The Different Types of Bariatric Surgery

If you’re considering bariatric surgery, you know there’s no shortage of decisions you need to make before going through with the procedure. One of the most important choices you’ll make is deciding which type of bariatric weight-loss procedure to undergo.

The procedure that’s right for you will depend on your unique situation, goals, and health, and your surgeon and weight loss team will help you carefully consider the options. That said, the first step toward making a well-informed decision is understanding what each of the common types of bariatric surgery entail. 

Gastric Sleeve

During gastric sleeve surgery, also called a sleeve gastrectomy, the majority of the stomach is removed. The remaining portion is about 1/10 of the original size and shaped like a banana—hence, the “sleeve.” 

The smaller stomach can hold much less food than it originally could, leading to a caloric decrease that helps patients rapidly lose weight. In addition, the removal of most of the stomach decreases hunger-causing hormones like ghrelin and leptin, causing patients to feel less hungry less often.

Sleeve gastrostomies are the most commonly performed bariatric procedure in the United States. To qualify for surgery, patients need a BMI of 40 or higher. They can also qualify with a BMI of 35 if they have one or more obesity-related conditions that could be relieved with weight-loss, like:

• High blood pressure
• Obstructive sleep apnea
• Diabetes
• Joint pain

Gastric sleeve surgery takes about an hour and is minimally invasive, performed through several small incisions with the use of a tiny camera called a laparoscope. Patients can expect to stay in the hospital 1–3 days following the procedure. With proper diet and exercise, gastric sleeve patients typically lose about 50–60% of their excess body weight. 

Gastric Bypass

Gastric bypass surgery is sometimes called Roux-en-Y gastric bypass. During the surgery, the surgeon sections off a small portion of the upper stomach, leaving behind a small pouch. This pouch is then connected to a middle portion of the small intestine, allowing food to bypass the upper section, as well as most of the stomach.

Again, with a smaller stomach, patients feel hungry less often and can hold less food when they do eat. In addition, because the food bypasses parts of the digestive tract, the patient absorbs fewer calories. While this facilitates rapid weight-loss, it also means the patient won’t get all the nutrients they need from their food, meaning they’ll need to take supplements on a lifelong basis after surgery. 

The requirements to qualify for gastric bypass are the same as those to qualify for the gastric sleeve. The surgery takes about 1½ hours, and the hospital stay lasts 1–3 days. Like gastric sleeve surgery, gastric bypasses are performed laparoscopically. Patients usually lose about 70% of their excess weight. 

Duodenal Switch with Gastric Sleeve

As the name implies, this weight-loss surgery includes a sleeve gastrectomy. However, during surgery, the lower intestine is also divided, allowing food to bypass 2/3 of the intestines. This significantly decreases the calories that can be absorbed from food, and like other malabsorptive surgeries, patients will need to supplement their food with vitamins and minerals.  

The full surgery is performed laparoscopically and takes about 2–3 hours, but on extremely overweight patients, the procedure is sometimes done in two parts spaced 9–12 months apart. If you have struggled to reach your desired weight with gastric sleeve alone, your surgeon may also recommend the duodenal switch to help further encourage weight-loss.

Patients can typically expect to lose 60–80% of their excess weight with this procedure.

If you’re seriously considering bariatric surgery, it’s essential to go into the procedure confident in your choice. It’s also important to choose a facility that offers long-term follow-up care, which lowers the risk of complications and ultimately ensures greater weight-loss success.

The Wellstar team can help you determine which weight-loss surgery is right for you, and we’re committed to providing the long-term care you need to feel supported during your weight-loss journey. Schedule a consultation with our experts today, and learn how we can help you take the first steps toward a healthier life.