1. Roux-en-Y gastric bypass (RYGB) showed superior weight loss and quality-of-life outcomes at 3 years.
2. Sleeve gastrectomy (SG) is an alternative, and adjustable gastric banding (AGB) is not recommended as standard treatment for severe obesity.
3. Long-term outcome assessments are needed to guide evidence-based practice in metabolic and bariatric surgery.
4. The study included 1,346 participants across 12 UK hospitals.
5. RYGB was found to be the most cost-effective option among the three interventions.
6. SG showed fewer adverse events compared with RYGB and AGB.
7. Future research is recommended to assess the long-term benefits and risks of each procedure.

Source: The Lancet Diabetes & Endocrinology