ClinicalTrials.gg
CompletedNCT02841527ByBandSleeveUpdated May 12, 2023

Gastric Bypass, Gastric Band or Sleeve Gastrectomy to Treat Obesity

An interventional study of Gastric Band and Gastric Bypass in Obesity, Surgery and Quality of Life, sponsored by University of Bristol. Completed at 12 sites in United Kingdom. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2023-05-12.

Sponsored by University of Bristol · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Registered 4 years 3 months after the study started (first participant enrolled Jan 2012, registered Apr 2016).
Phase
Not applicable
Study type
Interventional
Enrollment
1,351
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Obesity is an increasing health problem in the United Kingdom (UK) and is predicted to worsen.

In the UK and worldwide the three most commonly performed operations are laparoscopic adjustable gastric banding ('BAND surgery'), laparoscopic gastric bypass ('BYPASS') and laparoscopic sleeve gastrectomy ('SLEEVE'). All lead to weight loss, but they are associated with different problems. This study (BYBANDSLEEVE) is a randomised trial with a target recruitment of 1341 patients in twelve hospitals and its aim is to compare the effectiveness, cost effectiveness and acceptability of BAND, BYPASS and SLEEVE surgery.

Read the detailed description

Obesity is an increasing health problem in the UK and one which is predicted to worsen. It is associated with many health problems that can shorten a person's life span and impair quality of life. Current national guidelines recommend that surgery is considered for the very overweight (morbidly obese) or for those remaining obese after trying other options.

In the UK and worldwide the three most commonly performed operations are laparoscopic adjustable gastric banding ('BAND surgery'), laparoscopic gastric bypass ('BYPASS') and laparoscopic sleeve gastrectomy ('SLEEVE'). All lead to weight loss, but they are associated with different problems. In the short term there are varying complications and inconvenience relating to the operation. In the longer term there are different outcomes relating to weight regain, symptoms and side effects of surgery. This study (BYBANDSLEEVE) is a randomised trial with a recruitment target of 1341 patients in twelve hospitals and its aim is to compare the effectiveness, cost effectiveness and acceptability of BAND, BYPASS and SLEEVE surgery. The process of randomisation will mean that participants have a chance of receiving one of the three procedures, so a fair comparison between them can be made.

The first phase (in two hospitals) will test the feasibility of recruitment and optimise information for patients to maximise trial recruitment. It will establish a core set of clinical outcomes to use to evaluate the surgery for morbid obesity. The second stage (in 12 hospitals) will recruit the full sample and follow up all participants for at least three years. The investigators will compare the effects of BAND, BYPASS AND SLEEVE surgery three years after randomisation on weight loss, a wide range of symptoms and aspects of quality of life. The investigators will also examine patients' detailed experiences during follow up, nutritional outcomes, short and long term surgical complications and National Health Service (NHS) value for money.

02

Conditions studied

  • Obesity
  • Surgery
  • Quality of Life
  • Weight Loss
03

In context

Obesity

11,522 studies on the registry are indexed under Obesity; 2,033 are open to participants now.

This study's enrollment of 1,351 is above the median of 67 across 9,006 interventional studies indexed under Obesity.

Browse Obesity studies →

Lead sponsor

University of Bristol is the lead sponsor of 22 studies on the registry; none are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Male or female patients
  2. Over 18 years of age
  3. Referred for bariatric surgery according to the National Institute for Health and Care Excellence (NICE) guidelines - of 40kg/m2 or more, OR BMI of 35 kg/m2 to 40 kg/m2 and other significant disease (e.g. type 2 diabetes or high blood pressure) OR BMI of 30 kg/m2 or more and recent onset diabetes OR Asian family origin with lower BMI and recent onset diabetes, that could improve with weight loss
  4. Has been or is willing to receive intensive management in a specialist tier 3 obesity service
  5. Fit for anaesthesia and surgery
  6. Committed to follow-up and able to complete quality of life questionnaires
  7. Able to provide written .

Exclusion criteria

Exclusion Criteria:

  1. Previous gastric surgery or surgery for severe and complex obesity
  2. Previous abdominal surgery or gastro-intestinal (GI) condition that precludes one or more of Band, Bypass or Sleeve
  3. Large abdominal ventral hernia
  4. Pregnancy (women who have given birth and women planning pregnancy will NOT be excluded)
  5. Crohn's disease
  6. Liver cirrhosis and portal hypertension
  7. Systemic lupus erythematosis
  8. Known silicone allergy
  9. Hiatus hernia >5cm
  10. Other clinical/psychological reason, to be specified
  11. Active participation in another interventional research study which might interfere with By-Band-Sleeve
Terms in these criteria, in plain language(2)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
1,351 participants (actual)

Study arms

  • Active comparator
    Gastric Band

    The procedure will involve an operation in which a gastric Band and port will be fitted using a laparoscopic technique.

