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Objective: To determine the 10-year outcomes regarding weight loss and remission of obesity-related diseases after primary Roux-en-Y gastric bypass (RYGB), when performed in routine clinical care.

Summary of background data: Long-term results of metabolic bariatric surgery (MBS) are important, as the number of patients needing help with this chronic condition is increasing globally. However, results from larger nation-wide studies are lacking.

Methods: Cohort study of RYGB-patients from the Scandinavian Obesity Surgery Registry (SOReg), a national Swedish quality registry of MBS. Supplementary data was obtained from the Prescribed Drug Register (pharmacological therapy) and the National Diabetes Register (clinical data). Weight loss, complete remission of comorbidities (defined as no pharmacological therapy and normal laboratory values), and associations for new-onset disease were studied.

Results: 29,578 individuals (mean age 41.0 ± 11.0 years, 75.6% females) had a RYGB in Sweden 2007-2012. At ten years, mean body weight was reduced from 112.7 kg to 91.4 kg, corresponding to a total body weight loss of 24.6%. A significant complete remission rate persisted in type 2 diabetes (29.7%), hypertension (15.1%) and dyslipidemia (8.8%), while the use of antidepressants increased by 38.6%, p<0.001 for all. The use of continuous positive airway pressure for sleep apnea decreased from 9.8% to 4.1%. New-onset disease was in general associated to age, low weight loss and presence of other comorbidities.

Conclusions: At ten years, patients undergoing primary RYGB in Sweden demonstrate lasting weight loss and substantial remission of obesity-related diseases. RYGB is a valuable treatment option in the long-term for patients with severe obesity.