When it comes to choosing which bariatric procedure is right for you, you’re
not alone. Your care team will help with this important decision based
on a number of personal factors, including weight, general health, other
health conditions, National Institutes of Health (NIH) guidelines, and
personal preferences.
Roux-en-Y Gastric Bypass
According to the American Society of Bariatric and Metabolic Surgery and
the NIH, gastric bypass is considered one of the best procedures for weight-loss
surgery. It is the second most frequently performed weight-loss procedure
in the United States. Patients who undergo gastric bypass lose an average
of 50% to 70% of their excess body weight and keep most of it off long term.
This procedure combines restrictive eating with malabsorption, in which
food is delayed in mixing with bile and pancreatic juices to help aid
in the absorption of nutrients. The result is an early sense of fullness,
combined with a sense of satisfaction that reduces the desire to eat.
In this procedure, a small stomach pouch is created. The rest of the stomach
is not removed from the body but is completely stapled shut from the stomach
pouch. The food leaves the newly formed stomach pouch and flows into the
lower portion of the small intestine, thus bypassing this first part of
the small intestine. This is done by cutting the small intestine open
and connecting the second section with the newly formed stomach pouch.
The first section is then attached to the lower portion of the small intestine
(creating the “Y”in the Roux-en-Y name).
Sleeve Gastrectomy
The vertical sleeve gastrectomy procedure (also known as the “gastric
sleeve”) is the most common weight-loss surgery procedure. The reason
for this procedure’s popularity is the fact that the digestive system
stays largely intact, and its high success rate. Like gastric bypass,
gastric sleeve patients lose an average of 50% to 70% of their excess
body weight and keep most of it off long term.
During the gastric sleeve procedure, the surgeon staples and removes the
outer three-fourths of the stomach, leaving a smaller, banana-shaped or
sleeve-shaped stomach. This technique shrinks the capacity of the stomach.
How do I qualify for weight loss surgery?
To qualify for weight loss surgery, you must meet the following guidelines:
Must be 18 years of age or older
Must have a BMI > 35 kg/m2 regardless of presence, absence, or severity
of other medical conditions
Must have a BMI of 30-34.9 kg/m2 with at least one obesity related medical
condition including diabetes, high blood pressure, sleep apnea, high cholesterol,
and others
Which surgery is right for you?
Roux-en-Y Gastric Bypass
Sleeve Gastrectomy
Length of Surgery
90 - 120 minutes
20 - 60 minutes
Changes to Digestive System
Digestive system is rerouted and shortened. Food moves through body much quicker.
Lower two thirds of stomach is removed, leaving a smaller, banana shaped stomach.
Biggest Risk
Patients can have respiratory problems, leaking, hernias, bowel obstructions,
ulcers, intolerance to certain foods, and nutritional deficiencies.
Patients can have increased risk of gastroesophageal reflux disease (GERD).
The stomach can leak, narrow to further restrict its size, and you may
develop hernias.
