ABSTRACT
If medical treatment fails, patients may be referred for surgery. Current surgical procedures for weight loss include vertical-banded gastroplasty and Roux-en-Y gastric bypass; these effectively make the stomach smaller and produce a malabsorption syndrome. Patients who undergo such surgery lose 50-70% of their excess weight in 2 years, but approxi mately one-third to one-half of those who lose weight regain much of it after 5-10 years. The magnitude and duration of benefits of gastric surgery are the same for patients with OHS and/or sleep apnea as they are for simple obesity. An alternative surgical approach for certain patients is panniculectomy. This procedure can reduce body weight by 20%, but the long-term results are not known.