    Procedure: Gastric Band

  • Active comparator
    Gastric Bypass

    The procedure will involve a laparoscopic operation in which a small pouch is made in the top of the stomach and a loop of bowel connected to this pouch to bypass the rest of the stomach.

    Procedure: Gastric Bypass

  • Active comparator
    Sleeve Gastrectomy

    The procedure involves an operation which reduces the size of the stomach by about 75%, creating a narrow tube. It is done by stapling down the stomach and removing the remainder of the stomach using a laparoscopic technique.

    Procedure: Sleeve Gastrectomy

Interventions

  • ProcedureGastric Band

    Surgical intervention in which a band is inserted around the top of the stomach to reduce its size.

  • ProcedureGastric Bypass

    Surgical intervention where a small pouch is made in the top of the stomach and a loop of bowel connected to this pouch to bypass the rest of the stomach.

  • ProcedureSleeve Gastrectomy

    Surgical intervention which reduces the size of the stomach by about 75%, creating a narrow tube. It is done by stapling down the stomach and removing the remainder of the stomach.

06

What researchers measure

Primary outcomes

  1. The proportion achieving loss of greater than 50% of excess weight at three years.

    The proportion achieving loss of greater than 50% of excess weight at three years (calculated as 100×\[BMI at 3 years - BMI at randomisation1\] / \[BMI at randomisation - 25\])

    Time frame: Three years

  2. Health-related Quality of Life (HRQoL)

    HRQoL at three 3 years, will be assessed using the EQ-5D-5L

    Time frame: Three years

Secondary outcomes

  1. Change in BMI over time adjusted for BMI at randomisation

    Change in BMI over time adjusted for BMI at randomisation

    Time frame: Three years

  2. Percentage weight loss at 3 years

    Percentage weight loss at 3 years

    Time frame: Three years

  3. Waist circumference at 3 years

    Waist circumference at 3 years

    Time frame: Three years

  4. Time taken from randomisation to reach first loss of at least 50% of excess BMI

    Time taken from randomisation to reach first loss of at least 50% of excess BMI

    Time frame: Three years

  5. Time taken from first losing 50% excess BMI to first relapse

    Time taken from first losing 50% excess BMI to first relapse (defined as weight re-gain such that the target of at least 50% of excess weight loss is no longer met)

    Time frame: Three years

  6. Generic and symptom specific Health-related Quality of Life (HRQOL)

    Impact of Weight on Quality of Life (IWQOL-Lite)

    Time frame: Three years

  7. Generic and symptom specific Health-related Quality of Life (HRQOL)

    The Gastrointestinal Quality of Life Index

    Time frame: Three years

  8. Generic and symptom specific Health-related Quality of Life (HRQOL)

    Eating Habits Questionnaire

    Time frame: Three years

  9. Generic and symptom specific Health-related Quality of Life (HRQOL)

    SF-12v2 Health Survey

    Time frame: Three years

  10. Generic and symptom specific Health-related Quality of Life (HRQOL)

    Hospital Anxiety and Depression Scale (HADS).

    Time frame: Three years

  11. Resource use to three years

    Use of health service resources over the three-year study period.

    Time frame: Three years

  12. Standard healthcare blood tests

    Standard NHS nutritional blood tests will be performed at each assessment.

    Time frame: Three years

  13. Dietary recall

    Measures of 24 hour recall eating using a standardised and validated interview process

    Time frame: Three years

  14. Binge eating behaviour

    Binge eating behaviour using a validated questionnaire

    Time frame: Three years

  15. Adverse health events

    Adverse health events including the need for re-operation and cross over between interventions

    Time frame: Three years

  16. Resolution of co-morbidities

    Resolution of co-morbidities at 3 years, including sleep apnoea, non alcoholic fatty liver disease, type-2 diabetes, hypertension and hyperlipidaemia.

