Study Background and Disease Burden
Obesity remains a major global health challenge, contributing to comorbidities such as type 2 diabetes, hypertension, dyslipidaemia, and obstructive sleep apnea, which collectively impair quality of life and increase cardiovascular risks. Bariatric surgery is the most effective long-term weight loss intervention for severe obesity, improving metabolic outcomes and reducing mortality. Among surgical options, Roux-en-Y gastric bypass (RYGB) is a well-established procedure with durable efficacy. Since 2007, single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) has emerged as a promising alternative potentially offering comparable or improved results with simpler technique. However, robust comparative data on efficacy and safety remain limited. The SADISLEEVE trial was designed to address this gap by directly comparing SADI-S with RYGB in a large French cohort at 2 years follow-up.