16 September 2025
Press
- Obésité
A major French clinical study, published in the international medical journal The Lancet, offers new hope in the fight against severe obesity. Coordinated by the FORCE (French Obesity Research Center of Excellence) clinical research network, it highlights the benefits of a surgical technique that is still not widely used in France: SADI-S (Single-Anastomosis Duodeno-Ileal bypass with Sleeve gastrectomy). This procedure is more effective than traditional gastric bypass (Roux-en-Y) in promoting weight loss in patients.
A nationwide study
Conducted in 22 bariatric surgery centers in France,the SADISLEEVE study followed more than 370 patients with severe obesity. All met the usual criteria to benefit from bariatric surgery (BMI ≥ 40, or ≥ 35 with comorbidities such as diabetes or hypertension). Participants were randomized to receive either Roux-en-Y gastric bypass (RYGB), the gold-standard technique for over 20 years, or SADI-S, a more recent procedure combining sleeve gastrectomy and simplified intestinal bypass.
Results after 2 years: more weight lost with SADI-S
Two years after surgery, patients operated on with SADI-S had lost an average of 76% of their excess weight, compared with 68% in those operated on with gastric bypass. This statistically significant difference confirms that SADI-S enables greater weight loss.
Security: comparable profiles
The study also shows that the safety of the two procedures is similar. On the SADI-S side, a few cases of leakage and severe diarrhea were observed. On the bypass side, the most frequent complications were internal hernias and abdominal pain, sometimes necessitating a repeat operation. Overall, the researchers conclude that the benefits and risks are comparable between the two techniques.
A breakthrough in the management of severe obesity
Severe obesityconcerns more than two million French people and rreduces life expectancy considerably. Today, bariatric surgery remains one of the most effective treatments for lasting weight loss and improvement in associated diseases such as type 2 diabetes or hypertension.
This study provides solid scientific evidence that SADI-S could become a credible alternative to gastric bypass, the technique hitherto considered the gold standard.
"These results open up a new avenue for improving the management of severe obesity. SADI-S appears to be a safe and more effective technique than bypass, but it still needs to be evaluated over the long term, particularly with regard to nutritional deficiencies", explain Emmanuel DISSE and Sébastien CZERNICHOW, co-coordinators of the Force Network.
To remember
- A French, multicenter, randomized study published in The Lancet.
- More than 370 patients followed for 2 years.
- SADI-S results in superior weight loss to bypass (+8% excess weight lost).
- Similar safety profile between the two procedures.
- SADI-S could become a serious alternative to gastric bypass in the coming years.
Study reference
Robert M., Poghosyan T., Romain-Scelle N., Czernichow S., Delaunay D., Sterkers A., Khamphommala L., Lazzati A., Blanchard C., Caiazzo R., Pattou F., Disse E., and the SADISLEEVE Collaborative Group.
Efficacy and safety of single-anastomosis duodeno-ileal bypass with sleeve gastrectomy versus Roux-en-Y gastric bypass in France (SADISLEEVE): results of a randomised, open-label, superiority trial at 2 years of follow-up.
The Lancet, August 23, 2025. DOI : https://doi.org/10.1016/S0140-6736(25)01070-0
The FORCE network is the national clinical research network specializing in nutrition, obesity and associated metabolic diseases, labeled an F-CRIN network of excellence since 2014. FORCE is coordinated by Professors Sébastien CZERNICHOW (APHP) and Emmanuel DISSE (HCL). The network brings together the 37 Specialized Obesity Centers (CSOs) across France. It thus brings together French experts (researchers, clinicians and scientists) who, together, form a strong national collaborative organization, whose aim is to boost the performance and attractiveness of clinical research in these fields at national and international level, and thus improve diagnosis and preventive and therapeutic strategies for obesity and related pathologies.
For more information: https://www.force-obesity.org/
Set up in 2012, F-CRIN (French Clinical Research Infrastructure Network) is a national platform dedicated to the development of French clinical research. It is led by Inserm in association with hospitals, healthcare manufacturers and universities, and supported by the French National Research Agency and the Ministry of Health. F-CRIN's mission is to federate clinical research players in order to boost the international competitiveness and attractiveness of French research, develop the expertise of professionals by pooling know-how, resources and means, and thus accelerate the adoption of new practices and the development of new therapeutic solutions. Today, F-CRIN is based on a federative model structured around 27 components: 25 thematic research and clinical investigation networks, a multiservice platform available to sponsors and investigators to support their trials, and a national coordination unit, the infrastructure headquarters, based in Toulouse. With more than 2,000 professionals pooling their expertise and resources, F-CRIN is also the French interface for the European clinical research network ECRIN, promoting the participation of French teams and centers in multinational clinical trials.
For more information: https://www.fcrin.org/
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