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Know Your Weight Loss Surgery Options: Sleeve vs. Gastric Bypass

If you are eligible for bariatric surgery, two procedures can be considered: gastric sleeve surgery and gastric bypass surgery. Both procedures are aimed at helping qualifying individuals lose weight. But understanding the key differences and benefits is crucial to making an informed decision about which surgery is best for you. 

“Which surgery we recommend depends a lot on the patient’s other medical issues,” says Ellen Morrow, MD, MS, FACS, a bariatric surgeon at University of Utah Health. “Both procedures can be great options for the right patient, and it’s important to have an individual conversation about your goals.”

What Is a Sleeve?

A sleeve surgery reduces the size of your stomach, which will make you fill full more quickly. Your surgeon will use a stapler to divide the stomach and remove about two-thirds of it, leaving a narrow pouch shaped like banana. It reduces the amount of ghrelin, a hormone that triggers hunger, produced in your body, so you feel satisfied on a lower-calorie diet.

People who have a higher risk for developing ulcers are better suited for the sleeve than gastric bypass. 

“Gastric bypass has a higher risk of ulcers, so if patients have recently quit smoking or are dependent on NSAIDS like ibuprofen for pain management, we’re likely to recommend a sleeve,” Morrow says. 

Sleeve Quick Facts:

  • Hospital stay length: The surgery itself takes about one to two hours, and you will likely stay in the hospital for one to two days post-surgery. 
  • Total recovery time: An average of two weeks. Sleeve patients stay on a liquid diet for about four weeks before reintroducing solids.
  • Average weight lost post-surgery: About a quarter of your body weight.
  • Weight loss timeline: Weight loss may not be as rapid as after gastric bypass surgery, but most patients lose the weight in the first one to two years post-op.

What Is Gastric Bypass?

Gastric bypass surgery, also known as Roux-en-Y gastric bypass, involves creating a small stomach pouch about the size of an egg. Your surgeon will then connect that pouch directly to a lower part of your small intestine, which is reconnected into a Y shape. 

“That rerouting of the food results in some bigger hormonal changes, which gives the patients a higher average weight loss and also a bigger impact on blood sugar,” Morrow says. “That is particularly important for patients who have diabetes or are at high risk of developing diabetes.”.

Besides diabetes, gastric bypass also has a positive impact on acid reflux (heartburn). 

“For most weight-related conditions, people are going to potentially see more improvement with gastric bypass just because they’re going to lose a little bit more weight on average,” Morrow says.

Gastric Bypass Quick Facts:

  • Hospital stay length: Gastric bypass surgery takes about two and a half hours. You’ll stay in the hospital for one to two days post-surgery. 
  • Total recovery time: An average of two weeks. Gastric bypass patients stay on a liquid diet for about two weeks before reintroducing softer solids.
  • Average weight lost post-surgery: About one-third of total body weight (or 75% of excess weight).
  • Weight loss timeline: Weight loss is rapid and mostly occurs in the first six months post-op. After that, weight loss will continue but will be more gradual until the end of the year.

Life Post-Op

Regardless of if the sleeve or gastric bypass is better for you, bariatric surgery patients must commit to major, permanent lifestyle changes. Both surgeries will require you to quit smoking and follow a special diet before your procedure. 

After your surgery, your doctor will encourage you to: 

  • Avoid alcohol
  • Avoid carbonated beverages and limit caffeine
  • Stay hydrated by drinking at least 64 ounces of water each day
  • Avoid foods with high amounts of sugars
  • Control portion size (one cup max) and only have one snack per day
  • Consume between 60-100 grams of protein per day
  • Exercise regularly
  • Take vitamin and mineral supplements to avoid nutritional deficiencies

Bariatric surgery is a big commitment, but combined with a healthy diet, exercise, and working with your doctor, it can be a huge step in your journey to a healthier life.