Three months after gastric bypass surgery, 51-year-old David Serber is thrilled. He feels and looks like a different person.
"I've lost about 75 pounds. I feel good, my friend tells me I look good, I look younger from what they say," said Serber.
And after battling Type 2 diabetes for years, his blood sugar is now normal.
"My dad passed away of diabetes years ago and I was following in his footsteps, so I was really trying to find a way to eliminate that," said Serber.
A new University of California-San Francisco study compared 100 gastric-bypass patients to 100 Lap-Band patients.
After a year the gastric bypass group lost a higher percentage of excess weight -- 64 percent versus 36 percent -- and the gastric bypass group also saw an increase resolution in diabetes, 76 versus 50 percent.
"One of the reasons is because gastric bypass operates by three mechanisms: one, it shrinks the size of the stomach; two, it alters the anatomy of the intestines so you can't suck all the calories out of the food you take in," said Dr. Miguel Burch, director of the Center for Weight Loss at Cedars-Sinai.
Burch says the third reason is it alters the way hormones act in the body, which decreases appetite and regulates blood sugar.
So should patients choose gastric bypass over Lap-Band? Burch says it depends.
"Patients should sit down with a surgeon or with their primary-care doctor and discuss the options. For some patients Lap-Band is by far the best operation," said Burch.
Gastric bypass is a more involved procedure. And the study only followed patients for up to a year.
Doctors say most people with Lap-Bands will take up to two to three years to lose their excess weight.
David Serber is halfway to his goal weight. He exercises regularly and feels in control.
"It's not really dieting. It's just more so eating what you want to eat but just a smaller amount," said Serber.
Burch says the Lap-Band may be a better procedure for folks who don't have Type 2 diabetes and for those who can control their intake of sugary drinks and sweets.
For the best success, he adds, patients should have their bands adjusted every six to eight weeks.