In a previous study, Roux-Y gastric bypass was found to be significantly more effective than vertical banded gastroplasty for weight loss in morbid weight problems, especially for patients addicted to sweets, probably consequently of dumping syndrome symptoms. This study evaluated the capability to selectively assign nonsweet eaters to vertical banded gastroplasty and sweet eaters to gastric bypass.
Compared with random project, the percentage unwanted weight lost at 2 years improved significantly with both groups mixed. In the vertical banded gastroplasty group, the percentage increased from 41 ± 19 to 55 ± 19 percent. With selective project, the percentage unwanted weight lost with gastric bypass was better than that with vertical banded gastroplasty still. Weight loss with gastric bypass was still more advanced than that of vertical banded gastroplasty but at the expense of more complications. Gastric bypass was ineffective in 19 percent of the very obese patients. A combined restrictive, malabsorptive procedure may be necessary in such persons.
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