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Bariatric Surgery

Get the inside scoop on bariatric surgery from Dr. Caroline Cederquist, a board certified bariatric physician. Find out what this group of procedures entail, and receive advice from our world-renowned expert in medical weight loss.

How the Different Types of Weight Loss Surgery Vary

Bariatric surgeries help people lose weight but how does one choose with many options? Learn the types of weight loss surgeries and the pros and cons of each for guidance!

How the Different Types of Weight Loss Surgery Vary


Also known as bariatric surgeries, weight loss surgeries are performed in hopes to assist in weight loss that goes beyond wanting to lose a few inches or pounds. 

There are different types of weight loss surgeries, in which a surgeon will make anatomical changes to your stomach, small intestine, or even both. They can be life-changing, but also offer health benefits not gained on individual weight loss efforts.

What are the types of weight loss surgery and how are they different? Explore what each option involves along with the pros and cons each option offers.

4 Types of Weight Loss Surgeries and How They are Different

Identified by the American Society for Metabolic and Bariatric Surgery, the four most commonly used weight-loss surgeries include: 

1. Gastric bypass
2. Gastric band
3. Gastric sleeve
4. Biliopancreatic diversion with duodenal switch

All different types of bariatric surgeries are slightly different and have pros and cons.

1. Gastric Bypass

Formally known as Roux-en-Y gastric bypass, the procedure is the most common type of weight loss surgery. Gastric bypass takes out a portion of the stomach to reduce its capacity. The leftover portion is approximately the size of an egg and limits the volume of food it can hold. 

The small intestine is cut below the main stomach area and connected to a smaller stomach pouch, in which food "bypasses" part of the small intestine. This bypassing causes the body to absorb fewer calories and nutrients, though the remaining portion of the stomach is left to stimulate necessary digestive juices.

Pros: This type of weight loss surgery has a long history of providing long-lasting weight loss. It also helps treat obesity-related health conditions.

Cons: Because of the missed nutrient absorption, supplements need to be taken to avoid vitamin and mineral deficiencies. There may be unpleasant side effects if the wrong food amounts are eaten. For example, if too much sugar is eaten, it could lead to diarrhea or cramping. 

While this surgery is the most common, there are potential risks for complications after surgery with the small intestine. Especially if a smoker, gastric bypass also increases the risk of ulcers.

2. Gastric Band

Also known as the lap band, the gastric band involves an inflatable balloon placed around the upper portion of the stomach. The adjustable gastric "banding" creates a small pouch with a much narrower opening to the distal portion of the stomach area. 

Pros: Like gastric bypasses, gastric bands restrict food volume held in the stomach but with minimized concern of calorie and nutrient malabsorption. It is considered to be less invasive as well. 

Cons: The band will need continual adjusting after surgery. Weight loss may come off slower compared to other types of weight loss surgery.

3. Gastric Sleeve

This type of weight loss surgery removes more than half of the stomach, leaving a thin vertical "sleeve" or tube. 

Unlike the other indicated operations, the gastric sleeve is an invasive and irreversible procedure, as it removes a large part of the stomach. The remaining stomach portion is about the size of a banana, leaving little room to hold food.

Pros: The gastric sleeve could be a safer option for those with certain high-risk medical conditions. This procedure is considered safer and less invasive compared to other weight loss surgeries.

Cons: This surgery is irreversible, and it may worsen symptoms of heartburn in some people.

4. Biliopancreatic Diversion with Duodenal Switch (BPD/DS) Gastric Bypass

Unlike the other three surgeries described, the BPD/DS comprises two components. It first starts out similar to the gastric sleeve, then a large portion of the small intestine is bypassed. 

More specifically, the duodenum (the first portion of the small intestine) is connected to the last portion of the small intestine. This reduces the amount of food while still stimulating important enzymes for efficient nutrient breakdown. And like the gastric sleeve, the BPD/DS may be considered a more aggressive bariatric surgery.

Pros: This option has been shown to provide some of the best weight loss results and treat type 2 diabetes out of all weight loss surgeries. Because different parts of the intestine remain active, satiety cues remain intact.

Cons: This surgery option is considered more complex than other options. It may cause more gastrointestinal side effects like heartburn, irregular bowel movements, and nutritional deficiencies.

Weight Loss Surgery Recap

Each of the four weight loss surgery options varies, but they can all lead to dramatic weight loss and health gains. Discussing options with your primary healthcare provider will best determine what weight loss options are best for you. They can help guide you to appropriate options that are best suited for your individual needs and answer any questions you have.

It is important to note before doing a weight loss surgery, insurance companies often require going through medical weight loss. Perspective weight loss surgery participants must meet stipulations and guidelines such as:

• Body mass index (BMI) of 40 or greater or more than 100-pounds overweight.

• BMI equal to or greater than 35 plus two obesity-related comorbidities, including diabetes, high blood pressure (hypertension), non-alcoholic fatty liver disease, and heart disease.

• Have continued to demonstrate efforts toward weight loss without the physical outcome of gravitating toward a healthier weight.

• Be aware of the potential side effects. Although they may vary based on specific weight loss surgeries, common consequences include nausea and vomiting, diarrhea, infection, nutritional deficiencies, and medical complications.

• While you cannot put a price on health, it is important to acknowledge the monetary price tag attached. Health insurance and loans are available to assist in healthcare costs, but may not offer full coverage and require tapping into individuals' private wallets. Before jumping into bariatric surgery, weigh out your own personal financial options and have a plan to implement.

• You must be committed to a complete lifestyle change for a lifetime - like meeting with an interdisciplinary team regularly, receiving lab checks frequently, and taking multivitamins consistently. Overall, you still must put in the effort towards a healthy lifestyle for the least health complication risks and greatest success.

Last but not least, know bistroMD is inspired and dedicated to your desired success! BistroMD delivers well-balanced meals scientifically-proven to facilitate weight loss. In fact, BistroMD's founding physician, Dr. Caroline Cederquist is board certified in medical weight loss.

Reference:

Bariatric surgery procedures. American Society for Metabolic and Bariatric Surgery. https://asmbs.org/patients/bariatric-surgery-procedures. Published May 2021.

Sydney Lappe's Photo
Written By Sydney Lappe, MS, RDN. Published on February 21, 2017. Updated on August 12, 2022.

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