Gastric Bypass Surgery - All You Need to Know

gastric bypass surgery

Gastric bypass surgery (“Roux-en-Y gastric bypass”) makes the stomach smaller and reroutes the intestines. As a result, patients:

  • Feel full sooner after eating
  • Absorb less food
  • Lose up to two-thirds of their excess weight within 2 years
  • Have significant health improvement

This page covers everything you need to determine whether gastric bypass is the right weight loss procedure for you.

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Weight Loss
Half to Most of Your Excess Weight

Weight Loss – Half to Most of Your Excess Weight

gastric bypass surgery

Gastric bypass patients usually lose a lot of weight very quickly. Within 3 months, the average patient will lose about one-third of their excess weight. By the one-year mark, almost two-thirds of the excess weight will be gone.

Many patients reach “peak” weight loss between one and two years, then gain a little back (more about Weight Regain in the “Downsides” section below). But long-term results are still impressive, with the average patient keeping about 60% of their excess weight off.

Gastric Bypass Weight Loss Studies

Summary of Findings When Comparing Gastric Bypass to Other Procedures
Summary of Findings When Comparing Gastric Bypass to Other Procedures
Lap Band Surgery vs Gastric Bypass
Lap Band Surgery vs Gastric Bypass
Roux-en-Y gastric bypass is associated with better weight loss, resulting in a better correction of some comorbidities than gastric banding, at the price of a higher early complication rate. This difference, however, is largely compensated by the much higher long-term complication and reoperation rates seen after gastric banding.O
Roux-en-Y gastric bypass is associated with better weight loss, resulting in a better correction of some comorbidities than gastric banding, at the price of a higher early complication rate. This difference, however, is largely compensated by the much higher long-term complication and reoperation rates seen after gastric banding.O
Weight loss outcomes strongly favored gastric bypass over lap band surgery. Patients treated with lap band had lower short-term morbidity than those treated with gastric bypass, but reoperation rates were higher among patients who received lap band surgery. Gastric bypass should remain the primary bariatric procedure used to treat obesity in the United States.A
Editor’s Note: This study was published before long-term results had been published for gastric sleeve surgery.
Weight loss outcomes strongly favored gastric bypass over lap band surgery. Patients treated withlap band had lower short-term morbidity than those treated with gastric bypass, but reoperation rates were higher among patients who receivedlap band surgery. Gastric bypass should remain the primary bariatric procedure used to treat obesity in the United States.A
Editor’s Note: This study was published before long-term results had been published for gastric sleeve surgery.
Collectively, data clearly point to distinct changes in dietary habits after bariatric operations which markedly differ between gastric bypass andlap band patients. Overall, it is tempting to conclude that gastric bypass operations lead to a healthier and a more balanced diet thanlap band implantations.B
Collectively, data clearly point to distinct changes in dietary habits after bariatric operations which markedly differ between gastric bypass andlap band patients. Overall, it is tempting to conclude that gastric bypass operations lead to a healthier and a more balanced diet thanlap band implantations.B
Gastric bypass seems to provide a stronger suppression of ghrelin in comparison with gastric lap band procedure. These findings are consistent with the hypothesis that suppression of ghrelin is one mechanism by which gastric bypass can reduce body weight long term, more thanlap band.C
Gastric bypass seems to provide a stronger suppression of ghrelin in comparison with gastric lap band procedure. These findings are consistent with the hypothesis that suppression of ghrelin is one mechanism by which gastric bypass can reduce body weight long term, more thanlap band.C
Pending long-term evaluation, mini gastric bypass surgery seems a good alternative to gastric bypass, giving the same results with a more simple and reproducible technique.D
Pending long-term evaluation, mini gastric bypass surgery seems a good alternative to gastric bypass, giving the same results with a more simple and reproducible technique.D
Previous studies have demonstrated that hospitalization after gastric bypass increases remarkably (20% per year). The present study shows that hospitalization followingmini gastric bypass surgery instead of rising, as reported with gastric bypass, decreases by a third. Themini gastric bypass has been shown to be a short, safe successful weight loss surgery in previous work. The present study supports themini gastric bypass as a low risk procedure that decreases the need for hospitalization.E
Previous studies have demonstrated that hospitalization after gastric bypass increases remarkably (20% per year). The present study shows that hospitalization followingmini gastric bypass surgery instead of rising, as reported with gastric bypass, decreases by a third. Themini gastric bypass has been shown to be a short, safe successful weight loss surgery in previous work. The present study supports themini gastric bypass as a low risk procedure that decreases the need for hospitalization.E
Both gastric bypass andmini gastric bypass surgery are effective for morbid obesity with similar results for resolution of metabolic syndrome and improvement of quality of life. Mini gastric bypass surgery is a simpler and safer procedure that has no disadvantage compared with gastric bypass at 2 years of follow-up.F
Both gastric bypass andmini gastric bypass surgery are effective for morbid obesity with similar results for resolution of metabolic syndrome and improvement of quality of life. Mini gastric bypass surgery is a simpler and safer procedure that has no disadvantage compared with gastric bypass at 2 years of follow-up.F
Gastric Sleeve Surgery vs Gastric Bypass
Gastric Sleeve Surgery vs Gastric Bypass
Compared with gastric sleeve, gastric bypass had significantly better effect in resolving type 2 diabetes mellitus, hypertension, hypercholesterolemia, gastroesophageal reflux disease, and arthritis. However, gastric bypass had higher incidence of complications and reoperation, and longer operation time than gastric sleeve.P
Compared with gastric sleeve, gastric bypass had significantly better effect in resolving type 2 diabetes mellitus, hypertension, hypercholesterolemia, gastroesophageal reflux disease, and arthritis. However, gastric bypass had higher incidence of complications and reoperation, and longer operation time than gastric sleeve.P
Overall complication rates among patients undergoing gastric sleeve (SG) (6.3%) were significantly lower than for gastric bypass (RYGB) (10.0%, P < 0.0001). Serious complication rates were similar for SG (2.4%) and RYGB (2.5%, P = 0.736). Excess body weight loss at 1 year was 13% lower for SG (60%) than for RYGB (69%, P < 0.0001). SG was closer to RYGB than lap band (LAGB) with regard to remission of obesity-related comorbidities.Q
Overall complication rates among patients undergoing gastric sleeve (SG) (6.3%) were significantly lower than for gastric bypass (RYGB) (10.0%, P < 0.0001). Serious complication rates were similar for SG (2.4%) and RYGB (2.5%, P = 0.736). Excess body weight loss at 1 year was 13% lower for SG (60%) than for RYGB (69%, P < 0.0001). SG was closer to RYGB than lap band (LAGB) with regard to remission of obesity-related comorbidities.Q
PYY levels increased similarly after either procedure. The markedly reduced ghrelin levels in addition to increased PYY levels after gastric sleeve surgery, are associated with greater appetite suppression and excess weight loss compared with gastric bypass.I
(Editors’s note: both ghrelin and peptide YY effect appetite. See our obesity and genetics page for more details)
PYY levels increased similarly after either procedure. The markedly reduced ghrelin levels in addition to increased PYY levels after gastric sleeve surgery, are associated with greater appetite suppression and excess weight loss compared with gastric bypass.I
(Editors’s note: both ghrelin and peptide YY effect appetite. See our obesity and genetics page for more details)
The gastric sleeve operation is able to achieve significant weight loss comparable to the gastric bypass and duodenal switch operations but with the low morbidity profile similar to that of lap band placement.J
The gastric sleeve operation is able to achieve significant weight loss comparable to the gastric bypass and duodenal switch operations but with the low morbidity profile similar to that of lap band placement.J
Duodenal Switch (DS) vs Gastric Bypass
Duodenal Switch (DS) vs Gastric Bypass
Compared with gastric bypass, duodenal switch may be associated with a greater risk of vitamin A and D deficiencies in the first year after surgery and of thiamine deficiency in the initial months after surgery.K(Editors’s note: See our Bariatric Vitamins page for more.)
Compared with gastric bypass, duodenal switch may be associated with a greater risk of vitamin A and D deficiencies in the first year after surgery and of thiamine deficiency in the initial months after surgery.K(Editors’s note: See our Bariatric Vitamins page for more.)
Although duodenal switch is associated with more bowel episodes than gastric bypass, the difference is not statistically significant. Bowel habits are similar in patients who achieve 50% estimated body weight loss with duodenal switch surgery or gastric bypass.L
Although duodenal switch is associated with more bowel episodes than gastric bypass, the difference is not statistically significant. Bowel habits are similar in patients who achieve 50% estimated body weight loss with duodenal switch surgery or gastric bypass.L
Direct comparison of Duodenal Switch toGastric Bypass demonstrates superior weight loss outcomes for DS. Importantly, the likelihood of successful weight loss (excess weight loss >50%) was significantly greater in patients following DS (12 months, 83.9% vs. 70.4%; 18 months, 90.3% vs. 75.9%; 36 months, 84.2% vs. 59.3%).M
Direct comparison of Duodenal Switch toGastric Bypass demonstrates superior weight loss outcomes for DS. Importantly, the likelihood of successful weight loss (excess weight loss >50%) was significantly greater in patients following DS (12 months, 83.9% vs. 70.4%; 18 months, 90.3% vs. 75.9%; 36 months, 84.2% vs. 59.3%).M
No patients reported dumping syndrome (after DS surgery), and marginal ulcers were not seen.N
No patients reported dumping syndrome (after DS surgery), and marginal ulcers were not seen.N
Summary of Findings When Comparing Gastric Bypass to Other Procedures
Year of Study
Lap Band Surgery vs Gastric Bypass
Roux-en-Y gastric bypass is associated with better weight loss, resulting in a better correction of some comorbidities than gastric banding, at the price of a higher early complication rate. This difference, however, is largely compensated by the much higher long-term complication and reoperation rates seen after gastric banding.O
2012
Weight loss outcomes strongly favoredgastric bypass over lap band surgery. Patients treated withlap band had lower short-term morbidity than those treated with gastric bypass, but reoperation rates were higher among patients who receivedlap band surgery. Gastric bypass should remain the primary bariatric procedure used to treat obesity in the United States.A
Editor’s Note: This study was published before long-term results had been published for gastric sleeve surgery.
2008
Collectively, data clearly point to distinct changes in dietary habits after bariatric operations which markedly differ between gastric bypass andlap band patients. Overall, it is tempting to conclude that gastric bypass operations lead to a healthier and a more balanced diet thanlap band implantations.B
2008
Gastric bypass seems to provide a stronger suppression of ghrelin in comparison with gastric lap band procedure. These findings are consistent with the hypothesis that suppression of ghrelin is one mechanism by which gastric bypass can reduce body weight long term, more thanlap band.C
2003
Pending long-term evaluation, mini gastric bypass surgery seems a good alternative to gastric bypass, giving the same results with a more simple and reproducible technique.D
2008
Previous studies have demonstrated that hospitalization after gastric bypass increases remarkably (20% per year). The present study shows that hospitalization followingmini gastric bypass surgery instead of rising, as reported with gastric bypass, decreases by a third. Themini gastric bypass has been shown to be a short, safe successful weight loss surgery in previous work. The present study supports themini gastric bypass as a low risk procedure that decreases the need for hospitalization.E
2006
Both gastric bypass andmini gastric bypass surgery are effective for morbid obesity with similar results for resolution of metabolic syndrome and improvement of quality of life. Mini gastric bypass surgery is a simpler and safer procedure that has no disadvantage compared with gastric bypass at 2 years of follow-up.F
2005
Gastric Sleeve Surgery vs Gastric Bypass
Compared with gastric sleeve, gastric bypass had significantly better effect in resolving type 2 diabetes mellitus, hypertension, hypercholesterolemia, gastroesophageal reflux disease, and arthritis. However, gastric bypass had higher incidence of complications and reoperation, and longer operation time than gastric sleeve.P
2014
Overall complication rates among patients undergoing gastric sleeve (SG) (6.3%) were significantly lower than for gastric bypass (RYGB) (10.0%, P < 0.0001). Serious complication rates were similar for SG (2.4%) and RYGB (2.5%, P = 0.736). Excess body weight loss at 1 year was 13% lower for SG (60%) than for RYGB (69%, P < 0.0001). SG was closer to RYGB than lap band (LAGB) with regard to remission of obesity-related comorbidities.Q
2013
PYY levels increased similarly after either procedure. The markedly reduced ghrelin levels in addition to increased PYY levels after gastric sleeve surgery, are associated with greater appetite suppression and excess weight loss compared with gastric bypass.I
(Editors’s note: both ghrelin and peptide YY effect appetite. See our obesity and genetics page for more details)
2008
The gastric sleeve operation is able to achieve significant weight loss comparable to the gastric bypass and duodenal switch operations but with the low morbidity profile similar to that of lap band placement.J
2007
Duodenal Switch (DS) vs Gastric Bypass
Compared with gastric bypass, duodenal switch may be associated with a greater risk of vitamin A and D deficiencies in the first year after surgery and of thiamine deficiency in the initial months after surgery.K(Editors’s note: See our Bariatric Vitamins page for more.)
2009
Although duodenal switch is associated with more bowel episodes than gastric bypass, the difference is not statistically significant. Bowel habits are similar in patients who achieve 50% estimated body weight loss with duodenal switch surgery or gastric bypass.L
2008
Direct comparison of Duodenal Switch toGastric Bypass demonstrates superior weight loss outcomes for DS. Importantly, the likelihood of successful weight loss (excess weight loss >50%) was significantly greater in patients following DS (12 months, 83.9% vs. 70.4%; 18 months, 90.3% vs. 75.9%; 36 months, 84.2% vs. 59.3%).M
2006
No patients reported dumping syndrome (after DS surgery), and marginal ulcers were not seen.N
2006

Keep in mind that these are averages – “middle of the road” results. Patients who eat the right foods, exercise regularly, and follow their surgeon’s advice can lose even more, while patients who veer off-track lose less.

References: (1) (2) (3) (4) (5) (6) (7) (8)

Health Benefits
Improves or Cures At Least 15 Conditions

Health Benefits – Improves or Cures At Least 15 Conditions

gastric bypass surgery

Most gastric bypass patients experience significant improvement in or a complete “cure” of obesity-related health problems, including:

Mortality Reduction/Life Expectancy (5 year mortality)

89% reduction in risk of death vs obese patients who did not have bariatric surgery (9)

Asthma

Completely resolved or improved in 80% to 100% of patients (11)

Cardiovascular Disease

Up to 79% reduction in cardiovascular risks (12)

Degenerative Joint Disease

Complete resolution in 43% of patients (13)

Depression

Improvement for majority of patients (14)

Diabetes

83% experience complete resolution by 1 year (15)

Gastroesophageal Reflux Disease (GERD)

Completely resolved or improved in 80% to 100% of patients (17)

High Blood Pressure (hypertension)

Up to 69% of patients experience complete resolution by 1 year (18, 19)

Hyperlipidemia (high levels of fat in the blood)

73% experience improvement or complete resolution (20)

Metabolic Syndrome

80% resolved (21)

Migraines

57% resolved (22)

Non-Alcoholic Fatty Liver Disease

90% improved steatosis, 37% resolution of inflammation, 20% resolution of fibrosis (23)

Obstructive Sleep Apnea

Up to 98% resolved (24, 25)

Polycystic Ovarian Syndrome

Improvement or resolution in nearly all women (26, 27)

Pregnancy

  • Infertility – Obesity-related infertility resolved in up to 100% of women (28,29)
  • Menstrual irregularities – reduced by 65%.
  • Gestational Diabetes – 25% less likely to develop
  • Pregnancy-Induced Hypertension – 73% less likely to develop

Pseudotumor cerebri

96% resolved (30)

Stress Urinary Incontinence

Up to 88% resolved (31)

Venous Stasis Disease

Resolved in up to 95% of patients (32)

Qualify
35+ BMI with Health Issues, 40+ Without

Qualify – 35+ BMI with Health Issues, 40+ Without

Most surgeons and insurance companies follow the guidelines of the National Institutes of Health (NIH) which state that you must fall into one of the following categories in order to qualify for gastric bypass surgery:

  • Have a body mass index (BMI) of 40 or more (“morbidly obese” or “super obese”), OR
  • Have a BMI between 35 and 39.9 (“severely obese”) and have a serious obesity-related health problem

Serious obesity-related health problems most commonly include:

  • High blood pressure
  • High cholesterol
  • Type 2 diabetes
  • Sleep apnea

Other qualifying health conditions related to obesity are listed in the Health Benefits section above.

