6 Types of Weight Loss Surgery - All You Need to Know

Established & Widely Accepted Types of Weight Loss Surgery

There is no “one size fits all” procedure, so this page will help you determine which ones best fit your goals.

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

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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

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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.

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Weight Loss
Ranges from Part to Most of Your Excess Weight
types of bariatric surgery

Weight Loss: Ranges from Part to Most of Your Excess Weight

Most Weight Loss

  • Winner: Duodenal Switch

  • Runners Up: (Tie) Gastric Sleeve & Gastric Bypass

Patients lose weight quickly after most procedures, with the low point coming 12 to 18 months after the procedure.

The duodenal switch (DS), gastric sleeve, and gastric bypass are very close in terms of their average low point, but the DS pulls ahead over the long-term as it results in less weight regain over time.

Excess Weight Loss by Procedure

The following graph and chart compare weight loss over time for each procedure:

 
 
Gastric Sleeve
Gastric Sleeve
Gastric Bypass
Gastric Bypass
Gastric Balloon
Gastric Balloon
Duodenal Switch
Duodenal Switch
Lap-Band
Lap-Band
vBloc Therapy
vBloc Therapy
AspireAssist
AspireAssist
 
3 Months
Gastric Sleeve
30%
Gastric Bypass
30%
Gastric Balloon
15%
Duodenal Switch
30%
Lap-Band
20%
vBloc Therapy
10%
AspireAssist
8%
 
6 Months
Gastric Sleeve
50%
Gastric Bypass
50%
Gastric Balloon
30%
Duodenal Switch
45%
Lap-Band
30%
vBloc Therapy
20%
AspireAssist
15%
 
1 Year
Gastric Sleeve
70%
Gastric Bypass
65%
Gastric Balloon
varies (balloon removed after 6 mo)
Duodenal Switch
65%
Lap-Band
40%
vBloc Therapy
25%
AspireAssist
30%
 
2 Years
Gastric Sleeve
65%
Gastric Bypass
60%
Gastric Balloon
varies (balloon removed after 6 mo)
Duodenal Switch
70%
Lap-Band
55%
vBloc Therapy
25%
AspireAssist y
no data yet
 
3 years
Gastric Sleeve
60%
Gastric Bypass
60%
Gastric Balloon
varies (balloon removed after 6 mo)
Duodenal Switch
70%
Lap-Band
55%
vBloc Therapy
25%
AspireAssist
no data yet
 
5 years
Gastric Sleeve
55.%
Gastric Bypass
60%
Gastric Balloon
varies (balloon removed after 6 mo)
Duodenal Switch
70%
Lap-Band
55%
vBloc Therapy
25%
AspireAssist
no data yet

Health Benefits
Diabetes, Cardiac, Asthma, Joints, Many Others

Health Benefits Diabetes, Cardiac, Asthma, Joints, Many Others

Best Health Improvement

  • Winner: Duodenal Switch

  • Runners Up: (Tie) Gastric Sleeve & Gastric Bypass

The duodenal switch (DS) seems to deserve more attention than it has gotten as it is the clear front-runner in terms of health improvement. In fact, DS surgery is even being performed on non-morbidly obese patients to treat metabolic syndrome and diabetes (1).

It works so well because it combines the restriction of gastric sleeve, making patients feel full sooner after eating, with its own brand of malabsorption to limit the number of calories that the body can absorb.

Despite its effectiveness, most surgeons tend to only consider it for super-obese patients (BMI of 50 or greater) because:

  • It is more difficult to perform
  • It takes longer to perform
  • It requires much more diligent follow up for both surgeons and patients due to the the level of malabsorption that it causes

While not as good as the DS, gastric sleeve and gastric bypass have extremely impressive health improvement stats as well.

Compare Health Improvement

The following table compares available studies for all procedures and conditions:

