Study record managers: refer to the Data Element Definitions if submitting registration or results information. Obesity is an increasing health problem in the United Kingdom UK and is predicted to worsen. All lead to weight loss, but they are associated with different problems. 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 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. 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 also examine patients' detailed experiences during follow up, nutritional outcomes, short and long term surgical complications and National Health Service NHS value for money.
Procedure: Gastric Band Surgical intervention in which a band is inserted around the top of the stomach to reduce its size. 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.
