Bariatric surgery isn’t one single procedure. There are multiple types, and each works in a different way to support weight loss and improve health. Some surgeries reduce how much you can eat, others change how your body absorbs food, and many do both.
Here’s a breakdown of the most common options:
1. Gastric Sleeve (Sleeve Gastrectomy)
This is the most commonly performed bariatric surgery in the U.S. today. About 80% of the stomach is removed, leaving a narrow tube or “sleeve.”
How it works: Restriction. You feel full faster.
Additional effects: Reduces hunger hormones like ghrelin.
Pros: No rerouting of the intestines.
Cons: Irreversible. Can lead to acid reflux and vitamin deficiencies.
2. Gastric Bypass (Roux-en-Y)
A small stomach pouch is created and connected directly to the small intestine, bypassing a portion of the digestive tract.
How it works: Restriction + malabsorption + hormonal changes
Pros: Often leads to fast weight loss and improved blood sugar control
Cons: More complex procedure. Higher risk of dumping syndrome and nutrient deficiencies
3. Mini Gastric Bypass (MGB)
Also known as the one-anastomosis gastric bypass. Similar to Roux-en-Y but uses a longer pouch and connects the intestine in one spot instead of two.
How it works: Restriction + mild malabsorption
Pros: Less complex than traditional bypass with similar outcomes
Cons: May increase risk of bile reflux. Long-term data is still developing
4. Duodenal Switch (BPD-DS)
Combines a sleeve gastrectomy with rerouting of the intestines to limit both intake and absorption.
How it works: Restriction + significant malabsorption
Pros: Highest expected weight loss and strongest effect on type 2 diabetes
Cons: Most complex procedure. Requires strict lifelong vitamin monitoring
Other Options
Adjustable Gastric Band (Lap-Band):
An inflatable band is placed around the upper part of the stomach to create a small pouch.
Why it’s rarely used now: Lower long-term success rates and higher revision/removal rates
Pros: Reversible and adjustable
Cons: Slower weight loss. Frequent follow-ups needed. Higher complication rate over time
Endoscopic Sleeve Gastroplasty (ESG):
A non-surgical procedure that uses sutures to reduce stomach volume.
Pros: No incisions. Outpatient procedure
Cons: Still emerging. Not as effective as surgical options for most patients
Gastric Balloon:
A temporary balloon is placed in the stomach to create fullness.
Pros: Non-surgical and temporary
Cons: Only stays in for a few months. Requires strict dietary changes to maintain results
Which One Is Right for You?
The best procedure depends on your medical history, weight loss goals, and your ability to stick to long-term changes. Your surgeon will help guide you based on your individual needs.