Co-morbidity
Co-morbidity
Dyslipidemia hyperchole­sterolemia
Dyslipidemia hyperchole­sterolemia
Diabetes
Diabetes
Hyperli­pidemia (high levels of fat in the blood, high cholesterol)
Hyperli­pidemia (high levels of fat in the blood, high cholesterol)
High Blood Pressure (hypertension)
High Blood Pressure (hypertension)
Joint/Bone Disease (osteoar­thropathy)
Joint/Bone Disease (osteoar­thropathy)
Depression
Depression
Migraines
Migraines
Pseudotumor cerebri
Pseudotumor cerebri
Cardiova­scular Disease
Cardiova­scular Disease
Venous Stasis Disease
Venous Stasis Disease
Gastroeso­phageal Reflux Disease (GERD)
Gastroeso­phageal Reflux Disease (GERD)
Non-Alcoholic Fatty Liver Disease
Non-Alcoholic Fatty Liver Disease
Mortality Reduction/Life Expectancy (5 year mortality)
Mortality Reduction/Life Expectancy (5 year mortality)
Quality of Life Improve­ments
Quality of Life Improve­ments
Metabolic Syndrome
Metabolic Syndrome
Polycystic Ovarian Syndrome
Polycystic Ovarian Syndrome
Pregnancy
Pregnancy
Asthma
Asthma
Obstructive Sleep Apnea
Obstructive Sleep Apnea
Stress Urinary Inconti­­nence
Stress Urinary Incontinence
Co-morbidity
Gastric Balloon % Improved /Resolved
Dyslipidemia hypercholesterolemia
10%
Diabetes
33%
Hyperlipidemia (high levels of fat in the blood, high cholesterol)
34%
High Blood Pressure (hypertension)
45%
Joint/Bone Disease (osteoarthropathy)
48%
Depression
 
Migraines
 
Pseudotumor cerebri
 
Cardiovascular Disease
 
Venous Stasis Disease
 
Gastroesophageal Reflux Disease (GERD)
 
Non-Alcoholic Fatty Liver Disease
 
Mortality Reduction/Life Expectancy (5 year mortality)
 
Quality of Life Improvements
 
Metabolic Syndrome
 
Polycystic Ovarian Syndrome
 
Pregnancy
 
Asthma
 
Obstructive Sleep Apnea
 
Stress Urinary Incontinence
 
Co-morbidity
Gastric Sleeve % Improved /Resolved
Dyslipidemia hypercholesterolemia
64%
Diabetes
55.%
Hyperlipidemia (high levels of fat in the blood, high cholesterol)
35%
High Blood Pressure (hypertension)
68%
Joint/Bone Disease (osteoarthropathy)
46%
Depression
Most
Migraines
40%
Pseudotumor cerebri
n/a
Cardiovascular Disease
100%
Venous Stasis Disease
95%
Gastroesophageal Reflux Disease (GERD)
50%
Non-Alcoholic Fatty Liver Disease
n/a
Mortality Reduction/Life Expectancy (5 year mortality)
89%
Quality of Life Improvements
93%
Metabolic Syndrome
62%
Polycystic Ovarian Syndrome
Most
Pregnancy
Most
Asthma
90%
Obstructive Sleep Apnea
62%
Stress Urinary Incontinence
90%
Co-morbidity
Bypass % Improved /Resolved
Dyslipidemia hypercholesterolemia
63%
Diabetes
83%
Hyperlipidemia (high levels of fat in the blood, high cholesterol)
73%
High Blood Pressure (hypertension)
69%
Joint/Bone Disease (osteoarthropathy)
43%
Depression
Most
Migraines
57.%
Pseudotumor cerebri
96%
Cardiovascular Disease
79%
Venous Stasis Disease
95%
Gastroesophageal Reflux Disease (GERD)
80%
Non-Alcoholic Fatty Liver Disease
90%
Mortality Reduction/Life Expectancy (5 year mortality)
89%
Quality of Life Improvements
95%
Metabolic Syndrome
80%
Polycystic Ovarian Syndrome
Most
Pregnancy
Most
Asthma
80%
Obstructive Sleep Apnea
98%
Stress Urinary Incontinence
88%
Co-morbidity
DS % Improved /Resolved
Dyslipidemia hypercholesterolemia
99%
Diabetes
92%
Hyperlipidemia (high levels of fat in the blood, high cholesterol)
99%
High Blood Pressure (hypertension)
83%
Joint/Bone Disease (osteoarthropathy)
43%
Depression
Most
Migraines
Most
Pseudotumor cerebri
Cardiovascular Disease
86%
Venous Stasis Disease
Gastroesophageal Reflux Disease (GERD)
49%
Non-Alcoholic Fatty Liver Disease
99%
Mortality Reduction/Life Expectancy (5 year mortality)
89%
Quality of Life Improvements
95%
Metabolic Syndrome
99%
Polycystic Ovarian Syndrome
Most
Pregnancy
Asthma
90%
Obstructive Sleep Apnea
99%
Stress Urinary Incontinence
Co-morbidity
vBloc % Improved /Resolved
Dyslipidemia hypercholesterolemia
Diabetes
Moderate
Hyperlipidemia (high levels of fat in the blood, high cholesterol)
High Blood Pressure (hypertension)
Joint/Bone Disease (osteoarthropathy)
Depression
Migraines
Pseudotumor cerebri
Cardiovascular Disease
Moderate
Venous Stasis Disease
Gastroesophageal Reflux Disease (GERD)
Non-Alcoholic Fatty Liver Disease
Mortality Reduction/Life Expectancy (5 year mortality)
Quality of Life Improvements
Metabolic Syndrome
Polycystic Ovarian Syndrome
Pregnancy
Asthma
Obstructive Sleep Apnea
Stress Urinary Incontinence
Co-morbidity
Band % Improved /Resolved
Dyslipidemia hypercholesterolemia
70%
Diabetes
60%
Hyperlipidemia (high levels of fat in the blood, high cholesterol)
23%
High Blood Pressure (hypertension)
43%
Joint/Bone Disease (osteoarthropathy)
81%
Depression
57.%
Migraines
Some
Pseudotumor cerebri
Most
Cardiovascular Disease
73%
Venous Stasis Disease
Gastroesophageal Reflux Disease (GERD)
87%
Non-Alcoholic Fatty Liver Disease
Most
Mortality Reduction/Life Expectancy (5 year mortality)
89%
Quality of Life Improvements
Most
Metabolic Syndrome
78%
Polycystic Ovarian Syndrome
48%
Pregnancy
Most
Asthma
82%
Obstructive Sleep Apnea
85%
Stress Urinary Incontinence
82%

