Homan J, et al. - A longer biliopancreatic limb Roux-en-Y gastric bypass (LBP-GB) vs a standard RYGB (S-GB) were compared regarding effect on weight loss. Randomizing 146 patients into two groups, researchers measured weight loss, morbidity, reduction of comorbidities, nutritional status, and quality of life during a period of 4 years. Observations revealed that in the first years after surgery, LBP-GB achieved a significant increase in %EWL, but after 4 years, there was no difference in long-term %TWL. While the advantage of LBP-GB in regard to weight loss was modest, it presents promising points that could assist in improving the RYGB design.