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Metabolic and bariatric surgery (MBS) is shown to be more effective in the treatment of type 2 diabetes mellitus and obesity than medical weight loss in the retrospective study comparing surgical and medical cohorts with body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) lower than 35 in this issue of JAMA Surgery.1 Rates of follow-up are 96.2% in the surgical group and 83.6% in the medical group at 5 years. The effect of treatment for diabetes and obesity followed up for 5 years demonstrates durability. A comparison of 2 MBS procedures, gastric bypass (n = 33 at baseline) and sleeve gastrectomy (n = 19 at baseline), shows higher complete remission of type 2 diabetes for gastric bypass than for sleeve gastrectomy (46.9% vs 16.7%, respectively) and comparable results between the 2 procedures in the treatment of obesity. The procedure groups are small. The indication for procedure choice was patient preference. The BMI range is appropriate as East Asian patients and citizens of Asian ancestry in the United States are affected by diabetes at a much lower BMI than other groups.2
Blackstone RP. Is Metabolic and Bariatric Surgery a Population Solution for Obesity and Type 2 Diabetes?. JAMA Surg. 2015;150(12):1124-1125. doi:10.1001/jamasurg.2015.2616