distal bypass produced greater long-term weight loss, but the comparison also raised nutritional safety concerns. Vitamin D deficiency was more frequent, and some patients needed revision for malnutrition. Quality of life and the prevalence of several metabolic conditions did not clearly differ. More weight loss therefore did not translate into a demonstrated advantage across all outcomes.
Only 79 of the original 113 patients were available at follow-up. This limits confidence in the long-term comparison, particularly for uncommon harms.
What researchers found
Greater BMI reduction after distal bypass
Between-group difference in mean BMI reduction from baseline, distal versus standard bypass at 10 years; P = 0.002.
Nutritional outcomes
Diarrhoea was more frequent after distal surgery. Malnutrition was also numerically more common, but that difference was not statistically significant. Revision surgery for malnutrition occurred in the distal group.
Deaths require careful interpretation
All reported deaths occurred after distal surgery. The abstract says a death may have been surgery-associated in a patient with previously unrecognized liver cirrhosis; it does not establish that the procedure caused every death.
The original publication
Effect of standard versus long alimentary limb distal Roux-en-Y gastric bypass on weight loss and nutritional outcomes at 10 years in patients with BMI 50-60 kg/m2-a secondary analysis of a randomized clinical trial.
Salte OB, Hagen RE, Svanevik M et al.
Br J Surg · 2025
- PubMed ID
- 41553109
- Record checked
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