Weight Loss Team

Which Surgery is Better, The Gastric Bypass or The Gastric Sleeve?

By Gerald Witt on January 26, 2021

Weight Loss Surgery or Bariatric Surgery is a procedure that helps obese people lose weight with a surgical technique. Weight loss surgery is typically a safe option for patients who need to lose a lot of weight, especially if changing their diet, becoming more active and diet pills have not worked in the past.  Surgery should never be your first option but as a weight loss tool, bariatric surgery has very good results in helping the morbidly obese lose weight and reach their goal weights.  That said, people always ask, what is the best bariatric surgery out there. The two most common weight loss procedures are Gastric Bypass Surgery and Gastric Sleeve Surgery, and they have similarities and differences between them, but which one is better, the Gastric Bypass or the Gastric Sleeve?

  • Gastric Sleeve and Gastric Bypass, both reduce patient’s stomach from its regular size to a small pouch, causing weight loss by restricting the amount of food the patient can eat before they feel full and reducing the hunger hormone ‘ghrelin’
  • Gastric Sleeve and Gastric Bypass differ in the way the new pouch is created:

Gastric Sleeve is a safe procedure where the surgeon permanently removes about 70 to 80 % of the patient’s stomach and what remains looks like a small banana-shaped or men’s shirt sleeve type stomach pouch.

Gastric Bypass is also known as Roux-en-Y, is a procedure where the surgeon creates a small stomach pouch by removing or bypassing most of the patient’s stomach and the first part of their small intestine. So, the newly created stomach pouch is reconnected to the remaining small intestine.

  • Gastric Bypass patients lose between 60 to 80 percent of excess body weight in the first year and up to 90 percent of their excess weight over time. Gastric Sleeve patients lose between to 60 to 80 percent of their excess body weight in the first two years.
  • Gastric Bypass is a more complicated procedure than Gastric Sleeve but both are usually done laparoscopically.  The Gastric Bypass carries more risk but has more rewards for patients who need to lose 150 plus pounds, whereas the Gastric Sleeve surgery has a lower complication rate but also the patients who have success typically need to lose 100 or fewer pounds with the gastric sleeve.
  • For patients with BMI over 45, Gastric Bypass is often recommended; however, many surgeons are finding that Gastric Sleeve is also helpful for very obese patients.
  • The Gastric Sleeve is ideal for patients who do not want to deal with malabsorption or do not need to lose more than 130 pounds.  The Gastric Bypass is ideal for those patients who need to lose 150 plus pounds.

What is the best Weight Loss Surgery option between the two procedures mentioned above? The important question here would be what is the best surgery for each specific patient.  Each person is different and each person has specific needs that can be met by one or the other surgery. It is important how much weight they can expect to lose after the surgery, how committed they are to making a new lifestyle change, how prepared they and their family are to take the step of having surgery. That is if the patient does not implement healthy lifestyle changes after any of the surgeries, plain and simple they just won’t succeed.

It is important that patients contact and ask questions to the medical office for their surgeon so that they are able to make a more informed decision about which procedure might be better suited for their needs. For example, Dr. Hidalgo and his Bariatric practice, Weight Loss Team in Puerto Vallarta Mexico, try to get to know each patient's needs prior to surgery, and usually, they will be more than ready to help guide their patients through their weight loss journey.

So to make a long story short, both the Gastric Sleeve and Gastric Bypass are excellent choices for surgery, and they are both adequate to help the patient reach their goal weight, but based on the patients BMI, the Gastric Sleeve would be considered a better surgery for patients needing to lose 130 pounds or less, and the Gastric Bypass surgery would be a better surgery for patients needing to lose 130 pounds or more.

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