"Less than a week after the Food and Drug Administration approved the marketing of LapBand weightloss surgery to  million new patients a pair of studies has found that a different older procedure is more effective and no riskier than either the LapBand or another lessdrastic surgery sleeve gastrectomy. In the first headtohead comparison of weightloss surgeries widely used in the United States UC San Francisco researchers found that those who had their stomach capacity reduced by a RouxenY bypass which reduces the stomachs capacity and bypasses a part of the intestine lost more weight required less diabetes medication and were less likely to need further surgery than those who received the LapBand. A second study found that diabetic patients who underwent sleeve gastrectomy which surgically narrows the stomach to reduce food capacity were more likely to continue needing diabetes medications than those who got the gastric bypass. Both studies were published Monday in the Archives of Surgery Last week the FDA broadened approval for the LapBand to people with a Body Mass Index as low as  if they also have a weightrelated medical condition a move that is expected to propel millions more obese patients into the offices of bariatric surgeons. The LapBand is an inflatable ring that is surgically implanted around the upper stomach. After surgical wounds have healed saline solution is injected to expand the ring limiting how much food can be consumed.   Yet both of the new studies suggest that the RouxenY gastric bypass procedure which is named for the surgeon who invented it and the shape of the altered small intestine remains the standard for patients with severe obesity and serious weightrelated illnesses such as diabetes. The procedure was first performed in . The UC San Francisco study led by surgeon Guilherme M. Campos measured weight loss improvement in metabolic function and quality of life in  patients one year after their surgeries. On all those measures gastric bypass produced far better results than LapBand surgery. For instance those who had had gastric bypass lost  of their excess weight on average in the year following surgery. Those who got the LapBand lost an average of  in the same period. The study also found that although gastric bypass patients had more complications in the first month after surgery those who underwent LapBand surgery had a higher rate of complications later andor more need for surgical adjustments making the overall complication rate similar for both procedures. The authors concluded that gastric bypass has a better riskbenefit profile than LapBand surgery. The second study conducted by researchers in Taiwan compared  obese patients who were treated with gastric bypass for their poorly controlled diabetes with  similar patients who were treated with a procedure called gastric sleeving which surgically reshapes the stomach to a smaller size but does not close down a portion of the intestine to food. The finding  that diabetes improved with gastric bypass but not with gastric sleeving  offered an important clue to why gastric bypasses seem to improve the metabolic function of diabetics virtually overnight. Neither sleeve gastrectomy nor the LapBand causes food to bypass any part of the intestine suggesting that hormones in that part of the gut may play a key role in the changes that lead to diabetes. We need to just register that gastric bypass is the gold standard for diabetic control in overweight patients said Beverly Hillsbased weightloss surgeon Ted Khalili director of the Khalili Center for Bariatric Care who was not involved in the study. But Khalili whose practice is roughly split between LapBand and gastricbypass surgery added that the UC San Francisco findings are far less clear for patients whose primary objective is to lose weight. Although more weight loss was seen for the gastric bypass group in the oneyear study patients getting the LapBand continue to lose weight for two to three years after the procedure Khalili said. Comparing the two patient populations three years after surgery would probably have narrowed the weightloss gap considerably Khalili said."