Qualify
Minimum Body Mass Index = 30

Qualify: Minimum Body Mass Index = 30

Easiest to Qualify

  • Winner: No Clear Winner

In order to qualify for any type of weight loss surgery, your body mass index (BMI) must fall within a certain range.

While gastric balloon is the only procedure to allow BMI’s between 30 and 35, it is also the only procedure to not allow BMI’s over 40.

vBloc Therapy also has a limited range of 35 to 45.

The rest of the procedures have the same qualification requirements:

  • Body mass index above 40 or
  • Body mass index between 35 and 40 as long as you have a serious obesity-related health problem (“comorbidity”) such as diabetes, asthma, hypertension, joint problems, sleep apnea, or one of many others.

Use the BMI Calculator below to determine your body mass index.

Cost
$8,150 – $27,000 Range, Financing Available for All

Cost: $8,150 – $27,000 Range, Financing Available for All

Low-Cost Procedure (Without Insurance)

  • Winner: Gastric Balloon (but long-term costs likely higher than more expensive procedures)

  • Runners Up: Lap Band (but long-term costs likely higher than more expensive procedures)

Low-Cost Procedure (With Insurance)

  • Winner: 4-Way Tie – Gastric Sleeve, Gastric Bypass, Duodenal Switch, & Lap-Band

  • Runners Up: Gastric Balloon

The cost of surgery should not dictate which procedure you have. Through research and consultation with your surgeon, you should move forward with the procedure that is most likely to work for you.

Still, if you don’t have insurance that covers bariatric surgery, it’s important to know what you’re up against financially.

*There are a few key caveats to the cost information and winners above:

  • The above costs are averages. Actual costs vary widely depending on the region, hospital, and surgeon.
  • These costs are not necessarily all inclusive. Talk with your surgeon or hospital for a more specific quote.
  • Long-term costs will probably be much lower for the more expensive procedures. Even though they are not declared “Low-Cost Winners” in this section, the more expensive procedures tend to do a much better job at improving or resolving obesity-related health problems which will save you more money over the long-term. More on this in the “Cost of Not Having Surgery” sub-section below.

Financing

Regardless of which procedure you choose, financing is available to many patients to help make surgery more affordable.

Please visit our Financing weight loss surgery page for all the possible ways to finance your surgery.

Cost of Not Having Surgery vs. Cost of Weight Loss Surgery

Even if you’re paying out of pocket, the cost of any procedure is far less than the long-term costs of obesity-related health problems for morbidly obese people who don’t have surgery.

On average, weight loss surgery patients pay off their entire surgery and start getting ahead financially after only 2 years (2).

To illustrate: One study 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 (3). Starting in month 13, that’s almost $11,000 saved per year in total medical costs.

Fewer prescription drugs alone have been found to save patients $3,000 or more per year (4).

