Comparing Options

Restrictive Surgery

Sleeve Gastrectomy

Advantages:  You can expect to lose on average> 60% of excess body weight at one year. Typically there are minimal long term complications. This surgery can be the first stage to a gastric bypass for individuals who are considered high risk.

Disadvantages: You may experience nausea and vomiting if you overeat which can result in pain and/or stretching of the stomach. Patients who have problems with acid reflux before surgery may have increased symptoms after surgery.

Lap-Band

Advantages: You can expect to lose on average 50% of excess body weight at one year. The lap-band typically has a low complication rate and is adjustable and removable. There is no nutrient or vitamin requirement after surgery.

Disadvantages: To keep the weight off, you will need to change your eating habits, stick to a long term plan of healthy eating, and engage in regular physical activity. There are frequent adjustments that need to be made to the band which is done with a needle. The lap-band offers the slowest weight loss of all procedures.

Combined Restrictive/Malabsorptive Surgery

Gastric Bypass

Advantages:  You can expect to lose on average 60-70% of excess body weight at once year and you may continue to lose weight for 18-24 months after the procedure. The bypass is the “gold standard” of bariatric surgery with rapid loss expected.

Disadvantages: Long term vitamin and nutrient supplementation is required. Bypass may cause “dumping syndrome,” an unpleasant reaction after you eat a meal high in sugar. The dumpling syndrome occurs when the contents in your stomach move too quickly through the small intestine.

Biliopancreatic Diversion with Duodenal Switch

Advantages: You can expect to lose> 70% of excess body weight at one year. This surgery yields the most rapid weight loss.

Disadvantages:  Long term vitamin and nutrient supplementation is required. Patients routinely experience frequent and foul smelling diarrhea. The surgery requires the most aggressive follow-up with the surgeon after the procedure due to the risk of protein-calorie malnutrition. The surgery is only considered in patients with a BMI>50 and for very select patients.