If you do not meet either of these BMI requirements, you still might qualify for one other type of weight loss surgery called Gastric Balloon. See our Gastric Balloon Patient Guide for more information.

Cost
$24,000 Avg Before Discounts, $2,000 Avg With Insurance

Cost – $24,000 Avg Before Discounts, $2,000 Avg With Insurance

On average, the all-in cost of gastric bypass equals (in U.S. Dollars for comparison purposes):

  • United States – $24,000 (ranges from $15,000 in Arkansas to $57,000 in Alaska)
  • Canada – $20,000
  • Australia – $17,000
  • Mexico – $7,400
  • India – $10,400
  • Thailand – $10,500
  • Costa Rica – $12,500

However, your out-of-pocket costs depend on several factors including:

  • Whether your procedure is open or laparoscopic – open gastric bypass surgery tends to cost about $2,500 more than laparoscopic surgery, on average (33)
  • Which hospital you have the surgery in
  • Whether or not you have insurance – if your surgeon and hospital are covered by your insurance, it is likely that a discount has been negotiated to allow that surgeon and hospital to participate in your insurance company’s network
  • Whether you obtain financing for some or all of the costs
  • Specific fees your bariatric surgeon and other professionals charge for the various pre-op, surgical, and post-op services.

Note that the above averages include total costs incurred during surgery. Some surgeons also include Pre-Op costs in their quoted fees (more on Pre-Op and Post-Op fees below).

However, the above averages do not include Post-Op costs which will be based on your specific circumstances.

Click here to see Costs by each US State

Region Region
Average Cost Average Cost
Region ALABAMA
Average Cost $21,650

ALABAMA surgeons surveyed are located in Birmingham, Decatur, Huntsville, Mobile, Montgomery and Tuscaloosa

Region ALASKA
Average Cost $56,820

ALASKA surgeons surveyed are located in Anchorage

Region ARIZONA
Average Cost $24,621

ARIZONA surgeons surveyed are located in Flagstaff, Mesa, Phoenix, Prescott, Scottsdale, Tempe and Tucson

Region ARKANSAS
Average Cost $15,117

ARKANSAS surgeons surveyed are located in El Dorado, Fayetteville, Fort Smith, Jonesboro, Little Rock and Pine Bluff

Region CALIFORNIA
Average Cost $21,600

CALIFORNIA surgeons surveyed are located in Bakersfield, Burbank, Chico, Fresno, Los Angeles, Orange, La Jolla, Modesto, Oakland, Poway, Riverside, Sacramento, San Diego, San Francisco, San Jose and Santa Barbara

Region COLORADO
Average Cost $20,710

COLORADO surgeons surveyed are located in Colorado Springs, Denver and Fort Collins

Region CONNECTICUT
Average Cost $23,864

CONNECTICUT surgeons surveyed are located in Farmington, Glastonbury, Meriden, Middletown, New Haven, Norwalk, Shelton and Stamford

Region DELAWARE
Average Cost $19,242

DELAWARE surgeons surveyed are located in Dover, Newark and Wilmington

Region FLORIDA
Average Cost $21,801

FLORIDA surgeons surveyed are located in Ft. Meyers, Gainesville, Jacksonville, Miami, Naples, Ocala, Orlando, Sarasota, St. Petersburg, Tallahassee, Tampa and West Palm Beach

Region GEORGIA
Average Cost $20,264

GEORGIA surgeons surveyed are located in Albany, Athens, Atlanta, Augusta, Columbus, Decatur, Macon, Marietta and Savannah

Region HAWAII
Average Cost $21,277

HAWAII surgeons surveyed are located in Aiea, Kailua-Kona, Honolulu and Wailuku

Region IDAHO
Average Cost $19,681

IDAHO surgeons surveyed are located in Boise, Meridian, Montpelier, Nampa, Pocatello and Post Falls

Region ILLINOIS
Average Cost $24,432

ILLINOIS surgeons surveyed are located in Chicago, Champaign, Decatur, Naperville, Peoria, Rockford and Springfield

Region INDIANA
Average Cost $25,591

INDIANA surgeons surveyed are located in Bloomington, Evansville, Fort Wayne, Gary, Indianapolis and South Bend

Region IOWA
Average Cost $25,908

IOWA surgeons surveyed are located in Cedar Rapids, Davenport, Des Moines and Iowa City

Region KANSAS
Average Cost $22,167

KANSAS surgeons surveyed are located in Topeka, Lenexa, Wichita, Overland Park, Olathe, and Kansas City

Region KENTUCKY
Average Cost $25,201

KENTUCKY surgeons surveyed are located in Lexington, Louisville and other towns.

Region LOUISIANA
Average Cost $21,650

LOUISIANA surgeons surveyed are located in Alexandria, New Orleans, Shreveport and other towns

Region MAINE
Average Cost $29,436

MAINE surgeons surveyed are located in Augusta, Bangor, Portland and other towns

Region MARYLAND
Average Cost $30,125

MARYLAND surgeons surveyed are located in Baltimore, Salisbury and other towns

Region MASSACHUSETTS
Average Cost $26,591

MASSACHUSETTS surgeons surveyed are located in Boston, New Bedford, Pittsfield, Springfield, Worcester and other towns.

Region MICHIGAN
Average Cost $25,875

MICHIGAN surgeons surveyed are located in Ann Arbor, Detroit, Grand Rapids, Lansing and other towns.

Region MINNESOTA
Average Cost $23,161

MINNESOTA surgeons surveyed are located in Minneapolis / St. Paul, Rochester and other towns

Region MISSISSIPPI
Average Cost $21,850

MISSISSIPPI surgeons surveyed are located in Jackson, Hattiesburg, Meridian, Tupelo and other towns.

Region MISSOURI
Average Cost $23,150

MISSOURI surgeons surveyed are located in Columbia, Kansas City, Springfield, St. Louis and other towns

Region MONTANA
Average Cost $28,167

MONTANA surgeons surveyed are located in Billings, Bozeman, Helena and other towns

Region NEBRASKA
Average Cost $23,050

NEBRASKA surgeons surveyed are located in Lincoln, Omaha and other towns

Region NEVADA
Average Cost $16,375

NEVADA surgeons surveyed are located in Henderson, Las Vegas and Reno Areas

Region NEW HAMPSHIRE
Average Cost $31,500

NEW HAMPSHIRE surgeons surveyed are located in Manchester, Nashua and other towns

Region NEW JERSEY
Average Cost $26,467

NEW JERSEY surgeons surveyed are located in Newark, Trenton and Other Areas

Region NEW MEXICO
Average Cost $17,640

NEW MEXICO surgeons surveyed are located in Albuquerque, Las Cruces, Santa Fe and Other Areas

Region NEW YORK
Average Cost $32,194

NEW YORK surgeons surveyed are located in Albany, Buffalo, New York City / Manhattan, Rochester, Watertown and Other Areas

Region NORTH CAROLINA
Average Cost $28,312

NORTH CAROLINA surgeons surveyed are located in Asheville, Chapel Hill, Charlotte, Durham, Greensboro, Greenville, Raleigh, Wilmington, Winston-Salem and Other Areas

Region NORTH DAKOTA
Average Cost $35,000

NORTH DAKOTA surgeons surveyed are located in Bismarck and Grand Forks

Region OHIO
Average Cost $23,083

OHIO surgeons surveyed are located in Akron, Cincinnati, Cleveland, Columbus, Dayton and Other Areas

Region OKLAHOMA
Average Cost $19,300

OKLAHOMA surgeons surveyed are located in Norman, Oklahoma City, Tulsa and Other Areas

Region OREGON
Average Cost $34,433

OREGON surgeons surveyed are located in Portland, Bend, McMinnville, Salem, Medford, Springfield, Eugene, Beaverton, Corvallis, and Coos Bay

Region PENNSYLVANIA
Average Cost $23,390

PENNSYLVANIA surgeons surveyed are located in Allentown, Altoona, Harrisburg, Lancaster, Philadelphia, Pittsburgh and Other Areas

Region SOUTH CAROLINA
Average Cost $25,167

SOUTH CAROLINA surgeons surveyed are located in Anderson, Charleston, Columbia, Greenville, Myrtle Beach, Rock Hill and Other Areas

Region SOUTH DAKOTA
Average Cost $25,500

SOUTH DAKOTA surgeons surveyed are located in Dakota Dunes, Rapid City and Sioux Falls

Region TENNESSEE
Average Cost $25,045

TENNESSEE surgeons surveyed are located in Chattanooga, Knoxville, Memphis and Nashville

Region TEXAS
Average Cost $17,490

TEXAS surgeons surveyed are located in Abilene, Amarillo, Austin, Corpus Christi, Dallas / Ft. Worth, Houston, Lubbock and San Antonio

Region UTAH
Average Cost $18,148

UTAH surgeons surveyed are located in Provo, Salt Lake City and St. George

Region VERMONT
Average Cost $26,400

VERMONT surgeons surveyed are located in Burlington, Montpelier and Springfield

Region VIRGINIA
Average Cost $20,625

VIRGINIA surgeons surveyed are located in Charlottesville, Newport News, Norfolk, Richmond, Roanoke, Virginia Beach and Other Towns

Region WASHINGTON
Average Cost $25,567

WASHINGTON surgeons surveyed are located in Everett, Olympia, Seattle, Spokane, Tacoma, Vancouver and Other Areas

Region WASHINGTON DC
Average Cost $20,463
Region WEST VIRGINIA
Average Cost $19,104

WEST VIRGINIA surgeons surveyed are located in Charleston, Huntington, Morgantown and Vienna

Region WISCONSIN
Average Cost $26,333

WISCONSIN surgeons surveyed are located in Eu Claire, Green Bay, La Crosse, Madison, Milwaukee and Other Areas

Region WYOMING
Average Cost $29,375

WYOMING surgeons surveyed are located in Afton, Cheyenne and Riverton

Click here to see Costs by each Australian State/Territory

Region Region
Average Cost Average Cost
Region NEW SOUTH WALES
Average Cost $4,500

NEW SOUTH WALES surgeons surveyed are located in Sydney

Region QUEENSLAND
Average Cost $5,246

QUEENSLAND surgeons surveyed are located in Brisbane and Gold Coast

Region SOUTH AUSTRALIA
Average Cost $3,250

SOUTH AUSTRALIA surgeons surveyed are located in Adelaide and Barossa Valley

TASMANIA surgeons surveyed are located in Hobart

Region VICTORIA
Average Cost $5,160

VICTORIA surgeons surveyed are located in Melbourne

WESTERN AUSTRALIA surgeons surveyed are located in Perth

Total surgery costs can be further complicated by:

  • Self-Pay Discounts – Most weight loss surgery clinics will offer some sort of self-pay discount or payment plan if you don’t have insurance (or if insurance won’t cover the procedure). All you have to do is ask!
  • Other Discounts – Additional discounts may be offered for things like full up-front payment. Ask your surgeon’s office if there are any other discounts that you might be able to take advantage of.
  • Same Surgeon, Different Hospitals – Some surgeons have “operating privileges” at more than one hospital. Since hospital costs can vary widely – even in the same town and regardless of quality – ask your surgeon if you have a choice.

Gastric bypass fees are split between Pre-Op, Surgery, and Post-Op services:

Pre-Op (Costs Before Surgery)

  • Physician-supervised weight loss program (required prior to surgery approval)
  • Dietitian/nutritionist consultations
  • Psychologist (mental health clearance)
  • Cardiologist (heart health clearance)
  • Lab/blood work, echocardiogram (also known as an “ECG” or “EKG”) and/or X-Ray fees
  • Surgeon consultation fees
  • Sleep study

Costs During Surgery

  • Hospital fees
  • Surgeon fees
  • Surgical assistant fees
  • Anesthesia fees
  • Operating room fees

Post-Op (Costs After Surgery)

  • Addressing any complications
  • Follow-up doctor visits
  • Bariatric vitamins
  • Additional food costs (healthier food tends to cost more)
  • Personal trainer and/or gym membership
  • New clothes (wait to go crazy with this until you reach your plateau weight)
  • Plastic surgery to address sagging skin (more on this in the Downsides section below)

Gastric Bypass Costs Vs. Cost of Not Having Surgery

While gastric bypass surgery is costly, the long-term costs of obesity-related health problems for people who don’t get the surgery are even higher.

Compared to morbidly obese people who don’t have surgery, bariatric patients pay off their entire surgery and start getting ahead financially after only 2 years (34).

Fewer prescription drugs alone have been found to save patients $3,000 or more per year (35).

A study published by the American Journal of Managed Care (AJMC) found that bariatric patients pay as much as $900 less per month as soon as 13 months after surgery than similar people who didn’t have surgery (36). That’s almost $11,000 per year in total medical costs saved for bariatric patients versus morbidly obese people who do not have surgery.

Vs. Other Procedures: 2nd Highest of 7 / With Insurance: Tied for Lowest

Gastric bypass has the 2nd highest average cost out of the 7 available types of weight loss surgery, if you don’t have insurance. It is tied for the lowest cost for patients with insurance.

Free Insurance Check & Cost Quote: Click here to contact a top gastric bypass surgeon

See our Types of Bariatric Surgery page for a full comparison.

Financing Options

Gastric bypass financing is available in most locations. With no insurance, patients can obtain financing for the entire cost of surgery. With insurance, patients can get assistance with paying large deductibles or other out-of-pocket expenses.

Options for making surgery more affordable include (follow links for more information):

Taxes: Several Ways to Save

Most countries provide tax benefits to gastric bypass patients who qualify.

United States: Might Be Deductible

Gastric bypass surgery is tax deductible as long as the costs are higher than 10% of your adjusted gross income (click here for IRS rules).

In order to receive the deductions, you’ll need to complete Schedule A of the IRS Form 1040. You’ll also need to save your medical bills and payment statements as proof. Note that any reimbursed amounts cannot be included (such as the amount that insurance paid).

Depending on your employment status, money accrued in special savings accounts (or even your IRA) could also be a tax-advantaged payment option. Special tax-favored accounts to consider include:

  1. Health Savings Account (HSA) – HSAs can only be opened alongside a “qualified high deductible” health plan. Money contributed to an HSA, accumulated interest from the accounts where the money is invested, AND money taken out of the HSA to pay for qualified medical expenses are all TAX FREE. No other account receives more favorable tax treatment. You may even be able to transfer money already in your IRA into an HSA. See the IRS’s Site for more info.
  2. Archer Medical Savings Account (Archer MSA) – Archer MSAs are very similar to HSAs, except they are for self-employed individuals or small businesses. Click here for the details.
  3. Health Reimbursement Account (HRA) – HRAs can only be offered by your employer, and only your employer can contribute money to them. If your company offers one, make sure your plan allows the use of HRA funds to pay for “all qualified medical expenses” as financing bariatric surgery is not allowed with some plans. More information can be found by clicking here.
  4. Flexible Spending Account (FSA) – Both employers and employees can contribute to an FSA, also known by its IRS code, “Section 125”. FSA’s can be offered alongside any health plan, and withdrawals from this account can be made tax-free as long as they are used to pay for qualified medical expenses. Click here to get the summary from the IRS.

Canada: Is Deductible

Canada is generous compared to other countries when it comes to medical tax deductions. As long as you can substantiate your out of pocket gastric bypass expenses with a prescription, receipt, or other documentation, you should be able to write them off.

If your surgery is covered by insurance, you can also deduct your monthly insurance premiums.

If your income is below a certain threshold, you may qualify for a tax credit called the refundable medical expense supplement.

Australia: Might Be Deductible

If your out of pocket expenses for bariatric surgery (and all other net medical expenses) are over the Australian Taxation Office (ATO) threshold, you can claim an offset on your tax return.

According to the ATO:

“To claim the net medical expenses tax offset in your tax return, you will need to know the total medical expenses you incurred for yourself and your dependants. You then deduct any refunds from Medicare, your health fund or any other reimbursements that relate to those expenses received during the financial year.”

Click here for updated Medicare Benefit Tax Statement information from the Department of Human Services.

Insurance
Covered If Your Policy Includes Bariatric Surgery

Insurance – Covered If Your Policy Includes Bariatric Surgery

gastric bypass surgery

United States: Covered If Your Plan Includes Bariatric Surgery

In the United States, if your specific policy covers bariatric surgery, gastric bypass surgery will be covered.

CHECK MY
INSURANCE TOOL
1

Choose your plan, state, and insurance company below.