    Time frame: Three years

  17. Time to resolution of co-morbidities

    Time to resolution of sleep apnoea, type-2 diabetes, hypertension and hyperlipidaemia

    Time frame: Three years

07

Study locations

12 sites
  • Heart of England NHS Foundation Trust
    Birmingham, United Kingdom
  • Royal Bournemouth and Christchurch Hospitals
    Bournemouth, United Kingdom
  • North Bristol NHS Trust
    Bristol, United Kingdom
  • Royal Derby Hospital
    Derby, United Kingdom
  • St James University Hospital, Leeds
    Leeds, United Kingdom
  • Homerton University Hospital
    London, United Kingdom
  • Imperial College Healthcare NHS Trust
    London, United Kingdom
  • Queen Alexandra Hospital
    Portsmouth, United Kingdom
  • University Hospital Southampton
    Southampton, United Kingdom
  • Sunderland Royal Hospital
    Sunderland, United Kingdom
  • Musgrove Park Hospital
    Taunton, United Kingdom
  • Royal Cornwall Hospital
    Truro, United Kingdom
08

References and documents

Publications

  • Blazeby JM, Byrne J, Welbourn R. What is the most effective operation for adults with severe and complex obesity? BMJ. 2014 Mar 14;348:g1763. doi: 10.1136/bmj.g1763. No abstract available. PubMed 24633209 ↗
  • Donovan JL, Paramasivan S, de Salis I, Toerien M. Clear obstacles and hidden challenges: understanding recruiter perspectives in six pragmatic randomised controlled trials. Trials. 2014 Jan 6;15:5. doi: 10.1186/1745-6215-15-5. PubMed 24393291 ↗
  • Rogers CA, Welbourn R, Byrne J, Donovan JL, Reeves BC, Wordsworth S, Andrews R, Thompson JL, Roderick P, Mahon D, Noble H, Kelly J, Mazza G, Pike K, Paramasivan S, Blencowe N, Perkins M, Porter T, Blazeby JM. The By-Band study: gastric bypass or adjustable gastric band surgery to treat morbid obesity: study protocol for a multi-centre randomised controlled trial with an internal pilot phase. Trials. 2014 Feb 11;15:53. doi: 10.1186/1745-6215-15-53. PubMed 24517309 ↗
  • Hopkins JC, Howes N, Chalmers K, Savovic J, Whale K, Coulman KD, Welbourn R, Whistance RN, Andrews RC, Byrne JP, Mahon D, Blazeby JM; By-Band Trial Management Group. Outcome reporting in bariatric surgery: an in-depth analysis to inform the development of a core outcome set, the BARIACT Study. Obes Rev. 2015 Jan;16(1):88-106. doi: 10.1111/obr.12240. Epub 2014 Nov 30. PubMed 25442513 ↗
  • Coulman KD, Hopkins J, Brookes ST, Chalmers K, Main B, Owen-Smith A, Andrews RC, Byrne J, Donovan JL, Mazza G, Reeves BC, Rogers CA, Thompson JL, Welbourn R, Wordsworth S, Blazeby JM; BARIACT working group. A Core Outcome Set for the Benefits and Adverse Events of Bariatric and Metabolic Surgery: The BARIACT Project. PLoS Med. 2016 Nov 29;13(11):e1002187. doi: 10.1371/journal.pmed.1002187. eCollection 2016 Nov. PubMed 27898680 ↗
  • Coulman KD, Howes N, Hopkins J, Whale K, Chalmers K, Brookes S, Nicholson A, Savovic J, Ferguson Y, Owen-Smith A, Blazeby J; By-Band-Sleeve Trial Management Group; Blazeby J, Welbourn R, Byrne J, Donovan J, Reeves BC, Wordsworth S, Andrews R, Thompson JL, Mazza G, Rogers CA. A Comparison of Health Professionals' and Patients' Views of the Importance of Outcomes of Bariatric Surgery. Obes Surg. 2016 Nov;26(11):2738-2746. doi: 10.1007/s11695-016-2186-0. PubMed 27138600 ↗
  • Hopkins JC, Blazeby JM, Rogers CA, Welbourn R. The use of adjustable gastric bands for management of severe and complex obesity. Br Med Bull. 2016 Jun;118(1):64-72. doi: 10.1093/bmb/ldw012. Epub 2016 Mar 31. PubMed 27034443 ↗
