If you’re like most Americans, you’ve tried multiple times to lose weight over the years, but you haven’t been able to get the body you really want. Even with focused discipline, a restricted diet, and exercising religiously, the results often never come. Some people in this situation have opted for bariatric surgery, but that can be an intimidating prospect. At True You Weight Loss, we focus on non-surgical approaches that produce results that are similar to surgery, without the surgery. If you are reviewing current weight loss options, including non-surgical ones, it’s still important to understand the two most popular bariatric surgeries performed today: gastric bypass and gastric sleeve.
In a way, both types of weight loss surgery are similar in that they rely on the same basic idea: reduce the size of the stomach in order to automatically reduce the number of calories that can be consumed in a single sitting. Such a reduction in stomach volume—and the resultant caloric deficit—is designed to promote weight loss over the long term by essentially retraining the body to expect fewer calories. The decreased stomach capacity means feeling full sooner, and the net effect of feeling full is that it becomes very difficult to overeat.
Though they both work by decreasing stomach capacity, one of the main differences between the two surgeries is the primary means of achieving a caloric deficit. In gastric sleeve surgery, the smaller stomach size simply means you’ll generally be less hungry; this essentially forces you to eat less because the new stomach simply can’t hold the same amount of food. With gastric bypass, the nature of the procedure makes it so that fewer nutrients are actually absorbed by the body because the stomach and part of the intestinal tract are bypassed.
This bypass of the stomach is another major difference between the two; in gastric bypass, the stomach is divided into two parts: a small gastric pouch and a larger portion of the stomach that is bypassed (known as the gastric remnant). The most popular version of gastric bypass surgery is called Roux-en-Y gastric bypass, and it involves connecting the pouch directly to the small intestine further down the digestive tract. Bypassing a significant portion of the small intestine means that fewer nutrients (and, by extension, calories) are absorbed from food. The surgeon also re-forms the bypassed section of intestine into a Y-shape so that digestive juices from the stomach and duodenum can still empty into the small intestine and aid in digestion.
Gastric sleeve (also known as sleeve gastrectomy, or laparoscopic sleeve gastrectomy) surgery is a somewhat less complicated bariatric procedure because it doesn’t require re-routing and bypassing the small intestine. The bariatric surgeon similarly reduces the size of the stomach, but it involves actually removing about 80% of the stomach lengthwise along the greater curvature. After this is removed, the remaining stomach tissue is formed into a banana-shaped “sleeve” that is still connected to the digestive tract exactly as before. But with only 20% of the capacity left, you are unable to eat as much food as before; weight loss is realized through reduced capacity and decreased appetite.
Both types of surgery aim to achieve weight loss results in a similar way, but through different means. Both methods are irreversible, so getting the surgery is a lifelong commitment. But because of the permanence of the procedures, they have the potential to lead to significant weight loss, especially during the first two years after the surgery. Though results vary by person, many gastric bypass patients and gastric sleeve patients report losing between 60% to 80% of excess body weight (which is defined as the amount of weight over the expected weight for someone’s age, build, and sex).
Gastric bypass surgery has been around since the 1960s, so it is a well-known procedure with relatively low risk and a high chance of a patient successfully losing weight. But as with any type of surgery, it’s important to weigh the pros and cons before committing to the procedure:
Gastric sleeve surgery (also known as sleeve gastrectomy) is currently the most common bariatric surgery, and it is similarly low risk and effective:
While both gastric bypass and sleeve gastrectomy are relatively safe ways to help people lose weight, they’re obviously not without the risk of complications. Surgery of any kind can be hard on the body, and even the small incisions associated with laparoscopy can be unpleasant and can take up to 4-6 weeks to fully heal. Moreover, most patients will not qualify for these surgeries unless their BMI (body mass index) is 40 or more, or they have medical comorbidities such as diabetes.
Fortunately, there are new weight loss options available that are lower risk, minimally invasive, and don’t require actual surgery at all. At True You, we specialize in offering these solutions as a distinct alternative to traditional surgery. With methods like Endoscopic Sleeve Gastroplasty (ESG), the ORBERA® gastric balloon, you can achieve the weight loss of bariatric surgery without the actual surgery. Or, if you’ve already had gastric bypass or sleeve gastrectomy surgery but have started to regain weight, we can also perform an endoscopic revision procedure that returns the gastric pouch or sleeve to its originally intended size. If you are interested in learning more about these weight loss procedures and how they compare to bariatric surgery, request a consultation today to speak with a weight loss professional.