Can’t find your insurance company/plan or have updated info? Click here to contact us.

This tool provides estimates only. Please contact your insurance company to verify your actual out of pocket costs.

Whether your policy covers bariatric surgery depends on what kind of plan you have:

  1. Individual/Family Plans & Small Group Plans (through Work, under 50 employees) – The Affordable Care Act (Obamacare) requires insurance companies in many states to include coverage for bariatric surgery. Click here for an updated list of states required to cover bariatric surgery.
  2. Large Group Plans (through Work, 50+ employees) – Whether bariatric surgery is covered by your insurance is completely up to your company to decide. Talk with your HR department or contact your insurance company to find out if it’s covered.
  3. Medicare & Medicaid – Medicare and Medicaid both cover gastric bypass surgery, although not all surgeons accept them.

Click the links below for more information:

If Your Policy Covers It: Ask for Free Insurance Check

Before your insurance company will cover gastric bypass, it will require you to submit documentation from your doctor or surgeon confirming that a medically supervised weight loss program was unsuccessful.

Many surgeons offer a free insurance check and have a staff that is highly trained and experienced at working with insurance companies. Rather than figuring it out on our own, talk with a surgeon’s office about doing the legwork for you.

If Your Policy Does NOT Cover It: Seek Partial Coverage

You’ll most likely be able to get some of your gastric bypass expenses covered, even if bariatric surgery isn’t a covered benefit.

During our annual Weight Loss Surgery Cost Survey, several surgeons told us that as long as your doctor files the claim using a covered “CPT Code” (Current Procedural Terminology Code), your insurance company will likely cover it as long as the code used accurately reflects the treatment provided.

For example, there are many non-bariatric surgery reasons for your doctor to recommend:

  • Lab work
  • Psychological exam
  • Cardiology exam
  • Sleep study
  • Medically supervised diet program

Each of these are also essential steps required before your surgeon will perform your surgery.

If your surgeon or primary care physician submits the above claims using a weight loss surgery CPT code, your insurance is unlikely to cover it. However, if your doctor submits the above claims using a NON-weight loss surgery CPT code, the claims will likely be considered covered benefits.

These tests will be beneficial regardless of whether you move forward with surgery, so your insurance company should have no problem covering them.

Find a Top Surgeon

The U.S. Insurance Approval Process

The entire gastric bypass insurance approval process can take anywhere from 1 to 12 months, depending on your situation

Following are the typical steps:

  1. Your minimum body mass index (BMI) requirements are confirmed by your physician:
    • BMI over 40 –OR–
    • BMI over 35 with one or more of the following:
      • Clinically significant obstructive sleep apnea
      • Coronary heart disease
      • Medically refractory hypertension
      • Type 2 diabetes mellitus
      • Other obesity-related health issues
  2. Complete 3 to 7 consecutive months of a medically supervised diet program, depending on your insurance company (can be coordinated by your bariatric surgeon).
  3. Schedule a consultation with your bariatric surgeon.
  4. Schedule a consultation with your primary care physician to obtain a medical clearance letter.
  5. Schedule a psychiatric evaluation to obtain a mental health clearance letter (usually coordinated by your bariatric surgeon).
  6. Schedule a nutritional evaluation from a Registered Dietitian (usually coordinated by your bariatric surgeon).
  7. Send all of the above documentation to your insurance company along with a detailed history of your obesity-related health problems, difficulties and treatment attempts. The review process typically happens in under one month (usually coordinated by your bariatric surgeon).
  8. Insurance company sends approval or denial letter:
    • If approved, your surgeon’s bariatric coordinator will contact you for scheduling.
    • If denied, you can choose to appeal the denial.

Your surgeon’s office will do most of this leg-work for you. They will be highly experienced in managing the process and may even have all of the required personnel on staff (e.g. registered dietitian, psychiatrist, bariatric coordinator, etc.).

Click here to access the weight loss surgeon directory to get started. Most offices will check your insurance for free to confirm coverage criteria.

For more information about gastric sleeve insurance, see our Bariatric Surgery Insurance Compete Patient Guide.

Disability Insurance During Recovery

Disability insurance (DI) is usually only available through an employer, although you can continue coverage as an individual if you leave the company.

It pays you a percentage of your monthly income if you are unable to work. Short term disability insurance (STD) most commonly pays 66 2/3% of your salary for the first 90 or 180 days of disability or sickness (also known as your disability period for bariatric surgery recovery).

Disability insurance usually includes pre-existing conditions limitations. In other words, insurance companies won’t let you buy coverage one month and go out on disability the next for something that you knew about before you signed up.

The best way to get around this for bariatric surgery is to enroll with your employer during the initial enrollment period (i.e., when you’re hired). You may not be allowed to enroll at any other time.

You must then remain enrolled for the entire “pre-existing conditions exclusionary period,” which usually lasts between 6 and 12 months. Call your insurance company, talk with HR or review your plan documents for details.

Canada: Covered, But Long Wait Times

Gastric bypass surgery is currently covered in the following provinces:

  • Alberta
  • British Columbia
  • Manitoba
  • Newfoundland and Labrador
  • Nova Scotia
  • Ontario
  • Quebec
  • Saskatchewan

Wait times range from 2 years to over 10 years, leading two out of every 3 patients to use private-pay clinics instead of public facilities.1

See our Weight Loss Surgery in Canada Patient Guide for more information.

Click here to find a private-pay clinic in Canada or the United States.

Australia: Covered by Medicare & Private Insurance

Australian Medicare will provide some reimbursement for gastric bypass surgery, although the rebate amount will still leave the majority of costs up to you and your private insurance.

To determine your rebate amount, Medicare applies a set rate to each covered procedure (that is much lower than the actual surgery costs), then they give you a rebate of 75% of that set rate.

For example, if the total procedure costs $10,000 but Medicare’s set rate is $850, then Medicare will pay $637.50 of the total bill (850 X 0.75), and you and your private insurance will be responsible for the balance.

Click here to access the Medicare Benefits Schedule (MBS) database and type in Gastric Bypass Item Number 31572 for current reimbursement levels.

Private insurance in Australia usually covers bariatric surgery, although you will still have out of pocket fees (between $1,700 and $5,300 after Medicare rebates).

Since obesity is considered a pre-existing condition, you will probably have to wait 12 months between joining a health fund and getting approved for surgery.

To get the specific coverage information and your out of pocket costs from your health fund, contact them directly and provide them with the same Medicare Item Number: 31575.

Click here for a full list of Australian health funds and their contact information.

Click here to find a top bariatric surgeon in Australia or here for our Australia Patient Guide.

Procedure
Laparoscopic, Creates Small Stomach Pouch, & Reroutes Small Intestine

Procedure – Laparoscopic, Creates Small Stomach Pouch, & Reroutes Small Intestine

gastric bypass surgery

Why Gastric Bypass Works

  • Reduced stomach size makes the patient feel full sooner after eating
  • Rearranged intestines causes the body to absorb fewer minerals
  • Dumping syndrome symptoms deter patients from eating unhealthy foods

Preparing for Surgery

During the weeks leading up to gastric bypass surgery, your surgeon’s team will do the following:

  • Pre-procedure health assessment, where you will be asked questions about your medical history, medications, and surgical history
  • Order certain tests like an ECG, x-ray, and blood tests
  • Establish a pre-surgery diet regimen, including:
    • 2 Weeks Before
      • No sugar
      • Lower carbs
      • Increased protein
      • Increased veggies
      • Plenty of fluids
    • 2 Days Before
      • Clear liquids, broth, one protein shake per day only
      • Talk with your surgeon about whether you should stop taking any medications
    • 2 Hours Before
      • No food or drink, no tobacco

Losing as much weight as possible prior to surgery is also critical because:

  • The more weight you lose pre-op, the more weight you will lose after surgery
  • The lower your pre-op weight, the lower your risk of complications
  • Gastric bypass surgery will not work over the long-term if you slip back into old habits. For about 70% of gastric bypass patients, eating unhealthy foods also lead to vomiting, diarrhea and other uncomfortable symptoms (37). The sooner you can start establishing good diet and exercise habits, the more likely you will be to maintain them after surgery

See our Preparing for Weight Loss Surgery page for more information.

How It’s Performed

The laparoscopic Roux-en-Y gastric bypass procedure takes about 4 hours to complete. Most patients remain in the hospital for 2 to 3 days following surgery.

The procedure serves 2 functions: it limits how much you can eat before feeling full (“restrictive”) and it prevents your body from absorbing as much food (“malabsorptive”).

Following are the steps your surgeon will perform:

  1. Cut and staple the stomach to create a small pouch at the end of the esophagus. Your stomach pouch will be about the size of a golf ball and hold around one ounce (28 grams) of food.
  2. Leave the remainder of the stomach attached to the top of the small intestines
  3. Go further down the small intestine, cut it, and attach it to the pouch. The food will now bypass the remainder of the stomach and top part of the small intestine.
  4. Take the end of the small intestine that is still connected with the remainder of the stomach and attaches it to the bottom of the “ Roux limb” of the small intestine. This allows the digestive juices produced by the stomach to meet up with the food in the intestines.

During the procedure, there will be 2 catheters (tubes) used to keep both portions of your stomach clear:

  • The first is inserted through your mouth and into the pouch.
  • The second is for the larger portion of the stomach and is threaded through an opening in the side of your abdomen.

Take a look at the following two videos for a more in-depth understanding…

Recovery
2 – 3 Days in Hospital, Back to Work in 2 Weeks, 4 – 6 Weeks to Full Recovery

Recovery – 2 – 3 Days in Hospital, Back to Work in 2 Weeks, 4 – 6 Weeks to Full Recovery

gastric bypass surgery

Gastric bypass patients usually spend 2 to 3 days in the hospital, and most patients have fully recovered in 4 to 6 weeks. Here’s what to expect following surgery:

1. Wake Up

You’ll be sore and a feel a little “out of it.” You’ll be on medication to control the pain and will likely have a bedside button to deliver additional pain meds through your IV as needed. To prevent gastrointestinal leaks, the two catheters inserted during surgery will remain in place for a couple of days to keep the stomach fluids drained.

2. Move Around

Your surgeon will have you up and walking around as soon as possible – usually within 5 or 6 hours – to reduce the risk of blood clots and jump-start your body’s healing process. You may also be asked to wear compression stockings, use a pneumatic compression device that keeps the blood flowing in your legs, or receive blood thinners. Continue to walk as much as possible, increasing it a little each day.

3. Get Released

Before releasing you, your surgical team will run a number of tests to ensure:

  • No staple line leaks
  • Wounds are healing properly
  • You’re able to “pass gass”, indicating that your digestion is working properly

4. Look for Warning Signs

Fever, no improvement or worsening of pain, signs of incision infection (pus, swelling, heat, or redness), difficulty swallowing, and ongoing nausea or vomiting are all a concern. Call your surgeon immediately if any of these happen.

5. Transition Your Diet

Your smaller stomach pouch will be sensitive, especially at first, so you’ll be on a liquid diet for a couple of weeks before slowly transitioning back to solid foods (read more about this in the Diet section of this page). Since you’ll be eating less, you may feel tired and lethargic until your body adjusts.

6. Ease Off Medications

Your surgeon will prescribe pain and digestion medication as needed and may adjust your pre-surgery medications until you’re fully healed. Follow their instructions to the letter.

7. Return to Your “New Normal” Life

Avoid swimming or bathing until your incisions have fully healed. Many patients return to normal life and work within a couple of weeks, but plan for up to 4 to 6 weeks off to be on the safe side. Full exercise and heavy lifting typically resume within one to two months. Due to your smaller walnut-sized stomach, you will feel full much sooner than you did before surgery. To avoid stretching your new stomach pouch which can lead to weight regain, do not overeat.

8. Have Follow-Up Visits During First Year

Follow-ups with your surgeon’s team will happen about one week post-op, then 4 weeks post-op, then every 3 or 4 months to ensure that everything is on track, including:

  • Discuss weight loss
  • Encourage regular exercise
  • Obtain lab work and make necessary adjustments to medications and dietary supplements
  • Understand diet and identify any potential eating disorders
  • Determine whether any potential complications may be arising
  • Monitor status of obesity-related health issues
  • Involve your family physician to help evaluate progress and ensure a successful transition

9. Transition to Semi-Annual or Yearly Follow-Up Visits

After you’ve reached your “low point” weight, your surgeon will probably still want to see you at least once per year (38). During those visits you may meet with several team members, including your surgeon, dietitian, and mental health care provider. They will probably request lab work to ensure that vitamin levels and other indicators are where they should be. If you experience any issues in between visits, don’t wait for your next visit… call your doctor right away.

Diet & Life After
Restricted Diet, Less Hungry, Full Sooner, Lifelong Supplements, Regular Exercise, Changing Relationships

Diet & Life After – Restricted Diet, Less Hungry, Full Sooner, Lifelong Supplements, Regular Exercise, Changing Relationships

Gastric bypass leads to impressive weight loss and health improvement, but what will day-to-day life be like? What are the tradeoffs?

Your surgery is only a tool, and long-term success requires diligence and sometimes difficult change in other areas.

Following is what to expect…

Food & Drink: Significant Changes

Following surgery, it will take about 6 weeks to transition into your new long-term gastric bypass diet which includes significant restrictions.

Timeframe Range
2+ Weeks Before Surgery

Recovering from surgery has its own set of challenges. Do not wait until after surgery to start your new life. Establish the following long-term diet habits ahead of time to:

  1. Optimize your body’s immune system for a quicker recovery
  2. Ease the transition into your new diet after surgery
  3. Make you much more likely to reach and maintain your weight-loss goals

Long-Term Habits to Begin Before Surgery

Food

  • Eat as healthy as possible, protein first
  • 60+ grams of protein per day
  • Small portion sizes
  • Cut food into small pieces
  • Eat slowly, chew food thoroughly
  • No more than 3 small meals per day
  • Limit snacking (no more than 2 small snacks per day)
  • Limit high-fat foods
  • No fibrous foods like asparagus, celery, or broccoli
  • No starchy foods like rice, pasta, or bread
  • No greasy or spicy foods
  • No whole milk products
  • No sugar
  • Take your vitamins

Drinks

  • Plenty of low-calorie fluids (64+ oz [2+ liters] per day)
  • Sip fluids, don’t gulp
  • Do not drink anything 30 minutes before, during, or after meals
  • No sodas or sugary drinks
  • Limit caffeine

Other Habits

2 Weeks Before Surgery

You will be on a special diet 2 weeks before surgery to reduce the risk of complications.

Add the following to the full ‘2+ Weeks Before’ list above:

  • No caffeinated drinks
  • No carbonated drinks
  • No over-the-counter herbal supplements

The typical 2 week pre-op meal plan includes:

  • Breakfast: Protein shake that is low-sugar and low-carbs
  • Lunch: Lean meat and vegetables
  • Dinner: Lean meat and vegetables

The purpose of this diet is to:

  • Shrink your liver and reduce your intra-abdominal fat. This will make your organs easier to see and work with during surgery.
  • Help you lose weight before surgery. The lower your weight, the lower your risk of complications
  • Optimize your immune system for a quicker recovery

Click the buttons below for more information:

1 Week Before Surgery

Your surgeon will ask you to stop taking several medications one week before surgery, such as:

  • Arthritis medications
  • Time-released medications – switch to non-time-released
  • NSAIDs (nonsteroidal anti-inflammatory drugs), such as:
    • Acetaminophen (Tylenol)
    • Aspirin (many brands)
    • Ibuprofen (Advil, Motrin)
    • Naproxen (Aleve)
  • Other anticoagulants, such as:
    • Enoxaparin (Lovenox)
    • Clopidogrel (Plavix)
    • Dipyridamole (Persantine)
    • Ticlopidine (Ticlid)
    • Warfarin (Coumadin)

Avoiding these medications will reduce the risk of bleeding and stomach problems after surgery.

Consult with your doctor or pharmacist prior to stopping or changing any of your medications.

2 Days Before Surgery

You should stop eating all foods and drink only clear liquids during the 2 days before surgery. This will clear out your digestive system before surgery.

