Gastric sleeve surgery and gastric bypass surgery are both weight loss procedures. However, they differ in how they lead to weight loss and their effects on the digestive system.
Gastric sleeve and gastric bypass surgery are the two most common types of bariatric surgery. Both surgeries aim to reduce the size of a person’s stomach and limit the amount of food they can eat. This article examines how they work, their benefits and risks, and how they affect recovery and lifestyle.
|Gastric sleeve||Gastric bypass|
|Approach||surgeons remove part of the stomach||surgeons bypass part of the stomach and intestines|
|Complexity||relatively simple||more technically complicated|
|Also known as||sleeve gastrectomy or vertical sleeve gastrectomy||Roux-en-Y|
|Areas impacted||stomach only||stomach and small intestine|
|Risks or complications||risk of some complications||risk of more serious complications|
|Surgical method||laparoscopic or open||laparoscopic or open|
Gastric sleeve surgery involves permanently removing about 80% of a person’s stomach, leaving a small banana-shaped pouch that can hold about a cup of food.
This surgery reduces the appetite by
Read more about gastric sleeve surgery.
Gastric bypass surgery involves creating a small pouch at the top of the stomach and connecting it directly to the middle part of the small intestine. This then bypasses the rest of the stomach and the first part of the small intestine.
This surgery reduces a person’s appetite by making them feel full with less food and reduces the absorption of calories and nutrients in the intestines. It is also called Roux-en-Y gastric bypass surgery.
Read more about gastric bypass surgery.
Approximately 90% of individuals who undergo bariatric surgery achieve a long-term weight loss of at least 50% of their excess body weight. One clinical trial noted
The following sections describe the benefits of both surgeries.
Gastric sleeve surgery benefits
Some of the reasons a person may choose this surgery include:
- Simplicity of procedure: The gastric sleeve procedure is
less complexthan gastric bypass, so it can lead to shorter operating times and potentially fewer complications related to surgical complexity.
- No rerouting of intestines: Unlike gastric bypass, sleeve surgery does not involve rerouting the intestines, which means that the typical absorption of nutrients remains largely intact. This can
reducethe risk of certain nutritional deficiencies.
Gastric bypass surgery benefits
Benefits of this surgery include:
- Rapid initial weight loss: People often experience rapid weight loss in the
first 6 monthsafter gastric bypass, which can be particularly motivating.
- Reduction in hunger hormones: Gastric bypass surgery
can reducethe production of the hunger hormone ghrelin, which can helppeople control their appetite more effectively.
Benefits that both procedures share
The benefits of both types of bariatric surgery include:
- Long-term sustained weight loss: Both gastric sleeve and gastric bypass can result in long-term weight loss, especially in combination with lifestyle changes, healthy eating habits, and regular physical activity.
- Improved quality of life: People often report an enhanced quality of life after weight loss surgery, including increased mobility, reduced pain, improved self-esteem, and a higher overall sense of well-being.
- Resolution of comorbidities: Many individuals experience
significant improvementsor remission of obesity-related health conditions such as type 2 diabetes, hypertension, sleep apnea, and joint pain.
- Reduced mortality: Weight loss surgery often has links to reduced overall mortality rates among individuals with obesity, particularly those with severe obesity.
Most people typically spend 1–2 days in the hospital after bariatric surgery. The exact duration may vary depending on individual factors and the surgical team’s recommendations.
People need to follow their healthcare team’s recommendations about food intake. Generally, it will involve the following plan:
- week 1–3: liquid diet — no caffeinated, carbonated, or alcoholic drinks
- week 4–5: pureed diet
- week 6–9: soft and moist solids
- week 10: very small amounts of regular food
Read about how to eat after gastric bypass surgery.
Both procedures are generally safe and effective for weight loss, but specific risks and complications can vary from person to person.
- weight regain
- nutritional deficiencies
- dumping syndrome
The following sections describe the risks and complications of both surgeries.
Gastric sleeve surgery complications
Some risks and complications of gastric sleeve surgery
- Gastroesophageal reflux disease (GERD): Some people may experience worsening or new-onset GERD symptoms after a sleeve gastrectomy gastric bypass surgery.
- Stricture: Narrowing of the sleeve may occur, causing difficulty in swallowing and requiring additional interventions.
Gastric bypass surgery
Some risks and complications of gastric bypass surgery
- Marginal ulcers: Ulcers can develop where the small intestine connects to the pouch. These ulcers may cause pain, bleeding, or discomfort.
- Internal hernia: There is a risk of developing internal hernias in the small bowel mesentery, which can cause bowel obstructions and require surgery.
- Gallstones: Rapid weight loss following gastric bypass can
increasethe risk of developing gallstones.
Gastric sleeve and gastric bypass surgery both require lifelong changes in a person’s diet and lifestyle to maintain their weight loss and health.
People also make the following lifestyle changes:
According to the American Society for Metabolic and Bariatric Surgery (ASMBS), bariatric surgery costs between $17,000 and $26,000.
Insurance may cover this cost if the procedure is medically necessary, depending on the specifics of a person’s insurance coverage.
Read about Medicare and weight loss surgery.
The choice between gastric sleeve and gastric bypass surgery depends on individual factors, including a person’s health status and preferences and discussions with a medical team.
Both surgeries lead to long-term weight loss in most people but have associated risks.
Individuals need to consult a healthcare professional to determine the most appropriate option.