Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Maud Robert, Lyon University,
- Second opponent: Associate professor Erik Stenberg, Örebro University,
- Third member and chair of the evaluation committee: Associate professor Vendel Ailin Kristensen, University of Oslo
Chair of the Defence
Associate Professor Elisabeth Qvigstad, University of Oslo
Principal Supervisor
Professor II Tom Mala, University of Oslo
Summary
Bariatric surgery aims to induce weight loss and improve obesity-related health issues in individuals with obesity. Patients with a BMI over 50 kg/m² represent less than 10% of those referred for surgery but are associated with additional challenges, including higher surgical risks and less weight loss than opted for compared to those with lower preoperative BMI. This thesis examines the long-term effects of bariatric surgery on patients with a BMI of 50-60 kg/m², using data from two randomized controlled trials (RCTs).
The VARG trial compared distal Roux-en-Y gastric bypass (RYGB) with a long alimentary limb, and standard RYGB. 10 years after surgery, distal RYGB resulted in greater average weight loss but also more severe adverse events and nutritional deficiencies. The ASGARD trial compared standard RYGB and duodenal switch (DS). DS induced greater average weight loss 10 years after surgery but with higher rates of adverse events and nutritional deficiencies. Despite the increased weight loss with distal RYGB and DS, there were no significant improvements in obesity-related conditions compared to standard RYGB.
Currently, neither distal RYGB nor DS is performed at the medical centers involved in these trials, which still favor standard RYGB due to its safety profile and lower long-term risks. The optimal surgical approach for patients with BMI over 50 kg/m² remains unresolved.