Clear liquids options include:

  • Clear broth (beef, chicken, or vegetable)
  • Jell-O (sugar free)
  • Juice without pulp or added sugar (such as apple juice or pulp-free orange juice)
  • Popsicles (sugar-free)
  • Tea (caffeine-free, unsweetened)
  • Water

Do NOT consume…

  • Food of any kind
  • Thick or pulpy drinks of any kind
  • Caffeinated drinks
  • Carbonated drinks
  • Sugary drinks
Midnight Before Surgery to 7 Days After Surgery (Varies by Surgeon)

Your digestive system must be completely free of food or liquids during surgery. This will reduce the risk of breathing in stomach-contents which can cause all sorts of problems like serious infection or pneumonia.

A clean digestive system is especially important for patients with gastroesophageal reflux disease (GERD) or gastric paresis (paralysis of the stomach). (39)

When you brush your teeth before heading to the hospital, rinse and spit out the water (don’t swallow).

In Hospital (1 -2 Days) thru Day 7 After Surgery

You will transition into drinking “richer” clear liquids along with the following guidelines:

  • Sip your liquids,no gulping
  • Do not use a straw or drink from a bottle as this can cause gas bubbles

Drinks that your nurse will provide may include:

  • Water or Ice (since you can’t eat anything yet, chewing ice may be more satisfying)
  • Clear broth (beef, chicken, or vegetable)
  • Drink mixes (sugar-free), like Crystal Light or Kool-Aid
  • Jell-O (sugar-free)
  • Thin juice or drinks without pulp or added sugar (such as apple juice, Propel Water, Powerade Zero, etc.)
  • Popsicles (sugar-free)
  • Tea (caffeine-free, unsweetened)

Your stomach is in healing mode, so go easy on it when you return from the hospital.

Be sure to drink plenty of fluids, but don’t drink too fast. Maintain the same clear liquids only diet that you were on in the hospital.

Take all vitamins and supplements recommended by your surgeon.

If you have no nausea or vomiting, your surgeon may allow you to try thicker items ahead of schedule (see below).

Other Habits

Day 1 to Week 2 After Surgery (Varies by Surgeon)

Your healing should be well underway. It’s now time to introduce thicker drinks and pureed foods. As soon as you’re ready, your surgeon will start you on many small “meals” per day which may include:

  • Clear liquids list from previous stages
  • Protein shakes
  • Clear broths (beef, chicken or vegetable)
  • Cream of Wheat
  • Cream soups (no chunks)
  • Carnation Instant Breakfast (sugar free)
  • Greek Yogurt
  • Natural applesauce
  • Sherbet (sugar-free)
  • Skim or Lactose-Free Milk Products
  • Thicker sugar-free juices like low-sodium V-8 or pulp-free orange juice
  • Vitamins and supplements

Remember: No soft or solid food and no drinks with chunks or seeds.

You can also drink clear liquids between meals.

While drinking anything:

  • Take small sips
  • Stop immediately as soon as you feel full or feel any pressure
Day 2 to Week 3 After Surgery (Varies by Surgeon)

By this point it should be safe to add softer solids to your diet, but take it slow!

When you’re ready to start pureed foods, blend water, skim milk, broth, or sugar-free juice with one of the following:

  • Beans
  • Cooked vegetables
  • Eggs
  • Fish
  • Ground meats (lean)
  • Soft fruits

As soon as the pureed foods are going down without a problem, work your way into soft foods like:

  • Cooked vegetables
  • Ground meats (lean)
  • Soft fruits (no seeds or skin)

And remember those habits you formed in the weeks and months leading up to surgery? Here’s where they start to come in handy.

General diet guidelines during this stage include:

Food

  • Test one new food at a time to confirm you can tolerate it
  • Eat as healthy as possible, protein first
  • 60+ grams of protein per day
  • Small portion sizes
  • Cut food into small pieces
  • Eat slowly, chew food thoroughly
  • No more than 3 small meals per day
  • Limit snacking (no more than 2 small snacks per day)
  • Limit high-fat foods
  • No fibrous foods like asparagus, celery, or broccoli
  • No starchy foods like rice, pasta, or bread
  • No greasy or spicy foods
  • No whole milk products
  • No sugar
  • Take your vitamins

Drinks

  • Plenty of low-calorie fluids (64+ oz [2+ liters] per day)
  • Sip fluids, don’t gulp
  • Do not drink anything 30 minutes before, during, or 30 minutes after meals
  • No sodas or sugary drinks
  • Limit caffeine

Other Habits

Day 3 to Weeks 4+ After Surgery (Varies by Surgeon)

Complete your slow transition to your “new normal” long-term diet.

Your focus should be on eating your proteins first, in solid form (not protein shakes). Here’s why:

  • You need 80g of protein to stay healthy, and getting that much can be tough if you fill up on other food first
  • Liquid protein is okay while healing. But it can lead to weight regain if continued after recovery
  • Get the majority of your calories from solids. You’ll feel hungry sooner if you get your calories from liquids instead of solids. This can lead to weight regain.

Other points to consider, besides those reviewed in Day 2 to Week 3 above, include:

  • Test one food at a time to make sure you can tolerate it
  • Eat healthy “whole” foods (avoid processed foods)
  • Eat slowly and chew thoroughly
  • No starchy foods like rice, bread, and pasta
  • No whole milk products
  • 64+ oz (2+ liters) of fluids spread throughout the day
  • No drinking 30 minutes before or after meals
Diet Requirements
Timeframe Range – Diet Requirements

Recovering from surgery has its own set of challenges. Do not wait until after surgery to start your new life. Establish the following long-term diet habits ahead of time to:

  1. Optimize your body’s immune system for a quicker recovery
  2. Ease the transition into your new diet after surgery
  3. Make you much more likely to reach and maintain your weight-loss goals

Long-Term Habits to Begin Before Surgery

Food

  • Eat as healthy as possible, protein first
  • 60+ grams of protein per day
  • Small portion sizes
  • Cut food into small pieces
  • Eat slowly, chew food thoroughly
  • No more than 3 small meals per day
  • Limit snacking (no more than 2 small snacks per day)
  • Limit high-fat foods
  • No fibrous foods like asparagus, celery, or broccoli
  • No starchy foods like rice, pasta, or bread
  • No greasy or spicy foods
  • No whole milk products
  • No sugar
  • Take your vitamins

Drinks

  • Plenty of low-calorie fluids (64+ oz [2+ liters] per day)
  • Sip fluids, don’t gulp
  • Do not drink anything 30 minutes before, during, or after meals
  • No sodas or sugary drinks
  • Limit caffeine

Other Habits

You will be on a special diet 2 weeks before surgery to reduce the risk of complications.

Add the following to the full ‘2+ Weeks Before’ list above:

  • No caffeinated drinks
  • No carbonated drinks
  • No over-the-counter herbal supplements

The typical 2 week pre-op meal plan includes:

  • Breakfast: Protein shake that is low-sugar and low-carbs
  • Lunch: Lean meat and vegetables
  • Dinner: Lean meat and vegetables

The purpose of this diet is to:

  • Shrink your liver and reduce your intra-abdominal fat. This will make your organs easier to see and work with during surgery.
  • Help you lose weight before surgery. The lower your weight, the lower your risk of complications
  • Optimize your immune system for a quicker recovery

Click the buttons below for more information:

Your surgeon will ask you to stop taking several medications one week before surgery, such as:

  • Arthritis medications
  • Time-released medications – switch to non-time-released
  • NSAIDs (nonsteroidal anti-inflammatory drugs), such as:
    • Acetaminophen (Tylenol)
    • Aspirin (many brands)
    • Ibuprofen (Advil, Motrin)
    • Naproxen (Aleve)
  • Other anticoagulants, such as:
    • Enoxaparin (Lovenox)
    • Clopidogrel (Plavix)
    • Dipyridamole (Persantine)
    • Ticlopidine (Ticlid)
    • Warfarin (Coumadin)

Avoiding these medications will reduce the risk of bleeding and stomach problems after surgery.

Consult with your doctor or pharmacist prior to stopping or changing any of your medications.

2 Days Before Surgery – Clear liquids only

You should stop eating all foods and drink only clear liquids during the 2 days before surgery. This will clear out your digestive system before surgery.

Clear liquids options include:

  • Clear broth (beef, chicken, or vegetable)
  • Jell-O (sugar free)
  • Juice without pulp or added sugar (such as apple juice or pulp-free orange juice)
  • Popsicles (sugar-free)
  • Tea (caffeine-free, unsweetened)
  • Water

Do NOT consume…

  • Food of any kind
  • Thick or pulpy drinks of any kind
  • Caffeinated drinks
  • Carbonated drinks
  • Sugary drinks
Midnight Before Surgery to 7 Days After Surgery (Varies by Surgeon) – Nothing to eat or drink

Your digestive system must be completely free of food or liquids during surgery. This will reduce the risk of breathing in stomach-contents which can cause all sorts of problems like serious infection or pneumonia.

A clean digestive system is especially important for patients with gastroesophageal reflux disease (GERD) or gastric paresis (paralysis of the stomach). (31)

When you brush your teeth before heading to the hospital, rinse and spit out the water (don’t swallow).

In Hospital (1 -2 Days) thru Day 7 After Surgery Clear liquids only

You will transition into drinking “richer” clear liquids along with the following guidelines:

  • Sip your liquids,no gulping
  • Do not use a straw or drink from a bottle as this can cause gas bubbles

Drinks that your nurse will provide may include:

  • Water or Ice (since you can’t eat anything yet, chewing ice may be more satisfying)
  • Clear broth (beef, chicken, or vegetable)
  • Drink mixes (sugar-free), like Crystal Light or Kool-Aid
  • Jell-O (sugar-free)
  • Thin juice or drinks without pulp or added sugar (such as apple juice, Propel Water, Powerade Zero, etc.)
  • Popsicles (sugar-free)
  • Tea (caffeine-free, unsweetened)

Your stomach is in healing mode, so go easy on it when you return from the hospital.

Be sure to drink plenty of fluids, but don’t drink too fast. Maintain the same clear liquids only diet that you were on in the hospital.

Take all vitamins and supplements recommended by your surgeon.

If you have no nausea or vomiting, your surgeon may allow you to try thicker items ahead of schedule (see below).

Other Habits

Your healing should be well underway. It’s now time to introduce thicker drinks and pureed foods. As soon as you’re ready, your surgeon will start you on many small “meals” per day which may include:

  • Clear liquids list from previous stages
  • Protein shakes
  • Clear broths (beef, chicken or vegetable)
  • Cream of Wheat
  • Cream soups (no chunks)
  • Carnation Instant Breakfast (sugar free)
  • Greek Yogurt
  • Natural applesauce
  • Sherbet (sugar-free)
  • Skim or Lactose-Free Milk Products
  • Thicker sugar-free juices like low-sodium V-8 or pulp-free orange juice
  • Vitamins and supplements

Remember: No soft or solid food and no drinks with chunks or seeds.

You can also drink clear liquids between meals.

While drinking anything:

  • Take small sips
  • Stop immediately as soon as you feel full or feel any pressure

By this point it should be safe to add softer solids to your diet, but take it slow!

When you’re ready to start pureed foods, blend water, skim milk, broth, or sugar-free juice with one of the following:

  • Beans
  • Cooked vegetables
  • Eggs
  • Fish
  • Ground meats (lean)
  • Soft fruits

As soon as the pureed foods are going down without a problem, work your way into soft foods like:

  • Cooked vegetables
  • Ground meats (lean)
  • Soft fruits (no seeds or skin)

And remember those habits you formed in the weeks and months leading up to surgery? Here’s where they start to come in handy.

General diet guidelines during this stage include:

Food

  • Test one new food at a time to confirm you can tolerate it
  • Eat as healthy as possible, protein first
  • 60+ grams of protein per day
  • Small portion sizes
  • Cut food into small pieces
  • Eat slowly, chew food thoroughly
  • No more than 3 small meals per day
  • Limit snacking (no more than 2 small snacks per day)
  • Limit high-fat foods
  • No fibrous foods like asparagus, celery, or broccoli
  • No starchy foods like rice, pasta, or bread
  • No greasy or spicy foods
  • No whole milk products
  • No sugar
  • Take your vitamins

Drinks

  • Plenty of low-calorie fluids (64+ oz [2+ liters] per day)
  • Sip fluids, don’t gulp
  • Do not drink anything 30 minutes before, during, or 30 minutes after meals
  • No sodas or sugary drinks
  • Limit caffeine

Other Habits

Day 3 to Weeks 4+ After Surgery (Varies by Surgeon) Slowly test solid foods

Complete your slow transition to your “new normal” long-term diet.

Your focus should be on eating your proteins first, in solid form (not protein shakes). Here’s why:

  • You need 80g of protein to stay healthy, and getting that much can be tough if you fill up on other food first
  • Liquid protein is okay while healing. But it can lead to weight regain if continued after recovery
  • Get the majority of your calories from solids. You’ll feel hungry sooner if you get your calories from liquids instead of solids. This can lead to weight regain.

Other points to consider, besides those reviewed in Day 2 to Week 3 above, include:

  • Test one food at a time to make sure you can tolerate it
  • Eat healthy “whole” foods (avoid processed foods)
  • Eat slowly and chew thoroughly
  • No starchy foods like rice, bread, and pasta
  • No whole milk products
  • 64+ oz (2+ liters) of fluids spread throughout the day
  • No drinking 30 minutes before or after meals
  • Weeks 4+ Meal Plans & Shopping List
  • Complete Gastric Sleeve Diet Guide

For more information, see our Bariatric Diet page.

Vitamins & Supplements: Lifelong & Crucial

Since gastric bypass is a “malabsorptive” procedure by nature, it carries a high risk of malnutrition. Patients must be extremely diligent about taking prescribed vitamins and supplements or risk serious vitamin deficiency.

Vitamins
Multivitamin (40) (41)

A daily multivitamin with mineral supplements will help prevent hair loss and general nutrition problems.

  • 1 to 2 per day
  • Chewable and liquid versions are best
  • At least 200% of the Recommended Dietary Allowance (RDA) of iron, folic acid, thiamine, copper, selenium, and zinc
Calcium (42)

Calcium citrate supplements will keep your bones strong.

  • Must be calcium citrate (NOT other forms of calcium)
  • 500 – 600 mg doses
  • Take 3 times per day forever
  • Chewable and liquid versions are best
  • Try to find one that includes Vitamin D
Folate (folic acid) (43)

Patients who don’t get enough folate are at a higher risk of anemia.

  • Needed in up to 40% of gastric bypass patients (44)
  • If deficient, take 200% the recommended daily intake
Iron (45) (46)

Patients low on iron are more likely to have a stroke, heart attack, or other blood-related problems.

Some patients may require additional iron, which should be taken with Vitamin C for better absorption. For these patients, Iron supplements must be taken forever.

Thiamin (Vitamin B1)

Thiamin deficiency, also called Beriberi, can result in loss of appetite, headaches, nausea, weakness, irritability, depression, abdominal discomfort, pain in the limbs, shortness of breath, and swollen feet or legs

Deficiency may occur after vomiting, skipped meals, or missed supplementation

Vitamin D (47) (48) (49)

Without enough Vitamin D, you’re at risk of developing rickets, a weakening of the bones, muscles, and teeth.

  • Chewable and liquid versions are best
  • 3,000 International Units per day
  • Take with food
  • Take 2 hours apart from any Iron supplement (including a multivitamin that contains iron)

Talk with your surgeon to be sure, but you may be able to find a calcium supplement that fulfills your Vitamin D requirements.

Vitamin B12

Your central nervous system relies on Vitamin B12, and not getting enough of it could lead to serious issues like numbness, memory loss or even paralysis.

  • 1000 mcg. under your tongue, 2-3 times per week (or 500 mcg. daily). Other options include nasal spray and shots from your doctor.
  • Must be taken forever
Body Part Affected
Vitamins – Body Part Affected
Multivitamin (32) (33) – Entire body

A daily multivitamin with mineral supplements will help prevent hair loss and general nutrition problems.

  • 1 to 2 per day
  • Chewable and liquid versions are best
  • At least 200% of the Recommended Dietary Allowance (RDA) of iron, folic acid, thiamine, copper, selenium, and zinc
Calcium (34) – Bone

Calcium nitrate supplements will keep your bones strong.

  • Must be calcium citrate (NOT other forms of calcium)
  • 500 – 600 mg doses
  • Take 3 times per day forever
  • Chewable and liquid versions are best
  • Try to find one that includes Vitamin D
Folate (folic acid) (35) – Blood

Patients who don’t get enough folate are at a higher risk of anemia.

  • Needed in up to 40% of gastric bypass patients (36)
  • If deficient, take 200% the recommended daily intake
Iron (37) (38) – Blood

Patients low on iron are more likely to have a stroke, heart attack, or other blood-related problems.

Some patients may require additional iron, which should be taken with Vitamin C for better absorption. For these patients, Iron supplements must be taken forever.

Thiamin (Vitamin B1) – Entire Body

Thiamin deficiency, also called Beriberi, can result in loss of appetite, headaches, nausea, weakness, irritability, depression, abdominal discomfort, pain in the limbs, shortness of breath, and swollen feet or legs.

Deficiency may occur after vomiting, skipped meals, or missed supplementation

Vitamin D (39) (40) (41) – Entire Body
`

Without enough Vitamin D, you’re at risk of developing rickets, a weakening of the bones, muscles, and teeth.

  • Chewable and liquid versions are best
  • 3,000 International Units per day
  • Take with food
  • Take 2 hours apart from any Iron supplement (including a multivitamin that contains iron)

Talk with your surgeon to be sure, but you may be able to find a calcium supplement that fulfills your Vitamin D requirements.

Your central nervous system relies on Vitamin B12, and not getting enough of it could lead to serious issues like numbness, memory loss or even paralysis.

  • 1000 mcg. under your tongue, 2-3 times per week (or 500 mcg. daily). Other options include nasal spray and shots from your doctor.
  • Must be taken forever

For more information, see our Bariatric Vitamins page.

Exercise: 2.5 hours per week, spread out over 2 to 4 days

gastric bypass surgery

Exercise is almost as important as what you eat after gastric bypass surgery for two big reasons:

  • Patients who exercise regularly lose more weight over the long-term
  • Physical and mental health benefits make you much more likely to keep your new lifestyle requirements in line

How much exercise do you need to for noticeable results?

One study found that exercising 2.5 hours per week leads to 5.7% more weight loss (50). Another showed that gastric bypass patients who exercise at least 30 minutes a day, 3 days per week have a 4+% lower body mass index (51).

Further, regular exercise leads to quicker improvement in obesity-related health problems following surgery (52).

To help you stay on track:

  • Block out time to exercise at the same times on the same days of the week.
  • Spread your workouts over 3 or 4 days each week rather than having one or two long sessions. In addition to building endurance, this will make working out less intimidating.

Exercise Types

When choosing your exercise routine, focus on three aspects: endurance, flexibility, and strength. Here are suggestions for each:

  • Endurance:
    • Walking
    • Stationary bike
    • Swimming (best option)
  • Flexibility
    • Well-rounded stretching routine, ideally yoga since it incorporates proper breathing and uses your own bodyweight to build strength
  • Strength
    • Exercise balls
    • Weights
    • Yoga

See our Exercise After Bariatric Surgery page for more information.

Your Brain: Less Hungry, Careful About Food Addiction, New Mentality Will Change Behavior & Relationships

gastric bypass surgery

Ghrelin Hormone & Hunger

The big diet changes reviewed above may be easier than they sound for two reasons:

  1. You may permanently feel less hungry following surgery since the production of a key hunger-causing hormone, ghrelin, will be reduced
  2. Your stomach will be much smaller, causing you to feel full much sooner after eating

Food Addiction

If not addressed prior to surgery, food addiction can lead to long-term weight regain for gastric bypass patients. If you struggle with food addiction, talk with your surgeon before moving forward with surgery.

To find out if you may be suffering from food addiction, take our Food Addiction Quiz.

Relationships After Weight Loss

gastric bypass surgery

Gastric bypass leads to rapid and significant weight loss, and people will start treating you differently within a couple of months after surgery. Following are positive experiences reported by most patients:

  • Treated with more respect
  • More romantic interest from others
  • No more obesity discrimination
  • Deeper relationships as a result of being able to physically keep up with kids and more physically fit friends
  • More compliments from others
  • Increased self-confidence

However, being “newly thin” may carry unforeseen negatives as well:

  • How will overweight friends or family members feel when you’re losing weight but they are not?
  • If they’re not making diet and lifestyle changes as well, will your friends or family make it more difficult for you to stay on track?
  • How will your coworkers react? Should you even tell them you are having surgery?
  • Will your new healthier diet and smaller portion sizes make meals with others awkward?
  • Could intimacy with your spouse or partner be effected?
  • Could your spouse or partner become jealous now that others are noticing you more?

The way you view people and relationships may change as well. Common thoughts include:

  • “Would this person be treating me the same way if I hadn’t lost all of this weight?”
  • “How do I handle obesity discrimination now that I’m on the “other side”?”

For real life experiences and advice from other gastric bypass patients, see our Relationships After Weight Loss surgery page.

Downsides
Risk of Complications, Side Effects, & Weight Regain

Downsides – Risk of Complications, Side Effects, & Weight Regain

gastric bypass surgery

Like all bariatric surgery procedures, mortality rates for gastric bypass (risk of dying) are extremely low. It has a survival rate of 998 out of every 1,000 patients.

However, complications are more common, with about to 1 out of 7 patients experiencing one or more over the long-term (53, 54).

Preventing Gastric Bypass Complications

Follow these steps to reduce your risk of gastric bypass complications:

  1. Select the surgery that is most appropriate for your situation. Different surgeries carry different risks for different people. Our Types of Bariatric Surgery page compares and contrasts the safest and most effective procedures.
  2. Choose an experienced surgeon, since more experienced surgeons tend to have better outcomes. For example, one study evaluated a surgeon over his first 300 laparoscopic gastric bypass patients. Following were his results as he gained experience (55):
    Group
    Group
    First 100 patients
    First 100 patients
    Second 100 patients
    Second 100 patients
    Third 100 patients
    Third 100 patients
    Group
    Time in surgery
    First 100 patients
    163 minutes
    Second 100 patients
    119 minutes
    Third 100 patients
    94 minutes
    Group
    Number of reoperations
    First 100 patients
    9
    Second 100 patients
    2
    Third 100 patients
    1
    Group
    Number of conversions to open surgery
    First 100 patients
    2
    Second 100 patients
    1
    Third 100 patients
    1

    As you can see, the more procedures he performed, the lower the time it took to perform the surgery and the lower the number of reoperations required.

    A separate and much larger study of over 15,000 patients in Michigan had similar findings (56):

    # of procedures performed by surgeon over 3 years
    # of procedures performed by surgeon over 3 years
    Less than 100 cases
    Less than 100 cases
    100 – 249 cases
    100 – 249 cases
    Greater than or equal to 250 cases
    Greater than or equal to 250 cases
    # of procedures performed by surgeon over 3 years
    Rate of serious complications occuring within 30 days of surgery
    Less than 100 cases
    3.8%
    100 – 249 cases
    2.4%
    Greater than or equal to 250 cases
    1.9%

    Most surgeons offer free seminars that teach you about your weight loss surgery options, their practice’s experience, total procedures performed, and specific results. The seminars also allow you to get to know the surgeon prior to a one-on-one consultation.

    Click here to find and schedule a free in-person seminar or one-on-one consultation with a qualified weight loss surgeon in your area.

    You can also review our Bariatric Doctors page to learn how to interview multiple doctors and choose the best one.

  3. Eat and exercise as directed by your surgeon before, during, and after surgery. Your behavior before and after surgery directly and significantly impacts your gastric bypass complication risk. Read the other sections of this page for more information.

Possible Gastric Bypass Complications

The most common complications, which occur in greater than 1% of patients, include (57):

Stomal Stenosis – About 5% of patients

A narrowing or constriction of the diameter of a bodily passage or orifice. Results from a build-up of scar tissue between your intestine and your reduced stomach or at an intestine-to-intestine connection (anastomosis).

Wound Infection – About 3% of patients

When incisions are contaminated with a disease-producing substance or agent (such as bacteria). Much more common in open surgeries than in laparoscopic surgeries due to the size of the external incisions. Usually treated with antibiotics.

Bowel Obstruction – About 3% of patients

Also called an “internal hernia”, it occurs when the intestines twist and prevent the flow of food and digestive fluids. Patients with this condition usually experience abdominal pain, abdominal swelling, or vomiting. A doctor will confirm the diagnosis with a CAT scan or through surgery, and surgery may or may not be needed to treat it.

Leak – About 2% of patients

Occurs when sealed or sutured (stitched) openings leak digestive contents into the abdomen. This can cause infection and abscess. Can be repaired as long as it is caught early. Symptoms include fever, severe pain and a high heart rate. In order to prevent leaks, your surgeon should check the surgical connections a number of different ways, including (1) blowing air into the connection and observing whether any gets through and (2) using a dye to check for a leak. Leaks not discovered right away are usually treated by resting the stomach (being fed through an IV), but sometimes surgery is required to fix them.

Gastrointestinal bleeding – About 2% of patients

A copious discharge of blood from the blood vessels. After the surgeon determines the type and severity of internal bleeding, it can be resolved in a number of ways: on its own, replenishing bodily fluids, stopping the use of all anticoagulation drugs and (rarely) by transfusion or reoperation (58).

For a full list of potential issues, see our Gastric Bypass Complications page.

Gastric Bypass Side Effects: Digestion/Diet Issues, Dental Problems, Sagging Skin, & Others

Click below for more information about each gastric bypass side effect:

Digestion & Diet Issues

  • Dumping syndrome is experienced by 7 out of 10 gastric bypass patients, although for 95% of these patients, symptoms are relatively minor (59). Symptoms may include weakness, dizziness, flushing and warmth, nausea and palpitation immediately or shortly after eating. They are caused by abnormally rapid emptying of the stomach especially in individuals who have had part of the stomach removed.

    While this sounds like a bad thing, many patients view it as a “blessing in disguise.” The symptoms of dumping syndrome are completely avoidable by eating a proper bariatric diet… can you think of a more convincing way to keep you on track? In fact, some patients who do not suffer from dumping syndrome often comment that they wish they did, as “dumping” removes some of the choice involved in food selections. See our Dumping Syndrome page for more details.

  • Dehydration – an abnormal depletion of body fluids. You will need to drink a lot of water in the months following surgery – as much as 2 liters per day. Not doing so can lead to nausea and vomiting which can lead to even worse dehydration and other problems. In severe cases of dehydration patients may need to return to the hospital for IV fluids and vitamins.
  • Difficulty swallowing (also called dysphagia) can be caused by eating too quickly, too much or not chewing food enough and can usually be fixed by avoiding these issues.
  • Indigestion (also called dyspepsia) is the inability to digest or difficulty in digesting food, the incomplete or imperfect digestion of food or a case or attack of indigestion marked especially by a burning sensation or discomfort in the upper abdomen.

    Treatment is usually as simple as changing your diet, such as avoiding greasy foods or limiting liquid intake to certain times of day. Alcohol, aspirin and other drugs are also causes. If diet changes don’t work, antacids and H2 blockers are sometimes prescribed.

  • Intolerance to certain foods, beverages and drugs – With a changed stomach size and digestive system, there will be certain foods, beverages and drugs that you’ll need to avoid and certain diet habits you’ll need to maintain.It is important to talk with your doctor before taking ANY drugs, as they can damage your stomach pouch after gastric bypass surgery and cause ulcers (including over the counter pain relievers – Motrin, Advil, aspirin, Aleve).

    Regarding alcohol, a little may still be okay, but it will have a profoundly different effect on your body than it used to. First, it’s bad for your diet due to the large amounts of calories found in many alcoholic beverages. Second, you will become intoxicated more quickly following surgery which could lead to a number of problems.

    Finally, following surgery the effects of alcohol on your system could make liver disease more likely. As for smokers, you must stop now. If you smoke after gastric bypass surgery, there is a good chance that you will get an ulcer in your pouch.

  • Nausea and vomiting is one of the most common gastric bypass side effects and is experienced in up to 70% of patients. Following your doctor’s bariatric diet recommendations exactly will typically fix or improve the problem. While in the hospital, receiving a larger amount of IV fluids at a faster rate may make you less likely to feel nauseous or vomit (60). Keeping a food journal for a couple of days may help you to pinpoint the foods which seem to cause nausea and vomiting.
  • Change in bowel habits – bowel function after bariatric surgery may change in a number of ways, including (61)…
    • Diarrhea or loose stools – usually completely dependent on diet – you will need to figure out and avoid foods that “trigger” diarrhea. It could also be the result of lactose intolerance (not a side effect of surgery, but surgery can make you more sensitive to a problem that you didn’t know you had) which would require dairy products to be removed from the diet.
    • Constipation – usually fixed by increasing the amount of water you are drinking and by taking fiber supplements.

Dental Problems

Some gastric bypass patients experience problems with their teeth after surgery due to:

  • Malabsorption
  • Not taking proper vitamins in the right amounts
  • Potential pH changes in the saliva after surgery
  • Poor dental hygiene
  • Not addressing significant reflux or vomiting issues (stomach acid in the mouth is bad for the teeth)

See our Dental Problems After Gastric Bypass Surgery page for a dialogue between several patients, dentists and bariatric surgeons about the issue.

Sagging Skin

Gastric bypass surgery causes most patients to lose weight fast, and your skin simply can’t keep up.

Sagging skin can cause several mental and physical issues including:

  • Difficulty getting dressed
  • Difficulty exercising, which may impact long-term weight maintenance and health
  • Embarrassment with or without clothes on
  • Skin fold rashes or breakdown of skin
  • Skin fold infections

Options for addressing sagging skin include:

  • Body-contouring undergarments
  • Plastic surgery to remove the excess skin, which is often covered by insurance. See our Plastic Surgery After Weight Loss page for more information.

Other Potential Side Effects

  • Gallstones are small stones of cholesterol formed in the gallbladder or bile passages. They can be created following rapid weight loss which leads to their development in as many as 1/3 of bariatric surgery patients. To prevent this, your surgeon may remove your gallbladder during surgery or prescribe bile salt supplements after surgery.
  • Hair Loss occurs to some degree for most patients and can be caused by nutritional deficiencies or as your body’s response to major surgery or extreme weight loss. Most patients stop losing and start regrowing hair within 3 to 6 months following surgery. Supplementing your diet with protein, vitamin B, magnesium, calcium and zinc, among other bariatric vitamins, will help prevent hair loss and improve hair growth.
  • Kidney stones are stones in the kidney related to decreased urine volume or increased excretion of stone-forming components such as calcium, oxalate, urate, cystine, xanthine and phosphate. The stones form in the urine collecting area (the pelvis) of the kidney and may range in size from tiny to staghorn stones the size of the renal pelvis itself. Drinking lots of water, which gastric bypass patients should do anyway, will help to dilute the urine and may help prevent kidney stones.

Weight Regain: Half of All Bypass Patients After 2 Years

About half of all gastric bypass patients start to regain weight after two years.

After five years, the average bypass patient gains back about 8% of their weight compared to their 18-month to 2-year “low point.” (62)

Another study found that that up to 20% of morbidly obese patients (40 – 50 BMI) and up to 35% of super obese patients (BMI over 50) gained back more than 50% of their excess weight after 10 years (63).

Equally concerning, the more weight you gain back, the more likely your health problems are to come back. For example, one study showed that after gastric bypass surgery, all patients with Type 2 Diabetes experienced improvement or complete resolution. However, after 3 years, about 1 out of 4 of those patients saw their diabetes worsen or come back (64).

Why do patients gain back weight?

Usually it’s the patient’s fault. They veer off course and consume foods or beverages they shouldn’t, causing their stomach pouch or the connection between their stomach and small intestines (called the “stoma”) to stretch out (65).

If you start to gain back weight, contact your surgeon or dietitian immediately to assess your diet and exercise habits.

See our Weight Regain After Bariatric Surgery page for advice on how to avoid weight regain after gastric bypass surgery.

See the Revision section below for options to surgically address weight regain.

Revision
4 Surgical Options to Address Weight Regain

Revision – 4 Surgical Options to Address Weight Regain

Gastric bypass revision surgery may be an option in the following two circumstances:

  • Stretched stomach – reducing the size of a stretched stomach will cause your stomach to hold less, making you feel full sooner, just like after surgery.
  • Stretched stoma (connection between stomach and small intestine) – a properly sized stoma will cause your stomach to drain more slowly, prolonging your feelings of fullness.

In these cases, your surgeon will most likely choose one of the following procedures:

  1. Shrink the stoma by injecting a sclerosant. The injections attempt to create scarring that reduce the size of the stoma (connection between the stomach and small intestines).
  2. Add adjustable gastric band (convert to lap band surgery)
  3. Lengthen Roux limb – this somewhat controversial procedure is usually only considered when the patient has a very low base metabolic rate and continues with poor weight loss results despite an augmented exercise program.
  4. Convert to duodenal switch – more likely to be recommended by your surgeon if you were considered “super obese” (BMI over 50) prior to your initial surgery.

See our Gastric Bypass Revision page for more information.

Vs Other Types of Surgery
Similar or Better Weight Loss & Health Improvement, Similar or Higher Risk of Complications & Side Effects

Vs Other Types of Surgery – Similar or Better Weight Loss & Health Improvement, Similar or Higher Risk of Complications & Side Effects

gastric bypass surgery

Gastric bypass was considered the “gold standard” procedure for several years, until gastric sleeve surgery took its place.

However, it is still recommended by surgeons for some patients for its unique combination of benefits.

Picture of Procedure (click to expand)
Picture of Procedure (click to expand)
Video of Procedure
Video of Procedure
External Device Placed Inside Body?
External Device Placed Inside Body?
Year Device/Product Approved
Year Device/ Product Approved
Average Total Cost Before Insurance (U.S.)
Average Total Cost Before Insurance (U.S.)
Covered by Insurance?
Covered by Insurance?
Financing Available?
Financing Available?
BMI Requirements
BMI Requirements
Avg % Excess Weight Loss After 5 Years
Avg % Excess Weight Loss After 5 Years
Health Improvement
Health Improvement
Procedure Type
Procedure Type
Complication Rate
Complication Rate
Mortality Rate
Mortality Rate
Reversible?
Reversible?
Time Until Removed
Time Until Removed
Alters Path of Digestion (Higher Risk of Mal-absorption)?
Alters Path of Digestion (Higher Risk of Mal-absorption)?
Procedure Time (Average)
Procedure Time (Average)
Hospital Stay (Average)
Hospital Stay (Average)
Recovery Time (Back to Work) – Average
Recovery Time (Back to Work) – Average
Diet Challenges (Procedure-Specific; Click here for general diet changes to expect)
Diet Challenges (Procedure-Specific; Click here for general diet changes to expect)
Food Cravings Likely to Decrease?
Food Cravings Likely to Decrease?
Difficulty Swallowing? (due to food backing up because of smaller stomach)
Difficulty Swallowing? (due to food backing up because of smaller stomach)
Digestion & Bowel Movement Post-Recovery (Relatively common issues)
Digestion & Bowel Movement Post-Recovery (Relatively common issues)
Qualified Surgeons
Qualified Surgeons
Patient Guides
Patient Guides
 
Gastric Bypass
Picture of Procedure (click to expand)
Video of Procedure
Gastric Bypass
External Device Placed Inside Body?
No
Year Device/Product Approved
n/a
Average Total Cost Before Insurance (U.S.)
$24,000
Covered by Insurance?
Yes (other than some individual policies)
Financing Available?
Yes
BMI Requirements
35 – 39.9 with health problems; 40+ without
Avg % Excess Weight Loss After 5 Years
50 – 70%
Health Improvement
Compare % excess weight loss; the more weight loss, the more health improvement
Procedure Type
Laparoscopic
Complication Rate
Up to 15%
Mortality Rate
0.24%
Reversible?
No
Time Until Removed
n/a
Alters Path of Digestion (Higher Risk of Malabsorption)?
Yes
Procedure Time (Average)
~4 hours
Hospital Stay (Average)
2 to 3 days
Recovery Time (Back to Work) – Average
~2 weeks
Diet Challenges (Procedure-Specific; Click here for general diet changes to expect)
Potential problem foods:Sugars, Refined fats, Carbs, Dairy. Malabsorption will require life-long vitamin supple-mentation.
Food Cravings Likely to Decrease?
Maybe
Difficulty Swallowing? (due to food backing up because of smaller stomach)
Possible
Digestion & Bowel Movement Post-Recovery (Relatively common issues)
Dumping syndrome occurs in ~80% of patients who eat sugar, refined fats, or carbs.
Qualified Surgeons
Broad Network – Click Here to Find Surgeon
Patient Guides
(this page)
 
Gastric Sleeve
Picture of Procedure (click to expand)
Video of Procedure
Gastric Sleeve
External Device Placed Inside Body?
No
Year Device/Product Approved
n/a
Average Total Cost Before Insurance (U.S.)
$19,000
Covered by Insurance?
Yes (other than some individual policies)
Financing Available?
Yes
BMI Requirements
35 – 39.9 with health problems; 40+ without
Avg % Excess Weight Loss After 5 Years
64 – 75%
Health Improvement
Compare % excess weight loss; the more weight loss, the more health improvement
Procedure Type
Laparoscopic
Complication Rate
Up to 10%
Mortality Rate
0.19%
Reversible?
No
Time Until Removed
n/a
Alters Path of Digestion (Higher Risk of Malabsorption)?
No
Procedure Time (Average)
~2 hours
Hospital Stay (Average)
2 to 3 days
Recovery Time (Back to Work) – Average
~2 weeks
Diet Challenges (Procedure-Specific; Click here for general diet changes to expect)
Potential problem foods: Dairy
Food Cravings Likely to Decrease?
Maybe
Difficulty Swallowing? (due to food backing up because of smaller stomach)
Possible
Digestion & Bowel Movement Post-Recovery (Relatively common issues)
GERD (reflux) in ~1 out of 5 patients after 1 year, drops to 1~ out of 33 patients after 3 year. Some patients experience diarrhea.
Qualified Surgeons
Broad Network – Click Here to Find Surgeon
 
Lap Band
Picture of Procedure (click to expand)
Video of Procedure
Lap Band
External Device Placed Inside Body?
Yes
Year Device/Product Approved
2011 (FDA10)
Average Total Cost Before Insurance (U.S.)
$15,000
Covered by Insurance?
Yes (other than some individual policies)
Financing Available?
Yes
BMI Requirements
35 – 39.9 with health problems; 40+ without
Avg % Excess Weight Loss After 5 Years
25 – 80% (extremely variable among patients)
Health Improvement
Compare % excess weight loss; the more weight loss, the more health improvement
Procedure Type
Laparoscopic
Complication Rate
Up to 33%
Mortality Rate
0.10%
Reversible?
Yes
Time Until Removed
Patient-Specific (not necessarily required)
Alters Path of Digestion (Higher Risk of Malabsorption)?
No
Procedure Time (Average)
~1 hour
Hospital Stay (Average)
Outpatient to 1 day
Recovery Time (Back to Work) – Average
~2 weeks
Diet Challenges (Procedure-Specific; Click here for general diet changes to expect)
Potential problem foods: Dairy. Should not drink anything within 30 minutes before or after eating
Food Cravings Likely to Decrease?
No
Difficulty Swallowing? (due to food backing up because of smaller stomach)
Possible
Digestion & Bowel Movement Post-Recovery (Relatively common issues)
Reflux and vomiting common if band too tight (can be adjusted). Some patients experience constipation.
Qualified Surgeons
Broad Network – Click Here to Find Surgeon
Patient Guides
 
Duodenal Switch
Picture of Procedure (click to expand)
Video of Procedure
Duodenal Switch
External Device Placed Inside Body?
No
Year Device/Product Approved
n/a
Average Total Cost Before Insurance (U.S.)
$27,000
Covered by Insurance?
Yes (other than some individual policies)
Financing Available?
Yes
BMI Requirements
35 – 39.9 with health problems; 40+ without (but more common for 50+)
Avg % Excess Weight Loss After 5 Years
65 – 75%
Health Improvement
Compare % excess weight loss; the more weight loss, the more health improvement
Procedure Type
Laparoscopic
Complication Rate
Up to 24%
Mortality Rate
Up to 1.1% (but procedure tends to be performed on heavier patients who have higher risk)
Reversible?
No
Time Until Removed
n/a
Alters Path of Digestion (Higher Risk of Malabsorption)?
Yes
Procedure Time (Average)
3.5 – 4.5 hours
Hospital Stay (Average)
2 to 3 days
Recovery Time (Back to Work) – Average
~2 weeks
Diet Challenges(Procedure-Specific; Click here for general diet changes to expect)
Malabsorption will require life-long vitamin supple-mentation.
Food Cravings Likely to Decrease?
Maybe
Difficulty Swallowing? (due to food backing up because of smaller stomach)
Possible
Digestion & Bowel Movement Post-Recovery (Relatively common issues)
Might be significant, including frequency, diarrhea, and/or foul-smelling stools/ flatulence.
Qualified Surgeons
Fewer Options – Click Here to Find Surgeon
 
Gastric Balloon
Picture of Procedure (click to expand)
Video of Procedure
Gastric Balloon
External Device Placed Inside Body?
Yes
Year Device/Product Approved
2015 (FDA11)
Average Total Cost Before Insurance (U.S.)
$8,150
Covered by Insurance?
Possible with aggressive negotiation and appeals
Financing Available?
Yes
BMI Requirements
Between 30 & 40 in U.S. (above 27 elsewhere)
Avg % Excess Weight Loss After 5 Years
n/a (must be removed after 6 months; weight loss during that time is 26 – 46%)
Health Improvement
Compare % excess weight loss; the more weight loss, the more health improvement
Procedure Type
Through Mouth
Complication Rate
Up to 10%
Mortality Rate
Close to 0%
Reversible?
Yes
Time Until Removed
6 months max
Alters Path of Digestion (Higher Risk of Malabsorption)?
No
Procedure Time (Average)
30 minutes or less
Hospital Stay (Average)
Outpatient
Recovery Time (Back to Work) – Average
3 – 4 days
Click here for general diet changes to expect)
Potential Problem Foods: Pasta and other foods that might stick to balloon in stomach.
Food Cravings Likely to Decrease?
No
Difficulty Swallowing? (due to food backing up because of smaller stomach)
Unlikely
Digestion & Bowel Movement Post-Recovery (Relatively common issues)
Vomiting possible (but often avoidable with proper habits). “Feeling bloated” reported by some patients.
Qualified Surgeons
Fewer Options – Click Here to Find Surgeon
 
vBloc
Picture of Procedure (click to expand)
Video of Procedure
vBloc
External Device Placed Inside Body?
Yes
Year Device/Product Approved
2015 (FDA9)
Average Total Cost Before Insurance (U.S.)
$18,500
Covered by Insurance?
Possible with aggressive negotiation and appeals
Financing Available?
Yes
BMI Requirements
35 – 39.9 with health problems; 40 – 45 without (none over 45)
Avg % Excess Weight Loss After 5 Years
17 – 28%
Health Improvement
Compare % excess weight loss; the more weight loss, the more health improvement
Procedure Type
Laparoscopic
Complication Rate
3 – 4%
Mortality Rate
Close to 0%
Reversible?
Yes
Time Until Removed
Patient-Specific (not necessarily required)
Alters Path of Digestion (Higher Risk of Malabsorption)?
No
Procedure Time (Average)
60 to 90 minutes
Hospital Stay (Average)
Outpatient
Recovery Time (Back to Work) – Average
3 – 4 days
Diet Challenges (Procedure-Specific; Click here for general diet changes to expect)
None, but healthier eating recommended for better results
Food Cravings Likely to Decrease?
Yes
Difficulty Swallowing? (due to food backing up because of smaller stomach)
No
Digestion & Bowel Movement Post-Recovery (Relatively common issues)
None
Qualified Surgeons
Fewer Options – Click Here to Find Surgeon

Gastric Bypass Positives

  • Weight loss is usually in range of gastric sleeve and much better (on average) than after Lap Band surgery, gastric balloon, or vBloc Therapy (but less than duodenal switch). The AspireAssist needs more research, but initial results show a weight loss potential less than gastric bypass.
  • Health Improvement is generally better than after gastric sleeve, Lap Band, gastric balloon, or vBloc Therapy (but not as good as duodenal switch). Intital research shows AspireAssist will have similar health improvements to gastric balloon or vBloc Therapy, but more research is needed to confirm.
  • Short-term risk of gastric bypass is similar to that of gastric sleeve and lower than duodenal switch (but higher than Lap Band, gastric balloon, vBloc Therapy, or AspireAssist).
  • Long-term risk of gastric bypass is lower than duodenal switch (but higher than gastric sleeve, and Lap Band surgery; long-term data not yet available for balloon, vBloc, or AspireAssist).
  • There is no external device left inside the body as there is with Lap Band, gastric balloon, vBloc Therapy, and AspireAssist, so there is no risk of device-related complications. While the risk of device-related complications is relatively low for vBloc Therapy, gastric balloon, and AspireAssist, it is a concern and should be considered for Lap Band.
  • If you are on anticoagulation medication (blood thinners), compared with gastric sleeve, gastric bypass surgery is probably a better choice to reduce the risk of marginal ulcers.

Gastric Bypass Negatives

  • Not reversible – Unlike Lap Band, gastric balloon, vBloc Therapy, and AspireAssist, gastric bypass surgery (along with gastric sleeve and duodenal switch) should be considered irreversible – once your stomach size is reduced and your intestines are rerouted, it is very it is very difficult and uncommon for the procedure to be reversed.
  • Weight loss (on average) is usually lower than duodenal switch (but higher or similar to all other procedures).
  • Health Improvement is generally not as significant as after duodenal switch (but is generally better than all other procedures).
  • While survival rate is extremely high at 998 out of every 1,000 patients, risk of gastric bypass complications is higher than all other procedures except duodenal switch. Early complications occur in about 1 out of 10 patients while late complications occur in about 1 out of 7 (66, 67).
  • The two primarily “malabsorptive” procedures, gastric bypass and duodenal switch, are more complicated to perform and include the rearranging your digestive system. As a result, they have a:
    • Longer recovery
    • Higher risk of vitamin deficiency (and therefore require more daily supplements)
    • Higher costs
  • Dumping syndrome is experienced by up to 7 out of 10 gastric bypass patients, although many patients report this being a “good thing” since it helps them keep their diet on track (see more in the Downsides section above).

Click here to review studies that directly compare gastric bypass surgery to other forms of weight loss surgery.

