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Weight loss surgery is the most consistent, effective means of weight loss in the long term, beating out diet, exercise, or any type of pharmaceutical intervention. But not all of the surgical options produce the same results, and while much is dependent on the patient and their behavior, there is one procedure that is head and shoulders above the rest in eliminating pounds and type 2 diabetes.

A study, published in the February issue of the Archives of Surgery, compared 100 patients who had undergone gastric bypass against 100 who had the lap band procedure. Gastric bypass produced a weight loss average of 64 percent of excess weight, while the lap band group lost 36 percent. Also of benefit was the improvement in the participants’ diabetes. Seventy-five percent of the gastric bypass patients had an improvement or elimination of the disease, while the figure was around 50 percent for the lap band patients.

Gastric bypass surgery, first performed in 1966, has for years, been the most popular form of weight loss surgery. Gastric bypass is done laparoscopically, requires a three- or four-day hospital stay, and reversing it can be difficult and is usually only done in cases of medical necessity. Lap bands, also done laparoscopically, require only an overnight stay and are easily reversible. Success rates for both are high, while mortality risk is less than 1 percent.

The surgery is not for everyone. Only people morbidly obese are normally considered candidates for the surgery. The surgeries reduce the size of the “working” stomach. In the case of bypass surgery the “working” stomach is reduced from about the size of quart to about the size of a walnut. After gastric bypass surgery people eat less; but feel full. Gone is the constant nagging hunger. The weight comes off fast, very fast.

Insurance companies typically pay for the surgery only after several other avenues of medically supervised help have been exhausted since bypass surgery is costly, the surgery can pay for itself within a few years by helping to reduce insurance claims resulting from medical conditions that obese people can develop.

Gastric bypass surgery also increases survival rates for the morbidly obese. Two long-term studies, published in the New England Journal of medicine, found that obese people who had the surgery cut their risk of dying within 7 to 10 years by 30 to 40 percent over those who did not have the surgery.