Deciding which type of weight loss surgery is right for you is a decision between you and your bariatric surgeon. If you are a candidate for bariatric surgery, your doctor will explore the different types of surgical options with you and discuss the benefits as well as the challenges of each. Depending on your BMI, your health and weight loss history, and other unique factors, certain types of surgical procedures may be recommended over others.

Sleeve gastrectomy vs. bypass: similarities and differences

Sleeve gastrectomy or gastric sleeve, and gastric bypass, also known as Roux-en-Y gastric bypass, are two common types of procedures that involve reduction of your stomach size to a small pouch. When you eat, the pouch fills up very quickly, so it limits the amount you’re able to eat. You feel full very fast. This also reduces the amount of a hunger hormone called ghrelin, which signals your brain to eat more.

How sleeve gastrectomy and gastric bypass are different

When you have gastric sleeve surgery, your bariatric surgeon will permanently remove about 80 percent of your stomach, leaving a small pouch or “sleeve” shaped like a banana.

With gastric bypass, the surgeon removes most of the stomach but also “bypasses” it and the first part of the small intestine. The stomach gets attached further down the small intestine. By doing this, fewer calories are absorbed and you lose weight.

While both surgeries are considered “restrictive,” gastric bypass is also considered “malabsorptive” since it cuts off the body’s ability to absorb calories and nutrients.

Gastric bypass surgery is often the preferred option for patients with severe obesity and a Body Mass Index over 45. Find out more about obesity, BMI and bariatric surgery.

Who should get gastric sleeve vs. gastric bypass

Some considerations your doctor will explore with you include comorbidities you might have, such as diabetes, hypertension, high cholesterol, fatty liver disease or sleep apnea.

Gastric bypass may be recommended for patients with conditions such as:

• Type II diabetes
• Severe heartburn, acid reflux, or GERD

But your surgeon may recommend sleeve gastrectomy or another type of bariatric procedure if you have:

• Crohn’s disease
• Anemia or other vitamin and mineral deficiencies
• A condition that requires use of steroids, NSAIDs or anti-inflammatory medications

In these cases, your body depends more on the absorption of nutrients as well as medications associated with your condition. With Crohn’s and other abdominal illnesses, you may not be able to tolerate gastric bypass as well. Therefore, the gastric sleeve approach might be more appropriate.

What is dumping syndrome?

This is a condition caused by rapid emptying of poorly digest stomach contents into the small intestine. When this happens, it can cause nausea, abdominal cramps, diarrhea and bloating. People who have gastric sleeve or gastric bypass surgery are at risk for dumping syndrome, but the risk is higher with gastric bypass patients.

What are the risks of gastric sleeve vs. gastric bypass?

While all surgical procedures carry some risk of infection and there are individual risks associated with the use of anesthesia, there are a few more risks involved with gastric bypass because it is a more complex procedure affecting multiple processes in the body. Your bariatric surgeon will discuss all of this with you before you decide which is right for you. Also keep in mind that your bariatric team will be working with you every step of the way after your procedure to ensure your long-term health and well-being.

Gastric sleeve risks

Some of the risks associated with gastric sleeve surgery include:

• Reflux, heartburn
• Difficulty swallowing
• Leakage at the staple line (of the stomach pouch)
• Abdominal abscess
• Twisting of the stomach tube

Gastric bypass risks

Gastric bypass carries its own set of risks, including:

• Gastrointestinal bleeding
• Intestinal leakage and ulceration
• Breathing issues
• Gallstones
• Bowel obstruction
• Hernias

Keep in mind that gastric bypass also affects your ability to tolerate alcohol.  

If you experience any of these symptoms or conditions after you’ve had surgery, get in touch with your bariatric surgeon right away so you can be treated. A follow-up procedure is rare but may be needed in some cases.

Interested in a bariatric surgery consultation?

Set up a free consultation with our bariatric surgeon to explore your options. Call (941) 209-4646.