  • Rooshenas L, Elliott D, Wade J, Jepson M, Paramasivan S, Strong S, Wilson C, Beard D, Blazeby JM, Birtle A, Halliday A, Rogers CA, Stein R, Donovan JL; ACST-2 study group; By-Band-Sleeve study group; Chemorad study group; CSAW study group; Optima prelim study group; POUT study group. Conveying Equipoise during Recruitment for Clinical Trials: Qualitative Synthesis of Clinicians' Practices across Six Randomised Controlled Trials. PLoS Med. 2016 Oct 18;13(10):e1002147. doi: 10.1371/journal.pmed.1002147. eCollection 2016 Oct. PubMed 27755555 ↗
  • Welbourn R, le Roux CW, Owen-Smith A, Wordsworth S, Blazeby JM. Why the NHS should do more bariatric surgery; how much should we do? BMJ. 2016 May 11;353:i1472. doi: 10.1136/bmj.i1472. No abstract available. PubMed 27169605 ↗
  • Doble B, Wordsworth S, Rogers CA, Welbourn R, Byrne J, Blazeby JM; By-Band-Sleeve Trial Management Group. What Are the Real Procedural Costs of Bariatric Surgery? A Systematic Literature Review of Published Cost Analyses. Obes Surg. 2017 Aug;27(8):2179-2192. doi: 10.1007/s11695-017-2749-8. Erratum In: Obes Surg. 2017 Aug;27(8):2193. doi: 10.1007/s11695-017-2768-5. PubMed 28550438 ↗
  • Fermont JM, Blazeby JM, Rogers CA, Wordsworth S; By-Band-Sleeve Study Management Group. The EQ-5D-5L is a valid approach to measure health related quality of life in patients undergoing bariatric surgery. PLoS One. 2017 Dec 18;12(12):e0189190. doi: 10.1371/journal.pone.0189190. eCollection 2017. PubMed 29252996 ↗
  • Paramasivan S, Rogers CA, Welbourn R, Byrne JP, Salter N, Mahon D, Noble H, Kelly J, Mazza G, Whybrow P, Andrews RC, Wilson C, Blazeby JM, Donovan JL. Enabling recruitment success in bariatric surgical trials: pilot phase of the By-Band-Sleeve study. Int J Obes (Lond). 2017 Nov;41(11):1654-1661. doi: 10.1038/ijo.2017.153. Epub 2017 Jul 3. PubMed 28669987 ↗
  • Rogers CA, Reeves BC, Byrne J, Donovan JL, Mazza G, Paramasivan S, Andrews RC, Wordsworth S, Thompson J, Blazeby JM, Welbourn R; By-Band-Sleeve study investigators. Adaptation of the By-Band randomized clinical trial to By-Band-Sleeve to include a new intervention and maintain relevance of the study to practice. Br J Surg. 2017 Aug;104(9):1207-1214. doi: 10.1002/bjs.10562. PubMed 28703939 ↗
  • Doble B, Welbourn R, Carter N, Byrne J, Rogers CA, Blazeby JM, Wordsworth S; By-Band-Sleeve Trial Management Group. Multi-Centre Micro-Costing of Roux-En-Y Gastric Bypass, Sleeve Gastrectomy and Adjustable Gastric Banding Procedures for the Treatment of Severe, Complex Obesity. Obes Surg. 2019 Feb;29(2):474-484. doi: 10.1007/s11695-018-3553-9. PubMed 30368646 ↗
  • Rooshenas L, Scott LJ, Blazeby JM, Rogers CA, Tilling KM, Husbands S, Conefrey C, Mills N, Stein RC, Metcalfe C, Carr AJ, Beard DJ, Davis T, Paramasivan S, Jepson M, Avery K, Elliott D, Wilson C, Donovan JL; By-Band-Sleeve study group; CSAW study group; HAND-1 study group; Optima prelim study group; Romio feasibility study group. The QuinteT Recruitment Intervention supported five randomized trials to recruit to target: a mixed-methods evaluation. J Clin Epidemiol. 2019 Feb;106:108-120. doi: 10.1016/j.jclinepi.2018.10.004. Epub 2018 Oct 16. PubMed 30339938 ↗

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: No — All data will be anonymised and analysed in groups. Individual patient data (IPD) will be made available to the research team following analysis.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on May 12, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT02841527
Lead sponsor
University of Bristol
Responsible party
Jane Blazeby (Chief Investigator, University of Bristol) — Principal investigator
First posted
Jul 22, 2016
Start date
Jan 1, 2012
Primary completion
Sep 30, 2022
Completion
Mar 31, 2023
Last update
May 12, 2023

Study contacts

Jane Blazeby, BSc,MBChB,MD
study director · University of Bristol

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in May 2023. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion