"When it comes to shedding pounds and improving or eliminating type  diabetes gastric bypass surgery may be better than other surgical weightloss procedures two new studies find. But obese patients should be careful to choose surgeons who have performed a high volume of these procedures before committing said Dr. Guilherme M. Campos lead author of one of two papers appearing in the February issue of the Archives of Surgery. Gastric bypass and lapbanding are the two most common surgical weightloss procedures performed in the United States. The former involves stapling the stomach so food has to bypass a section of the small intestine meaning you get full faster and less food gets absorbed into the gut. Lapbanding introduced in  involves separating the stomach into two sections with a band so simply speaking eating too much becomes more difficult. Its a diet with a seatbelt said Dr. Mitchell Roslin chief of bariatric surgery at Lenox Hill Hospital in New York City and Northern Westchester Hospital in Mt. Kisco N.Y. In a third type of weightloss procedure known as sleeve gastrectomy surgeons remove part of the stomach. The study led by Campos compared weight loss and diabetes outcomes in  patients who underwent gastric bypass surgery with  patients who underwent lapbanding. Gastric bypass is considered riskier and more technically demanding than the band. All patients were morbidly obese with a bodymass index higher than  and  in each group had type  diabetes.  Although Campos is now an associate professor of surgery at the University of Wisconsin School of Medicine and Public Health in Madison he conducted the study while at the University of California San Francisco.  In the bypass group patients lost an average of  percent of their excess weight vs.  percent for those in the lapbanding group. Threequarters of those undergoing gastric bypass surgery saw their diabetes improve or resolve vs. only half in the other group. The average cost of a bariatric surgery is nearly  according to a recent study from Johns Hopkins University. Like all surgeries weightloss surgery carries its own set of possible risks including bleeding blood clots infection and leaks from sites where body tissues are sewn or stapled together according to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases. Later complications may include malnutrition hernias and a tendency in about one in  people to regain much of the weight they lost as a result of the procedure. In Campos study roughly equal numbers of patients in each group experienced complications after one year  percent in the gastric bypass group compared to  percent in the lapbanding group these included infection internal bleeding and blood clots but no deaths. More people in the bypass group had complications right after the surgery. More of those undergoing lapbanding however needed repeat surgeries  percent vs.  percent.  The second study conducted in Taiwan and led by Dr. WeiJei Lee of the MinSheng General Hospital involved randomly assigning  obese but not morbidly obese patients with type  diabetes to receive gastric bypass surgery or sleeve gastrectomy. Almost all of those undergoing gastric bypass surgery  percent had their diabetes resolved vs. only half in the other group these numbers declined to  percent and  percent after a year. Those in the gastric bypass group also lost more weight and there were no serious complications in either group. There are various theories to explain why gastric bypass may be superior including one that attributes the success to changes in hormones that control the metabolism of blood sugar.  And certain procedures may still be preferable for certain patient populations added Roslin such as bands for patients with lower BMI who dont have so many metabolic challenges. Everyone thinks that all weightloss operations are the same even the doctors and the surgeons. But theyre different and they have different resolutions of comorbidities and probably should be used for different indications he said. An editorial accompanying the studies noted the results should be interpreted with caution since longerterm data is not yet available. More information  Visit the American Society for Metabolic and Bariatric Surgery for more on weightloss procedures http_fs_surgery.pdf. SOURCES Guilherme M. Campos M.D. Ph.D. associate professor surgery University of Wisconsin School of Medicine and Public Health Madison Mitchell Roslin M.D. chief bariatric surgery Lenox Hill Hospital New York City and Northern Westchester Hospital Mt. KisCo N.Y. February  Archives of Surgery"