Gastric Bypass vs. Gastric Sleeve: Which Is Best for You?

If you’re struggling with obesity and health-related complications from carrying extra weight, you may be considering bariatric surgery. But which procedure is best for you?

Both gastric bypass and gastric sleeve surgeries can help you lose weight and improve obesity-related health conditions such as diabetes, hypertension and high cholesterol, but there are differences in the procedures.

How Are the Procedures Different?

Both gastric bypass and gastric sleeve surgeries reduce the size of your stomach.  They can help with significant weight loss by restricting the amount of food you can eat before you feel full and reducing the production of ghrelin — the “hunger hormone” — in the body.

Gastric Bypass

Gastric bypass involves the bariatric surgeon first creating a small stomach pouch, about the size of an egg. The second part of the surgery is the bypass. The surgeon will connect a part of your small intestine to the newly created stomach pouch. The food you eat will travel from the pouch to this opening in your small intestine, helping it “bypass” a large portion of your stomach and small intestine.

Patients need to take nutritional supplements after gastric bypass, because the changes in the small intestine may hinder the body’s ability to absorb vital nutrients.

A gastric bypass can be done through either open surgery or laparoscopically, using a tiny camera. The surgery typically takes two to three hours.

Potential complications for gastric bypass include:

• Risk of nutritional deficiencies

• Dumping syndrome, or food moving too quickly from the stomach into the small bowel

• Bowel obstruction

• Increased sensitivity to alcohol

• Stomach ulcers

With proper diet modifications, activity and the recommended vitamin regimen, most gastric bypass patients can expect to lose up to 70 percent of their excess body weight within 12 to 18 months after the procedure.

Gastric Sleeve

Gastric sleeve surgery involves removing a large portion of your stomach, resulting in a much smaller, banana-shaped stomach. Patients are left with 20 percent to 25 percent of their original stomach, which reduces the amount of food they can eat. Your stomach will remain attached to the small intestine as it was previously, leaving the ability to absorb nutrients unimpaired. The surgery usually takes 40 to 70 minutes.

Potential complications for gastric sleeve include:

• Acid reflux

• Leaking stomach fluids

• Stomach obstruction 

With diet modifications, activity and the recommended vitamin regimen, most gastric sleeve patients can expect to lose between 50 percent and 60 percent of their excess body weight 12 to 18 months after the procedure.

Which Surgery Is Right for Me?

Both gastric bypass and gastric sleeve procedures are permanent and lead to significant weight loss.

Gastric bypass is generally recommended for people with:

• BMI over 45

• Diabetes

• Severe acid reflux

Gastric sleeve is generally recommended for:

• People who have had multiple previous abdominal surgeries

• High-risk patients with major chronic issues like heart disease or lung problems

• People on multiple medications, as bypass can interfere with absorption and effectiveness

 Together with your doctor, you will decide which procedure is best for you.

Recovering from gastric bypass is generally more complicated than gastric sleeve recovery. Most procedures are typically done laparoscopically, and patients can usually go home between one to two days after surgery. If you have open surgery, you’ll be in the hospital for four or five days until your incision has healed. Most patients can resume normal activities within three to four weeks after the procedure.

What’s Life Like After Bariatric Surgery?

For the first four to six weeks after the procedure, you will consume small amounts of soft foods and liquids. You will gradually begin to add solid foods back into your diet, though you’ll notice you feel full much more quickly than you did before the procedure.

You can expect to lose between two and four pounds a week for up to two years after your gastric sleeve or bypass procedure.

This depends on making healthy nutrition and lifestyle decisions, including:

●      Eating a nutrient-dense diet. Ensure you are getting enough protein to keep your muscle mass along with eating a diet rich in fruits and vegetables.

●      Regular exercise. Once your body has healed, aim to get regular exercise daily. Start off slowly and gradually add more intensive exercise to your routine to help maintain weight loss and improve your overall health and well-being. 

●      Emotional support. Undergoing bariatric surgery means a complete overhaul of your lifestyle. Find support groups to talk with others who have had a bariatric procedure and lean on supportive friends and family as you navigate this new way of life.

●      Stay hydrated. Drink at least 64 ounces of water each day.

●      Take recommended dietary supplements. This may include vitamin and mineral supplements, depending on which procedure you had.

As your body heals from the procedure and you adjust to eating less food, making a plan for your day-to-day life will help you have successful, long-term weight loss.