Choosing Between Gastric Bypass And Gastric Sleeve

Christie Auyeung Weight Loss Surgery Leave a Comment

When it comes to weight loss surgery, you have a number of options to choose from. The three most common procedures are the gastric bypass, gastric sleeve, and gastric band. Each procedure works differently and has their own benefits and risks. Understanding these differences is essential to choosing the right surgery for you.

Many patients find themselves deciding between gastric bypass and gastric sleeve, which share many similarities. To help you make a more informed choice, we’re going to take a closer look at these two surgeries side by side.

How It Works:

Gastric Bypass

In gastric bypass surgery, your surgeon first makes your stomach smaller, using staples to divide your stomach into a small upper section and a larger bottom section. The top section, called the pouch, is where the food you eat goes. It’s only the size of a walnut and can hold about 1 ounce of food. This helps you eat less and stay full longer. Your surgeon will also connect the pouch to a small part of your small intestine, so food bypasses part of the intestine. This reduces the amount of calories your body absorbs. After surgery, your body stores fewer excess calories and uses your fat supply for energy.

Gastric Sleeve

In gastric sleeve, your surgeon removes the side part of your stomach, leaving behind a thin, vertical sleeve of stomach the size of a banana. Like with gastric bypass, this limits the amount of food you can eat at a time, makes you stay full longer, and makes your body use your fat supply for energy. The main difference with gastric bypass is that food still travels through the entire intestine.

How Much Weight You’ll Lose

Both procedures result in a drastic amount of weight loss after surgery. However, it’s important to have realistic expectations of how much weight you will lose, and keep in mind that long-term weight loss depends more on your lifestyle habits than which procedure you choose. Without changing what and how much you eat on a regular basis, you are likely to regain any weight lost.

On average, gastric bypass patients lose 60 to 80% of excess body weight in the first year, and gastric sleeve patients lose 50 to 70% of excess body weight in the first two years.

How Fast You’ll Lose Weight

On average, gastric bypass surgery patients lose more weight right after surgery. However, after three years, gastric sleeve patients begin to catch up. Also, your BMI affects your speed of weight loss. The higher your BMI, or the bigger you are prior to surgery, the faster you’ll lose weight, regardless of which procedure you choose.

Losing weight quicker through bypass surgery gets you to a healthier weight faster, which makes it easier to exercise and eat healthily. But some patients prefer losing weight more gradually with a gastric sleeve, as it can reduce saggy skin and stretch marks. Knowing your weight loss goals can help you decide which surgery to choose.

Benefits of Gastric Bypass

Gastric bypass has a number of benefits compared to gastric sleeve:
• The surgery has been around longer, so its results and complications have been studied and the benefits proven. The surgery historically produces more weight loss than gastric sleeve.
• Because food bypasses the large intestines, your body absorbs fewer calories, which reduces the body’s calorie intake.
• “Dumping syndrome,” a side effect unique to gastric bypass, is beneficial to weight loss. When too much sugary or fatty foods are consumed too quickly, the stomach dumps the food into the small intestine prematurely, which makes you feel nauseated, dizzy, or makes you vomit. It’s a very strong negative reinforcement that will force you to improve your eating habits.

Benefits of Gastric Sleeve

On the other hand, gastric sleeve offers its own benefits:
• The left portion of stomach is where the hunger hormone “ghrelin” is produced. This area is almost completely removed in gastric sleeve surgery, leading to significantly reduced hunger, often even more so than in gastric bypass.
• Gastric sleeve patients lose weight as a slower rate. This can lead to less saggy skin and fewer stretch marks.

Weigh The Risks

Fewer long-term studies have been done on gastric sleeve surgeries compared to gastric bypass.

Both surgeries have similar associated risks:
• Bleeding
• Infection
• Blood clots
• Stomach leakage
• Non-reversible

Additionally, gastric bypass risks include dumping syndrome, potential nutritional deficiency, ulcers, gallstones, bowel obstruction, and acid reflux. Gastric sleeve may have fewer associated risks, but it may not be covered by some insurance companies because it is considered experimental.

So, Which Is Better?

It depends. Many doctors recommend gastric sleeve because it is a less expensive procedure with fewer potential complications. If you take anti-inflammatory medication, which may cause ulcers after gastric bypass, or want a less invasive surgery, you may lean towards gastric sleeve.

Gastric bypass is proven to result in better long-term results, but the surgery is also more complex and risky. But if you have certain habits like severe binge eating or emotional eating, or want a more proven weight loss procedure, gastric bypass may be more appropriate for you.

Speaking with an experienced surgeon about your medical information and lifestyle habit can be immensely helpful as you make your decision. If you’re interested in learning more about gastric bypass or gastric sleeve, contact one of our world-class surgeons today!

Christie is a UChicago grad currently living in the San Francisco Bay Area. In her free time, she enjoys tap dancing, learning to windsurf, and trying new foods.