With the plication your stomach is folded in twice, not stapled or cut. Our stomachs are intact they are just shaped like a half a moon or banana for a few of us. With the restriction you can only eat a certain amount of food before you get full or feel sick from over-eating. My personal issue was or still is I eat without hunger. It's all in my mind. I eat bc am used to eating at a certain time or craze all day, Even with Mental Hunger I've lost 50 pounds by eating healthier and lots of cardio.