Obesity: Which Weight-Loss (Bariatric) Surgery Is Right for You?

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Bariatric surgery can help people lose weight. Two common types of bariatric surgery are gastric bypass and gastric sleeve. Both surgeries make changes to the shape and size of your stomach.

  • Gastric bypass surgery. People usually lose more weight with this surgery. If you have type 2 diabetes, it may go away. And it is less likely to come back than it is with gastric sleeve. But this surgery has a higher risk of serious problems than gastric sleeve.
  • Gastric sleeve surgery. In general, people don’t lose as much weight with this surgery. If you have type 2 diabetes, it may go away. But it’s more likely to come back than it is with gastric bypass. This surgery has fewer risks than gastric bypass.

Losing weight can help improve many weight-related health problems, like diabetes, high blood pressure, high cholesterol, knee arthritis, sleep apnea, and problems getting pregnant. It may also reduce your risk of developing heart disease or cancer.

Only you know which option is right for you. Work with your doctor to be sure that your decision aligns with what’s important to you. Take a few minutes to compare the options and see what you prefer.

What's involved

Gastric bypass surgery Gastric sleeve surgery
  • You have surgery to make your stomach smaller and connect it to the middle part of your small intestine. Food skips (bypasses) the rest of the stomach and part of the small intestine.
  • You will make lifelong changes in how you eat and drink. You will need to take vitamin and mineral supplements from now on. And you may need to work with a dietitian to plan meals to prevent vitamin and mineral deficiencies.
  • You have surgery to remove more than half your stomach, leaving a thin vertical tube, or sleeve.
  • You will make lifelong changes in how you eat and drink. You will need to take vitamin and mineral supplements from now on.

How well it works

Gastric bypass surgery Gastric sleeve surgery
  • People who have gastric bypass surgery lose more weight compared with those who have gastric sleeve surgery.
    • Within the first year, you may lose up to 30% of your body weight.
    • After 5 years, you may have lost about 25% of your body weight.
  • You may be less likely to regain a lot of weight after gastric bypass surgery.
  • People who have gastric sleeve surgery lose less weight compared with those who have gastric bypass surgery.
    • Within the first year, you may lose about 25% of your body weight.
    • After 5 years, you may have lost about 20% of your body weight.
  • You may be more likely to regain a lot of weight after gastric sleeve surgery.

Health benefits

Gastric bypass surgery Gastric sleeve surgery
  • If you have type 2 diabetes, it may go away after surgery. But sometimes diabetes will come back.
    • Type 2 diabetes will go away completely in more than 80 out of 100 people.
    • Fewer people will have diabetes come back after gastric bypass compared with gastric sleeve.
    • Within 5 years, diabetes will come back in about 33 out of 100 people.
  • If you have high blood pressure or high cholesterol, your levels may improve.
  • If you have acid reflux, it may get better after surgery.
  • You may have a lower risk of a heart attack or stroke and a lower risk of cancer.
  • If you have type 2 diabetes, it may go away after surgery. But sometimes diabetes will come back.
    • Type 2 diabetes will go away completely in more than 80 out of 100 people soon after surgery.
    • More people will have diabetes come back after gastric sleeve compared with gastric bypass.
    • Within 5 years, diabetes will come back in about 40 out of 100 people.
  • If you have high blood pressure or high cholesterol, your levels may improve.
  • You may have a lower risk of a heart attack or stroke and a lower risk of cancer.

Risks

Gastric bypass surgery Gastric sleeve surgery
  • Gastric bypass surgery has a higher risk of serious problems compared with gastric sleeve surgery. These problems aren't common. But they can happen after any surgery. They may include:
    • Blood clots.
    • Infection.
    • A very low risk of death.
  • People who have gastric bypass surgery are more likely to need more surgery to treat problems related to the first surgery.
    • Within 30 days, about 2 out of 100 people will need more surgery.
    • Within five years, 12 to 23 out of 100 people will need more surgery.
  • After gastric bypass, some people may develop a condition called dumping syndrome. This can make you feel faint, shaky, and sick to your stomach. It may give you diarrhea soon after eating.
  • Gastric sleeve surgery has a lower risk of serious problems compared with gastric bypass surgery. These problems aren't common. But they can happen after any surgery. They may include:
    • Blood clots.
    • Infection.
    • A very low risk of death.
  • People who have gastric sleeve surgery are less likely to need more surgery to treat problems related to the first surgery.
    • Within 30 days, less than 1 out of 100 people will need more surgery.
    • Within 5 years, 9 to 18 out of 100 people will need more surgery.
  • If you have acid reflux, it may get worse after gastric sleeve. Some people need to have more surgery to treat this.

Recovery

Gastric bypass surgery Gastric sleeve surgery
  • You'll need time to heal after surgery. Most people need 2 to 4 weeks before they are ready to get back to their usual routine.
  • Because the surgery makes your stomach smaller, you will not be able to eat very much at one time. You will get full quickly.
  • You'll need time to heal after surgery. Most people need 2 to 4 weeks before they are ready to get back to their usual routine.
  • Because the surgery makes your stomach smaller, you will not be able to eat very much at one time. You will get full quickly.

Cost

Gastric bypass surgery Gastric sleeve surgery
  • The cost of surgery varies. Check your insurance coverage.
  • Also think about the costs of:
    • Taking time off from work.
    • Getting help you may need during recovery.
  • The cost of surgery varies. Check your insurance coverage.
  • Also think about the costs of:
    • Taking time off from work.
    • Getting help you may need during recovery.

Where can you learn more?

Go to http://www.healthwise.net/patientEd

Enter B122 in the search box to learn more about "Obesity: Which Weight-Loss (Bariatric) Surgery Is Right for You?".

Current as of: April 30, 2024

Author: Ignite Healthwise, LLC Staff

Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.

Current as of: April 30, 2024

Author: Ignite Healthwise, LLC Staff

Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.

The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.