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Clinical Research

Greater durability of weight loss at ten years with gastric bypass compared to sleeve gastrectomy

International Journal of Obesity volume 49, pages 1153–1158 (2025)Cite this article

Subjects

Abstract

Introduction

Sleeve gastrectomy (SG) and gastric bypass (GB) are the most commonly performed bariatric surgeries. However, there is insufficient data on which leads to greater long-term (10 year) weight loss.

Methods

Subjects who underwent SG and GB from 2008–2013 were followed up at 2, 5, and 10 years post-operatively for weight and diabetes (DM) outcomes. Percentage total weight loss (%TWL), weight regain ( ≥ 20% from nadir) and DM remission rates were compared.

Results

Subjects (n = 253) who underwent SG (60.9%) and GB (39.1%) were included. The mean age was 41.4 ± 10.6 y, 39.1% were male, and the mean body mass index was 42.1 ± 9.3 kg/m2 with no significant difference between groups. The GB group had a greater proportion of subjects with DM (83.8% vs 19.5%, p < 0.001). At 2 y, %TWL was comparable (GB: 22.3 ± 9.6%, SG: 22.6 ± 10.5%, p = 0.824). However, those who underwent GB had significantly higher %TWL at 5 y (GB: 21.5 ± 8.9%, SG 18.0 ± 11.3%, p = 0.029) and 10 y (GB: 21.0 ± 9.0%, SG: 15.4 ± 12.1%, p = 0.001). The rate of significant weight regain was higher amongst the SG group at both 5 y (SG: 14.7%, GB: 3.8%, p = 0.018) and 10 y (SG: 27.9%, GB: 13.7%, p = 0.037) post-operatively. On multiple linear regression, GB remained significantly associated with greater %TWL at 10 y compared to SG (b = 5.51; adjusted p-value = 0.013), after adjusting for age, sex, pre-operative BMI, pre-operative glycemic status, and surgery year. There was no difference in DM remission rates at 10 y (SG: 26.7%, GB: 19.1%, p = 0.385).

Conclusion

GB was able to produce greater %TWL and less weight regain than SG at 5 and 10 years post-operatively. There was no difference in long-term DM remission rates between the two surgeries.

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Fig. 1
Fig. 2: Long-term weight loss after sleeve gastrectomy and gastric bypass.

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Data availability

The datasets generated and/or analysed during the current study are available from the corresponding author on reasonable request.

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Author information

Authors and Affiliations

  1. Department of Endocrinology, Singapore General Hospital, Singapore, Singapore

    Sarah Ying Tse Tan, Jasmine Kai Ling Chua, Hong Chang Tan, Emily Tse Lin Ho, Jean Paul Kovalik & Phong Ching Lee

  2. Department of Internal Medicine, Singapore General Hospital, Singapore, Singapore

    Yong Qin Lee, Fan Shuen Tseng & Orlanda Qi Mei Goh

  3. SingHealth Polyclinics, Singapore, Singapore

    Gwyneth Syn & Jeremy Tian Hui Tan

  4. Department of Upper Gastrointestinal & Bariatric Surgery, Singapore General Hospital, Singapore, Singapore

    Chin Hong Lim, Alvin Kim Hock Eng, Weng Hoong Chan & Eugene Kee Wee Lim

  5. Department of Speciality Nursing, Singapore General Hospital, Singapore, Singapore

    Angelina Xiangying Foo

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Contributions

Study conception and design: PCL, SYTT, CHL, JTHT, AKHE, OQMG; Data collection: YQL, GS, FST, JKLC, AXYF, ETLH, EKWL; Analysis and interpretation of results: SYTT, JPK, HCT, WHC; Draft manuscript preparation: SYTT, YQL, GS, FST; Critical revision of the manuscript: PCL, JPK, HCT, OQMG, WHC, CHL, JTHT, AKHE, ETLH; Study supervision: PCL, CHL, SYTT; All authors reviewed the results and approved the final version of the manuscript.

Corresponding author

Correspondence to Sarah Ying Tse Tan.

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The authors declare no competing interests.

Ethics approval and consent to participate

All methods were performed in accordance with the relevant guidelines and regulations. Approval was obtained from the hospital’s Centralized Institutional Review Board (CIRB Reference Number 2020/2482). A waiver of written informed consent was granted by the Centralized Institutional Review Board.

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Tan, S.Y.T., Lee, Y.Q., Syn, G. et al. Greater durability of weight loss at ten years with gastric bypass compared to sleeve gastrectomy. Int J Obes 49, 1153–1158 (2025). https://doi.org/10.1038/s41366-025-01760-2

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  • DOI: https://doi.org/10.1038/s41366-025-01760-2

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