Summary of Findings When Comparing Gastric Bypass to Other Procedures
Summary of Findings When Comparing Gastric Bypass to Other Procedures
Lap Band Surgery vs Gastric Bypass
Lap Band Surgery vs Gastric Bypass
Roux-en-Y gastric bypass is associated with better weight loss, resulting in a better correction of some comorbidities than gastric banding, at the price of a higher early complication rate. This difference, however, is largely compensated by the much higher long-term complication and reoperation rates seen after gastric banding.O
Roux-en-Y gastric bypass is associated with better weight loss, resulting in a better correction of some comorbidities than gastric banding, at the price of a higher early complication rate. This difference, however, is largely compensated by the much higher long-term complication and reoperation rates seen after gastric banding.O
Weight loss outcomes strongly favored gastric bypass over lap band surgery. Patients treated with lap band had lower short-term morbidity than those treated with gastric bypass, but reoperation rates were higher among patients who received lap band surgery. Gastric bypass should remain the primary bariatric procedure used to treat obesity in the United States.A
Editor’s Note: This study was published before long-term results had been published for gastric sleeve surgery.
Weight loss outcomes strongly favored gastric bypass over lap band surgery. Patients treated withlap band had lower short-term morbidity than those treated with gastric bypass, but reoperation rates were higher among patients who receivedlap band surgery. Gastric bypass should remain the primary bariatric procedure used to treat obesity in the United States.A
Editor’s Note: This study was published before long-term results had been published for gastric sleeve surgery.
Collectively, data clearly point to distinct changes in dietary habits after bariatric operations which markedly differ between gastric bypass andlap band patients. Overall, it is tempting to conclude that gastric bypass operations lead to a healthier and a more balanced diet thanlap band implantations.B
Collectively, data clearly point to distinct changes in dietary habits after bariatric operations which markedly differ between gastric bypass andlap band patients. Overall, it is tempting to conclude that gastric bypass operations lead to a healthier and a more balanced diet thanlap band implantations.B
Gastric bypass seems to provide a stronger suppression of ghrelin in comparison with gastric lap band procedure. These findings are consistent with the hypothesis that suppression of ghrelin is one mechanism by which gastric bypass can reduce body weight long term, more thanlap band.C
Gastric bypass seems to provide a stronger suppression of ghrelin in comparison with gastric lap band procedure. These findings are consistent with the hypothesis that suppression of ghrelin is one mechanism by which gastric bypass can reduce body weight long term, more thanlap band.C
Pending long-term evaluation, mini gastric bypass surgery seems a good alternative to gastric bypass, giving the same results with a more simple and reproducible technique.D
Pending long-term evaluation, mini gastric bypass surgery seems a good alternative to gastric bypass, giving the same results with a more simple and reproducible technique.D
Previous studies have demonstrated that hospitalization after gastric bypass increases remarkably (20% per year). The present study shows that hospitalization followingmini gastric bypass surgery instead of rising, as reported with gastric bypass, decreases by a third. Themini gastric bypass has been shown to be a short, safe successful weight loss surgery in previous work. The present study supports themini gastric bypass as a low risk procedure that decreases the need for hospitalization.E
Previous studies have demonstrated that hospitalization after gastric bypass increases remarkably (20% per year). The present study shows that hospitalization followingmini gastric bypass surgery instead of rising, as reported with gastric bypass, decreases by a third. Themini gastric bypass has been shown to be a short, safe successful weight loss surgery in previous work. The present study supports themini gastric bypass as a low risk procedure that decreases the need for hospitalization.E
Both gastric bypass andmini gastric bypass surgery are effective for morbid obesity with similar results for resolution of metabolic syndrome and improvement of quality of life. Mini gastric bypass surgery is a simpler and safer procedure that has no disadvantage compared with gastric bypass at 2 years of follow-up.F
Both gastric bypass andmini gastric bypass surgery are effective for morbid obesity with similar results for resolution of metabolic syndrome and improvement of quality of life. Mini gastric bypass surgery is a simpler and safer procedure that has no disadvantage compared with gastric bypass at 2 years of follow-up.F
Gastric Sleeve Surgery vs Gastric Bypass
Gastric Sleeve Surgery vs Gastric Bypass
Compared with gastric sleeve, gastric bypass had significantly better effect in resolving type 2 diabetes mellitus, hypertension, hypercholesterolemia, gastroesophageal reflux disease, and arthritis. However, gastric bypass had higher incidence of complications and reoperation, and longer operation time than gastric sleeve.P
Compared with gastric sleeve, gastric bypass had significantly better effect in resolving type 2 diabetes mellitus, hypertension, hypercholesterolemia, gastroesophageal reflux disease, and arthritis. However, gastric bypass had higher incidence of complications and reoperation, and longer operation time than gastric sleeve.P
Overall complication rates among patients undergoing gastric sleeve (SG) (6.3%) were significantly lower than for gastric bypass (RYGB) (10.0%, P < 0.0001). Serious complication rates were similar for SG (2.4%) and RYGB (2.5%, P = 0.736). Excess body weight loss at 1 year was 13% lower for SG (60%) than for RYGB (69%, P < 0.0001). SG was closer to RYGB than lap band (LAGB) with regard to remission of obesity-related comorbidities.Q
Overall complication rates among patients undergoing gastric sleeve (SG) (6.3%) were significantly lower than for gastric bypass (RYGB) (10.0%, P < 0.0001). Serious complication rates were similar for SG (2.4%) and RYGB (2.5%, P = 0.736). Excess body weight loss at 1 year was 13% lower for SG (60%) than for RYGB (69%, P < 0.0001). SG was closer to RYGB than lap band (LAGB) with regard to remission of obesity-related comorbidities.Q
PYY levels increased similarly after either procedure. The markedly reduced ghrelin levels in addition to increased PYY levels after gastric sleeve surgery, are associated with greater appetite suppression and excess weight loss compared with gastric bypass.I
(Editors’s note: both ghrelin and peptide YY effect appetite. See our obesity and genetics page for more details)
PYY levels increased similarly after either procedure. The markedly reduced ghrelin levels in addition to increased PYY levels after gastric sleeve surgery, are associated with greater appetite suppression and excess weight loss compared with gastric bypass.I
(Editors’s note: both ghrelin and peptide YY effect appetite. See our obesity and genetics page for more details)
The gastric sleeve operation is able to achieve significant weight loss comparable to the gastric bypass and duodenal switch operations but with the low morbidity profile similar to that of lap band placement.J
The gastric sleeve operation is able to achieve significant weight loss comparable to the gastric bypass and duodenal switch operations but with the low morbidity profile similar to that of lap band placement.J
Duodenal Switch (DS) vs Gastric Bypass
Duodenal Switch (DS) vs Gastric Bypass
Compared with gastric bypass, duodenal switch may be associated with a greater risk of vitamin A and D deficiencies in the first year after surgery and of thiamine deficiency in the initial months after surgery.K(Editors’s note: See our Bariatric Vitamins page for more.)
Compared with gastric bypass, duodenal switch may be associated with a greater risk of vitamin A and D deficiencies in the first year after surgery and of thiamine deficiency in the initial months after surgery.K(Editors’s note: See our Bariatric Vitamins page for more.)
Although duodenal switch is associated with more bowel episodes than gastric bypass, the difference is not statistically significant. Bowel habits are similar in patients who achieve 50% estimated body weight loss with duodenal switch surgery or gastric bypass.L
Although duodenal switch is associated with more bowel episodes than gastric bypass, the difference is not statistically significant. Bowel habits are similar in patients who achieve 50% estimated body weight loss with duodenal switch surgery or gastric bypass.L
Direct comparison of Duodenal Switch toGastric Bypass demonstrates superior weight loss outcomes for DS. Importantly, the likelihood of successful weight loss (excess weight loss >50%) was significantly greater in patients following DS (12 months, 83.9% vs. 70.4%; 18 months, 90.3% vs. 75.9%; 36 months, 84.2% vs. 59.3%).M
Direct comparison of Duodenal Switch toGastric Bypass demonstrates superior weight loss outcomes for DS. Importantly, the likelihood of successful weight loss (excess weight loss >50%) was significantly greater in patients following DS (12 months, 83.9% vs. 70.4%; 18 months, 90.3% vs. 75.9%; 36 months, 84.2% vs. 59.3%).M
No patients reported dumping syndrome (after DS surgery), and marginal ulcers were not seen.N
No patients reported dumping syndrome (after DS surgery), and marginal ulcers were not seen.N
Summary of Findings When Comparing Gastric Bypass to Other Procedures
Year of Study
Lap Band Surgery vs Gastric Bypass
Roux-en-Y gastric bypass is associated with better weight loss, resulting in a better correction of some comorbidities than gastric banding, at the price of a higher early complication rate. This difference, however, is largely compensated by the much higher long-term complication and reoperation rates seen after gastric banding.O
2012
Weight loss outcomes strongly favoredgastric bypass over lap band surgery. Patients treated withlap band had lower short-term morbidity than those treated with gastric bypass, but reoperation rates were higher among patients who receivedlap band surgery. Gastric bypass should remain the primary bariatric procedure used to treat obesity in the United States.A
Editor’s Note: This study was published before long-term results had been published for gastric sleeve surgery.
2008
Collectively, data clearly point to distinct changes in dietary habits after bariatric operations which markedly differ between gastric bypass andlap band patients. Overall, it is tempting to conclude that gastric bypass operations lead to a healthier and a more balanced diet thanlap band implantations.B
2008
Gastric bypass seems to provide a stronger suppression of ghrelin in comparison with gastric lap band procedure. These findings are consistent with the hypothesis that suppression of ghrelin is one mechanism by which gastric bypass can reduce body weight long term, more thanlap band.C
2003
Pending long-term evaluation, mini gastric bypass surgery seems a good alternative to gastric bypass, giving the same results with a more simple and reproducible technique.D
2008
Previous studies have demonstrated that hospitalization after gastric bypass increases remarkably (20% per year). The present study shows that hospitalization followingmini gastric bypass surgery instead of rising, as reported with gastric bypass, decreases by a third. Themini gastric bypass has been shown to be a short, safe successful weight loss surgery in previous work. The present study supports themini gastric bypass as a low risk procedure that decreases the need for hospitalization.E
2006
Both gastric bypass andmini gastric bypass surgery are effective for morbid obesity with similar results for resolution of metabolic syndrome and improvement of quality of life. Mini gastric bypass surgery is a simpler and safer procedure that has no disadvantage compared with gastric bypass at 2 years of follow-up.F
2005
Gastric Sleeve Surgery vs Gastric Bypass
Compared with gastric sleeve, gastric bypass had significantly better effect in resolving type 2 diabetes mellitus, hypertension, hypercholesterolemia, gastroesophageal reflux disease, and arthritis. However, gastric bypass had higher incidence of complications and reoperation, and longer operation time than gastric sleeve.P
2014
Overall complication rates among patients undergoing gastric sleeve (SG) (6.3%) were significantly lower than for gastric bypass (RYGB) (10.0%, P < 0.0001). Serious complication rates were similar for SG (2.4%) and RYGB (2.5%, P = 0.736). Excess body weight loss at 1 year was 13% lower for SG (60%) than for RYGB (69%, P < 0.0001). SG was closer to RYGB than lap band (LAGB) with regard to remission of obesity-related comorbidities.Q
2013
PYY levels increased similarly after either procedure. The markedly reduced ghrelin levels in addition to increased PYY levels after gastric sleeve surgery, are associated with greater appetite suppression and excess weight loss compared with gastric bypass.I
(Editors’s note: both ghrelin and peptide YY effect appetite. See our obesity and genetics page for more details)
2008
The gastric sleeve operation is able to achieve significant weight loss comparable to the gastric bypass and duodenal switch operations but with the low morbidity profile similar to that of lap band placement.J
2007
Duodenal Switch (DS) vs Gastric Bypass
Compared with gastric bypass, duodenal switch may be associated with a greater risk of vitamin A and D deficiencies in the first year after surgery and of thiamine deficiency in the initial months after surgery.K(Editors’s note: See our Bariatric Vitamins page for more.)
2009
Although duodenal switch is associated with more bowel episodes than gastric bypass, the difference is not statistically significant. Bowel habits are similar in patients who achieve 50% estimated body weight loss with duodenal switch surgery or gastric bypass.L
2008
Direct comparison of Duodenal Switch toGastric Bypass demonstrates superior weight loss outcomes for DS. Importantly, the likelihood of successful weight loss (excess weight loss >50%) was significantly greater in patients following DS (12 months, 83.9% vs. 70.4%; 18 months, 90.3% vs. 75.9%; 36 months, 84.2% vs. 59.3%).M
2006
No patients reported dumping syndrome (after DS surgery), and marginal ulcers were not seen.N
2006

For further comparison of gastric bypass surgery to other procedures, see our Types of Bariatric Surgery page.

Quiz: Which Weight Loss Surgery Is Best for You?

Quiz: Which Weight Loss Surgery Is Best for You? 1/10

Your Results

What is your gender?

Are you pregnant, or do you plan to be over the next two years?

Input your Height and Weight

Do you have any weight-related health issues (diabetes, asthma, hypertension, sleep apnea, joint problems, etc.)?

How do you feel about regular visits with a bariatric professional (doctor, dietician, etc.)?

Would the risk of uncomfortable side effects like nausea, vomiting, or diarrhea be a good motivator for you to maintain the right diet, or would you rather avoid those side effects at all costs?

Do you have insurance that covers bariatric surgery?

Are you on anticoagulation medication (blood thinners)?

Are you comfortable with the idea of an external device being left inside your body after surgery?

Are you willing to be on a serious regimen of vitamins and supplements for the rest of your life?

Unfortunately, none of the available types of weight loss surgery seem to be a good fit.

Here's why: Earlier you said that you have not thoroughly explored other treatments for obesity. That is required for all procedures except gastric balloon. Your body mass index ("BMI", which is based on your height and weight) is over 40, and gastric balloon is only available for BMI's between 30 and 40. So unfortunately, none of the available procedures seem to be a good fit.

Unfortunately, none of the available types of weight loss surgery seem to be a good fit for you.

Body Mass Index & Health Conditions

Your body mass index is XX.

In order to qualify for gastric sleeve, gastric bypass, duodenal switch, Lap-Band surgery, your body mass index (BMI) must be 40+ or between 35 and 40 only if you also have weight-related health issues.

For vBloc Therapy, your body mass index (BMI) must be 40+ or between 35 and 45 only if you also have weight-related health issues.

Gastric balloon requires a BMI between 30 and 40 (with or without health issues).

Even though your BMI would qualify you for the gastric balloon, you said anything less than 50% excess weight loss is unacceptable. Unfortuantely, gastric balloon only results in about 20% excess weight loss.

Learn more about Gastric Balloon

Since you are or are planning to be pregnant, you should not have weight loss surgery at this time.

Most women should wait least one year to 18 months after bariatric surgery before getting pregnant. This is the timeframe when many patients experience the biggest amount of weight loss, and it is the most difficult period for keeping your body’s nutritional needs in line.

Many bariatric surgery procedures prevent patients from getting the vitamins their bodies need from the foods they eat. So even after you’ve waited the 12 to 18 months, you’ll need to make sure you stay on top of your bariatric vitamins both before and during your pregnancy.

Learn More About Pregnancy After Weight Loss Surgery

Thank you for completing Bariatric Surgery Source’s "Which Weight Loss Surgery Is Best for You?" quiz! The results are in...

Winner:

Gastric sleeve surgery, also called “vertical sleeve gastrectomy”, drastically reduces the size of the stomach which causes patients to feel full sooner and lowers the production of hunger-inducing hormones, leading to significant long-term weight loss and health improvement.

Gastric bypass surgery, also called “ Roux-en-Y gastric bypass”, makes the stomach smaller and reroutes the intestines, causing patients to feel full sooner and absorb less food, resulting in significant long-term weight loss and health improvement.

The endoscopic intragastric balloon, or “gastric balloon,” is a relatively new, non-invasive, and temporary procedure whereby a durable silicone balloon is passed through the mouth, down into the stomach, and filled with saline to make patients feel full sooner, leading to significant short-term weight loss.

It was developed to "bridge the gap" between pure diet and exercise and a more complicated bariatric procedure like gastric sleeve surgery.

The Biliopancreatic Diversion with Duodenal Switch (BPD-DS), or “Duodenal Switch” (DS) for short, deserves more credit and attention than it’s been given. On average, it results in more weight loss than any other procedure.

Its mortality risks are on par with other procedures, and it may be the best procedure for those with a 50+ body mass index (“super-obese”) in terms of average weight loss and elimination of obesity health problems.

However, its higher rate of serious complications and the amount of malabsorption that it causes command careful consideration before moving forward.

Gastric banding, also called Lap-Band surgery, is quickly losing popularity due to the high number of patients requiring band removal over the long-term. However, the procedure still has a lot going for it such as being adjustable and reversible.

vBloc Therapy is an FDA-approved two-pronged method to help individuals with a BMI between 35 and 45 lose weight and control hunger.

First, vBloc Therapy uses an implanted vagal nerve stimulator that blocks hunger signals and reduces how hungry you feel day to day.

Second, a network of highly trained surgeons, nurses, and dietitians will use robust tools, technologies, and action plans to get your weight down and get it at your new low.

Your Projections After 6 Months: Lose XX

Your Projections After 2 Years: Lose XX

Find a Top Surgeon

Runner Up:

Gastric sleeve surgery, also called “vertical sleeve gastrectomy”, drastically reduces the size of the stomach which causes patients to feel full sooner and lowers the production of hunger-inducing hormones, leading to significant long-term weight loss and health improvement.

Gastric bypass surgery, also called “Roux-en-Y gastric bypass”, makes the stomach smaller and reroutes the intestines, causing patients to feel full sooner and absorb less food, resulting in significant long-term weight loss and health improvement.

The endoscopic intragastric balloon, or “gastric balloon,” is a relatively new, non-invasive, and temporary procedure whereby a durable silicone balloon is passed through the mouth, down into the stomach, and filled with saline to make patients feel full sooner, leading to significant short-term weight loss.

It was developed to "bridge the gap" between pure diet and exercise and a more complicated bariatric procedure like gastric sleeve surgery.

The Biliopancreatic Diversion with Duodenal Switch (BPD-DS), or “Duodenal Switch” (DS) for short, deserves more credit and attention than it’s been given. On average, it results in more weight loss than any other procedure.

Its mortality risks are on par with other procedures, and it may be the best procedure for those with a 50+ body mass index (“super-obese”) in terms of average weight loss and elimination of obesity health problems.

However, its higher rate of serious complications and the amount of malabsorption that it causes command careful consideration before moving forward.

Gastric banding, also called Lap-Band surgery, is quickly losing popularity due to the high number of patients requiring band removal over the long-term. However, the procedure still has a lot going for it such as being adjustable and reversible.

vBloc Therapy is an FDA-approved two-pronged method to help individuals with a BMI between 35 and 45 lose weight and control hunger.

