The open-label, single-center trial included 60 Italian patients -- 20 patients randomized to laparoscopic RYGB, BPD, or conventional medical therapy plus lifestyle interventions. The BPD was performed with an open-surgery approach with the Scopinaro procedure, which uses a horizontal gastrectomy and not a sleeve gastrectomy, the researchers explained. "The BPD used in this study leaves behind a larger gastric remnant and has a lesser effect on restriction of calorie intake than the duodenal switch variant.