Trial reportThe lancet. Diabetes & endocrinology2025
Roux-en-Y gastric bypass, adjustable gastric banding, or sleeve gastrectomy for severe obesity (By-Band-Sleeve): a multicentre, open label, three-group, randomised controlled trial.
Trial report in The lancet. Diabetes & endocrinology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02841527 (Gastric Bypass, Adjustable Gastric Banding or Sleeve Gastrectomy Surgery to Treat Severe and Complex Obesity), which is not on this map. Cited by 15 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Gastric Bypass, Adjustable Gastric Banding or Sleeve Gastrectomy Surgery to Treat Severe and Complex Obesity: a Multi-centre Randomised Controlled Trial
Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Experienced Weight Stigma Changes Following Bariatric Surgery: a Systematic Review and Meta-Analysis.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2026Pooled it
- Roux-en-Y Gastric Bypass versus Sleeve Gastrectomy for Cardiometabolic Outcomes: A Systematic Review and Meta-analysis of Randomized Controlled Trials.Obesity surgery · 2026Pooled it
- A multihit cascade of late complications after Roux-en-Y gastric bypass leading to refractory malnutrition: a case report.International journal of surgery case reports · 2026Article
- Reappraising obesity management in the GLP-1 receptor agonist era.npj metabolic health and disease · 2026Article
- Multivariate analysis of metabolomic data to identify biological pathways modified by a clinical intervention.Metabolomics : Official journal of the Metabolomic Society · 2026Article
- Article
- Changes in Health-Related Quality of Life After Metabolic and Bariatric Surgery: A Prospective Single-Center Cohort Study.Obesity science & practice · 2026Article
- Bariatric Surgery in the Era of GLP1RA: A Narrative Review.Advances in therapy · 2026Review
- Article
- Healthcare utilisation across five years among adolescents following metabolic-bariatric surgery; a prospective observational study.Lancet regional health. Americas · 2026Article
- Article
- Patient characteristics and perioperative outcomes in the Bypass Equipoise Sleeve Trial (BEST) compared to general metabolic bariatric practice in Sweden.The British journal of surgery · 2025Article
- Intravenous Iron Infusion in the Treatment of Iron Deficiency Anaemia Following Bariatric and Metabolic Surgery and Correlation with Gynaecological Disorders: Retrospective Review of Experience from a Tertiary Centre.Medicina (Kaunas, Lithuania) · 2025Article
- Sleeve gastrectomy versus Roux-en-Y-gastric bypass in patients with body mass index over 50 kg/m2: international multicentre cohort.BJS open · 2025Observational
- Untargeted metabolomics data in the By-Band-Sleeve trial and ALSPAC: integrating clinical trial and population cohort data.Wellcome open research · 2025Article
Corrections and comments
- Commented on by
Authors and funding
1 author.
Funding
Abstract
backgroundThe health risks of severe obesity can be reduced with metabolic and bariatric surgery, but it is uncertain which operation is most effective or cost-effective. We aimed to compare Roux-en-Y gastric bypass, adjustable gastric banding, and sleeve gastrectomy in patients with severe obesity.
methodsBy-Band-Sleeve is a pragmatic, multi-centre, open-label, randomised controlled trial conducted in 12 hospitals in the UK. Eligible participants were adults (aged ≥18 years) meeting national criteria for metabolic and bariatric surgery. Initially, a 2-group trial (Roux-en-Y gastric bypass versus adjustable gastric banding) became a 3-group trial to include sleeve gastrectomy at 2·6 years from study opening, when it became widely used in the UK. Co-primary endpoints were weight (proportion achieving ≥50% excess weight loss) and quality-of-life (EQ-5D utility score) at 3 years. If the proportion achieving at least 50% excess weight loss was non-inferior (<12% difference between groups) and quality-of-life was superior, sleeve gastrectomy and Roux-en-Y gastric bypass were considered more effective than adjustable gastric banding, and sleeve gastrectomy more effective than Roux-en-Y gastric bypass. Cost-effectiveness of the procedures was compared. This trial is registered with ClinicalTrials.gov, NCT02841527, and ISRCTN, 00786323.
resultsBetween Jan 16, 2013, and Sept 27, 2019, 1351 participants were randomly assigned; five withdrew consent and 1346 (mean age 47·3 [SD 10·6] years, 1020 [76%] women, 324 (24%) men, and two with missing data, mean weight of 129·7 kg [23·6] and mean BMI of 46·4 [6·9] kg/m
interpretationRoux-en-Y gastric bypass and sleeve gastrectomy are more effective than adjustable gastric banding. Sleeve gastrectomy has inferior weight loss and lower mean quality of life score compared with Roux-en-Y gastric bypass. Based on this evidence, it is recommended that patients electing to have metabolic and bariatric surgery are advised to have Roux-en-Y gastric bypass. Where contraindicated or unfeasible, sleeve gastrectomy should be offered. This evidence does not support adjustable gastric band as standard treatment for severe obesity.
fundingNational Institute for Health and Care Research Health Technology Assessment Programme.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.