First, vBloc Therapy uses an implanted vagal nerve stimulator that blocks hunger signals and reduces how hungry you feel day to day.

Second, a network of highly trained surgeons, nurses, and dietitians will use robust tools, technologies, and action plans to get your weight down and get it at your new low.

Your Projections After 6 Months: Lose XX

Your Projections After 2 Years: Lose XX

Find a Top Surgeon
Expand Your Detailed Results

Click the sections below to learn why you received these results…

Weight Loss

The more "involved" procedures like gastric sleeve, gastric bypass, duodenal switch, Lap-Band aggressively restrict the amount of food your stomach can hold ("restrictive") and/or alter your digestive system to reduce the amount of food your body can absorb ("malabsorptive"). As a result, they are much more likely to lead to weight loss that exceeds 50% of your excess weight.

The less involved restrictive procedures like gastric balloon and vBloc Therapy typically result in a more moderate amount of weight loss.

You said anything less than 50% excess weight loss is unacceptable, so your best options may be the more "involved" procedures like gastric sleeve, gastric bypass, duodenal switch, or Lap-Band.

You said you are only interested in less involved procedures, so gastric sleeve, gastric bypass, duodenal switch, and Lap-Band are probably not for you. Less involved procedures, including Gastric Balloon or vBloc Therapy, may be more appropriate.

Failed Diet Programs

Most types of weight loss surgery - gastric sleeve, gastric bypass, duodenal switch, Lap-Band, and vBloc Therapy - are only appropriate for people who have tried and failed with a medically supervised diet program.

Gastric balloon surgery is the only procedure that does not require this.

Talk with your surgeon about how to get started with a supervised diet program.

Failed Diet Programs

Most types of weight loss surgery - gastric sleeve, gastric bypass, duodenal switch, and Lap-Band, and vBloc Therapy - are only appropriate for people who have tried and failed with a medically supervised diet program.

Gastric balloon surgery is the only procedure that does not require this.

Talk with your surgeon about how to get started with a supervised diet program.

Health Improvement

You indicated that you currently have weight-related health issues, which will likely improve and may even be "cured" following weight loss surgery. Generally speaking, the more weight you lose, the more health improvement you are likely to experience. Following is the average excess weight loss by procedure, from highest to lowest:

  1. Duodenal switch (65% - 90%)
  2. Gastric Sleeve & Gastric Bypass (tie at 65% - 75%)
  3. Lap-Band (45% - 70%)
  4. vBloc Therapy (20 - 25%)
  5. Gastric Balloon (~20%, but removed after 6 months)

However, weight loss and health improvement are not the whole story, and several other factors have been taken into account in our recommendations.

Body Mass Index & Health Conditions

Your body mass index is XX.

In order to qualify for gastric sleeve, gastric bypass, duodenal switch, Lap-Band surgery, your body mass index (BMI) must be 40+ or between 35 and 40 only if you also have weight-related health issues.

For vBloc Therapy, your body mass index (BMI) must be 40+ or between 35 and 45 only if you also have weight-related health issues.

Gastric balloon requires a BMI between 30 and 40 (with or without health issues).

Patients Under 18

While bariatric surgery is performed on patients under 18 years of age, your surgeon will have several concerns including: whether you are disciplined enough to adhere to strict diet and exercise requirements (many teens are not ready for or cannot prepare for that level of dedication), whether your family and friends will be supportive enough, whether you can properly evaluate the risks vs the rewards of surgery, whether the procedure could potentially affect your growth or bone density (especially malaborptive procedures), and the unknowns about the long-term effect of having an external device in your body (for those procedures that include one like Lap-Band or vBloc). The gastric balloon is not an option as it is currently only allowed for patients over 18.

Patients 65 or Older

Since you are 65 or older, it is possible that bariatric surgery is a good option, but you may be less likely to qualify than younger patients due to higher risks.

For example, one study evaluated 100 patients over the age of 65 and found that bariatric surgery for seniors has similar benefits and no additional risks compared to patients under 65. Their results showed that morbidly obese patients over 65 have shorter hospital stays following bariatric surgery than younger patients. The same study showed that after two years older patients lost almost 76% of their excess weight.

However, a much larger aggregate study of over 25,000 patients showed that seniors experience less weight loss and more complications than younger patients and concluded that, "Limiting bariatric surgical procedures to those younger than 65 years is warranted because of the high morbidity and mortality associated with these operations in older patients."

Ongoing Doctor Visits

After the initial surgery, Lap-Band and vBloc Therapy may require several doctor visits to "fine tune" the device to the point that it is just right for you. The other procedures tend to require less long-term follow up doctor visits, including gastric sleeve, gastric bypass, gastric balloon, and duodenal switch. You indicated that seeing your doctor regularly is not an issue for you, so this is just for your information.

Ongoing Doctor Visits

Since avoiding the doctor is important to you, you may want to stick with procedures that tend to require less frequent follow up, including gastric sleeve, gastric bypass, gastric balloon, or duodenal switch. After the initial surgery, certain procedures like Lap-Band and vBloc Therapy may require several doctor visits to "fine tune" the device to the point that it is just right for you.

Ongoing Doctor Visits

Since avoiding the doctor is important to you, you may want to stick with procedures that tend to require less frequent follow up, including gastric sleeve, gastric bypass, gastric balloon, or duodenal switch. After the initial surgery, certain procedures like Lap-Band and vBloc Therapy may require several doctor visits to "fine tune" the device to the point that it is just right for you.

Food Cravings

There are several reasons people crave food, including food addiction, an overproduction of hunger-causing hormones, and hunger impulses sent from the stomach to the brain. Since food cravings are a big issue for you now, they are likely to continue after surgery unless you choose a procedure that specifically addresses them.

Although weight loss after vBloc Therapy is not as great as many of the other procedures, it is specifically designed to block hunger impulses sent to the brain. Gastric sleeve has impressive weight loss and reduces food cravings by completely removing a large portion of your hormone-secreting stomach.

Food Cravings

There are several reasons people crave food, including food addiction, an overproduction of hunger-causing hormones, and hunger impulses sent from the stomach to the brain. Since food cravings are an issue for you now, they are likely to continue after surgery unless you choose a procedure that specifically addresses them.

Although weight loss after vBloc Therapy is not as great as many of the other procedures, it is specifically designed to block hunger impulses sent to the brain. Gastric sleeve has impressive weight loss and reduces food cravings by completely removing a large portion of your hormone-secreting stomach.

Dumping Syndrome

For some patients, eating foods high in fat, carbohydrates, or sugar, eating foods that are too hot or too cold, or drinking liquids during meals can result in dumping syndrome. Symptoms include bloating, diarrhea, dizziness, heart palpitations, nausea, rapid heart rate, sweating, and vomiting.

While very uncomfortable if it happens, this can actually be a good thing as it provides a very strong deterrent against "cheating" on your new bariatric diet which can lead to better long-term weight loss.

Dumping syndrome is experienced by about 4 out of every 5 gastric bypass patients. The other procedures are much less likely to cause this issue.

Since you indicated that you're open to your body reacting negatively to the wrong diet choices, you may want to keep gastric bypass on your list of possible procedures.

Since you indicated that you don't want to worry about the symptoms associated with dumping syndrome, you may want to remove gastric bypass from your list of procedures to consider.

Insurance

The fact that your insurance covers weight loss surgery is great news, although some individual procedures may not be covered. Even after a new procedure has been proven in the scientific community, it often takes years for insurance companies to add it to their list

Your policy will probably cover gastric sleeve, gastric bypass, Lap-Band, and duodenal switch since they have all been around for a long time.

Gastric balloon and vBloc Therapy will probably not be covered directly, but your surgeon's office may be able to help you get some of the costs covered. However, these procedures may be covered on a case-by-case basis.

Read the Bariatric Insurance Guide

Insurance

You indicated that you're not sure whether your insurance covers weight loss surgery. If you find out that it's covered, note that some procedures may not be included in your policy. Even after a new procedure has been proven in the scientific community, it often takes years for insurance companies to add them to their list.

If your specific policy covers bariatric surgery, it will probably cover gastric sleeve, gastric bypass, Lap-Band, and duodenal switch since those procedures have been around for a long time.

Gastric balloon and vBloc Therapy will probably not be covered directly, but your surgeon's office may be able to help you get part of the procedure costs covered. However, these procedures may be covered on a case-by-case basis.

Read the Bariatric Insurance Guide

Anticoagulation Medicine

Since you are currently taking anticoagulation medication (blood thinners), you will have a higher risk of marginal ulcers forming in the new stomach pouch created during a gastric bypass procedure. As a result, if you are on the fence between gastric bypass and a different procedure, you may want to choose the other procedure.

Anticoagulation Medicine

If you are currently taking anticoagulation medication (blood thinners), you will have a higher risk of marginal ulcers forming in the new stomach pouch created during a gastric bypass procedure. As a result, if you are on the fence between gastric bypass and a different procedure, you may want to choose the other procedure.

Implanted Device

Gastric balloon, vBloc Therapy, and Lap-Band each include a different types of device that is left inside the body. Gastric sleeve, gastric bypass, and duodenal switch do not.

Since you're open to that idea, we haven't given this any weight in our recommendation - we just wanted you to be aware.

Since you are uncomfortable with the thought of a device being left inside your body, you may want to avoid gastric balloon, vBloc, and Lap-Band.

Reversible Procedures

Generally speaking, the reversible procedures, including vBloc Therapy, Lap-Band, and gastric balloon, do not result in as much weight loss or as much health improvement as the "permanent" gastric sleeve, gastric bypass, and duodenal switch procedures.

However, they do have a few points in their favor:

  1. Weight loss can still be significant, especially depending on your goals
  2. They allow you to "stick your toe in the weight loss surgery waters" without taking the full leap, especially when diet and exercise aren't working
  3. The risk of serious complications tends to be lower
  4. They can serve as a "bridge" (first step) to a permanent procedure. The more weight you lose before a permanent procedure, the lower the risk of complications and the more long-term weight loss you are likely to achieve.

Since the ability to reverse your procedure is important to you, you should move vBloc Therapy, gastric balloon, and Lap-Band surgery higher up your list.

Since the ability to reverse your procedure is not important to you, you may want to focus more on other procedure differences like potential weight loss, health improvement, and risks.

Vitamins & Supplements

All weight loss procedures require some level of supplementation, although some are more serious with their requirements than others. The two malabsorptive procedures, gastric bypass and duodenal switch, alter the path of your digestion to prevent your body from absorbing as much food. While this tends to lead to greater weight loss, it also carries with it a higher risk of malnutrition. As a result, you will be on a more robust and stricter vitamin and supplement regimen than with the other procedures.

Since you indicated that you are not willing to be on a serious regimen of vitamins and supplements for the rest of your life, you should think hard about whether weight loss surgery is right for you.

The only procedure that does not require permanent long-term supplementation is gastric balloon because the balloon is usually removed after 6 months.

The "restrictive" procedures tend to lead to much lower instances of vitamin deficiency, but you still may need to be on a more moderate regimen of vitamins since your body will not be able to hold (and therefore absorb nutrients from) as much food.

The malabsorptive procedures require strict, lifelong supplementation, so you should probably avoid those procedures.

Find a Top Surgeon

Start to Finish
7 Steps to Long-Term Weight Loss

Start to Finish – 7 Steps to Long-Term Weight Loss

Step 1: Start Working with a Top Surgeon As Soon as Possible

Top surgeons will help you effectively navigate the various procedure choices, pre-surgery steps, financing, and insurance options:

  1. As a first step, many surgeons offer a free initial consultation or a free local seminar or webinar to give you a better understanding of what to expect.
  2. Many will also provide a free insurance check to help you figure out how much insurance will cover, and, if necessary, appeal any denials or find additional financing. Most insurance companies require you to complete a medically supervised diet and exercise program before they will approve your surgery, so your surgeon will set this up for you if you haven’t done so already.
  3. Your surgeon will also push you towards new habits that will be essential to long-term success after surgery. Many surgeons will recommend that you attend support group meetings so you can listen to feedback from actual patients.

Step 2: Two Weeks Out: Prepare for Surgery

By 2 weeks out you will have completed your pre-op tests, physical, and any other necessary steps required by your surgeon or insurance company. You should have insurance approval (if applicable), and you should be well on your way towards developing your new long-term lifestyle and diet habits. In the week or two leading up to surgery you’ll be seeing the hospital pre-surgery department for an EKG, blood work, and any last minute instructions or other pre-op tests. You’ll see the surgeon one more time for consents, a pre-operative physical, and any last minute details. The night before surgery you’ll be asked to not eat or drink anything starting at midnight.

Step 3: Surgery Day

You’ll be asked to arrive at the hospital at least two hours prior to surgery to allow for prep time. The gastric bypass procedure itself will take about 4 hours to perform. For the first few hours after surgery, you probably won’t be awake to remember it, but you’ll have one-on-one attention from someone on your surgical team to manage your pain and monitor your vitals. Click here for more about what to expect in the hospital.

Step 4: Recovery

Most gastric bypass patients are in the hospital for 2 or 3 days total. You will probably not be allowed to eat or drink anything for at least 24 hours after surgery, and your surgeon will want you to get up and walk around as soon as possible to start the healing process. You’ll be discharged as soon as your surgeon is confident that you are well on the road to full recovery. You’ll likely need someone to drive you home from the hospital and care for you for at least a few days following surgery. Full recovery generally happens within 4 to 6 weeks. Click here for more about the recovery process.

Step 5: Adjust to Your New Post-Surgery Diet & Lifestyle

Over the course of the first 6 weeks following surgery you will slowly transition from a sugar-free clear liquid diet to your “new normal” gastric bypass diet. You should also continue your transition into a more active lifestyle. You will feel full sooner, you may feel less hungry generally, and you should start to experience significant weight loss within a couple weeks. Your surgeon’s dietitian or nutritionist will help you determine an appropriate diet. See the Diet & Life After section of this page for more information.

Step 6: Attend Support Groups Regularly

Regular weight loss surgery support group participation has been found to lead to the following benefits:

  1. Reduce post-op recovery time
  2. Lead to as much as 12% more long-term weight loss

Your surgeon will be able to recommend an in-person group near you.

Step 7: Ongoing Doctor Visits

For the first year, your surgeon will most likely schedule follow up visits. Shortly after surgery, they will be weekly then transition to every four weeks, and, later, once every few months to ensure that you are recovering well and to answer any questions you may have. Subsequent doctor visits will be scheduled on an as-needed basis along with annual check-ups.

Help & Support
Patient Experiences & Ask the Expert

Help & Support*

Patient Experience & Ask the Expert*

We would love to hear your experiences with the gastric bypass surgery. Much like how support groups help others, your insights are invaluable to making sure other people have the tools to meet their goals.

We would also be happy to answer any questions you may have about gastric bypass surgery.

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References for Laparoscopic Gastric Bypass Surgery

  1. Gasteyger C, Suter M, Gaillard RC, Giusti V. Nutritional deficiencies after Roux-en-Y gastric bypass for morbid obesity often cannot be prevented by standard multivitamin supplementation. Am J Clin Nutr. 2008 May;87(5):1128-33.
  2. Peluso L, Vanek VW. Efficacy of Gastric Bypass in the Treatment of Obesity-Related Comorbidities. Nutrition in Clinical Practice, Vol. 22, No. 1, 22-28 (2007)
  3. American Society for Metabolic and Bariatric Surgery. Brief History and Summary of Bariatric Surgery. May 2005. Available at: http://www.asbs.org/html/patients/bypass.php. Accessed: September 16,2009.
  4. Dymek, Maureen, et al. Quality of Life after Gastric Bypass Surgery: A Cross-Sectional Study. Obesity Research. 2002. DOI: 10.1038/oby.2002.154
  5. Li, Jian-Fang MDSurgical Laparoscopy, Endoscopy & Percutaneous Techniques: February 2014 – Volume 24 – Issue 1 – p 1-11 doi: 10.1097/SLE.0000000000000041

[ Last editorial review/modification of this page : 01/19/2017]

* Disclaimer: The information contained in this website is provided for general information purposes and your specific results may vary depending on a variety of circumstances. It is not intended as nor should be relied upon as medical advice. Rather, it is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her existing physician(s). Before you use any of the information provided in the site, you should seek the advice of a qualified medical, dietary, fitness or other appropriate professional. Read More