Insurance
4 of 6 Procedures Currently Covered

Insurance: 4 of 6 Procedures Currently Covered

Insurance Coverage

  • Winner: (4-Way Tie) Sleeve, Bypass, Band, & Duodenal Switch

For insurance policies that include weight loss surgery, four procedures are currently covered:

  • Gastric sleeve surgery
  • Gastric bypass surgery
  • Duodenal switch surgery (biliopancreatic diversion with duodenal switch)
  • Gastric banding (Lap-Band surgery)

The weight loss surgery insurance approval process can take anywhere from 1 to 12 months, depending on your insurance company and your situation.

Following are the typical steps:

  1. Confirm with your doctor that your body mass index and health conditions fall within one of the two qualification requirements:
    • 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.

Take the Easy Route – 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 weight loss surgery insurance, see our Bariatric Surgery Insurance Guide.

Procedure
6 Types Widely Performed

Procedure: 6 Types Widely Performed

Most Popular Procedure

  • Winner: Gastric Sleeve

  • Runners Up: Gastric Bypass

Procedure Fundamentals: Restriction, Malabsorption, & Vagal Nerve Stimulation

The established types of bariatric surgery work using one or more of the following techniques:

  • Restrictive surgeries reduce the amount of food the stomach can hold. This makes you feel full much sooner after eating than you did before surgery. The established restrictive procedures include:
    • Gastric sleeve
    • Adjustable gastric banding (Lap-Band surgery)
    • Intragastric balloon (gastric balloon)
  • Malabsorptive surgeries rearrange and/or remove part your digestive system, which then limits the amount of calories, minerals, and/or fat soluble vitamins that your body can absorb. Treatments with a large malabsorptive component result in the most weight loss but may have higher complication rates. Malabsorptive surgeries include:
    • Gastric bypass – mineral malabsorptive, not calorie malabsorptive
    • Duodenal switch – mineral, calorie, and fat-soluble vitamin malabsorptive
  • Vagal Nerve Blocking uses controlled electrical stimulation to block hunger signals sent from your stomach to your brain. The only FDA-approved device is:
    • vBloc Therapy

Experimental Procedures

Not included above are a few promising experimental procedures which can be reviewed on our Experimental Weight Loss Surgery page.

Rejected & Outdated Procedures

Two other procedures which are generally rejected by top surgeons and/or outdated include:

Why They Work & How They’re Performed

This section reviews how each of the generally accepted procedures work and how they are performed, including videos for each. Click the procedures for more information:

Gastric Sleeve

gastric sleeve surgery
Why Gastric Sleeve Works
  • Reduced stomach size makes the patient feel full sooner after eating
  • Removed portion of the stomach means fewer hunger-causing hormones are secreted, causing patient to feel less hungry generally
How Gastric Sleeve Is Performed

Gastric sleeve surgery, also called the Vertical Sleeve Gastrectomy (VSG), is performed by removing a large portion of the stomach to create a long pouch that connects the esophagus to the small intestine. The pouch is stapled and the rest of the stomach is removed. Some surgeons take an additional step to reinforce the staple line, although whether that is effective is up for debate.

Gastric Bypass

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
How Gastric Bypass Is Performed

Gastric bypass, also called Roux-en-Y gastric bypass or RNY for short, is performed using the following steps:

  • Cut and staple the top portion of the stomach to create a small pouch at the end of the esophagus
  • Leave the remainder of the stomach attached to the top of the small intestines
  • Go further down the small intestine, cut it, and attach it to the pouch
  • Take the end of the small intestine that is still connected with the non-pouch portion of the stomach and attach it to the bottom of the “Roux limb.” This allows the digestive juices produced by the stomach to “meet up” with the food in the intestines.

Duodenal Switch (DS)

Duodenal Switch Surgery (DS)
Why the Duodenal Switch Works
  • Reduced stomach size makes the patient feel full sooner after eating
  • Removed portion of the stomach means fewer hunger-causing hormones are secreted, causing patient to feel less hungry generally
  • Rearranged intestines causes the body to absorb fewer calories and minerals
How the Duodenal Switch Is Performed

More formally known as the Biliopancreatic Diversion with Duodenal Switch, the DS surgeon starts with a gastric sleeve to reduce the stomach size, then rearranges the intestines to reduce the amount of calories the body can absorb.

Here are the steps:

  • A large portion of the stomach is removed to create a banana-shaped pouch connecting the esophagus to the top of the small intestine (just like a gastric sleeve).
  • The top of the small intestine is cut, but the surgeon leaves part of the duodenum, the top part of the small intestine where most chemical digestion occurs, attached to the stomach.
  • The surgeon then cuts the small intestine several feet down. The part that is still attached to the large intestine (colon) is connected to the duodenum.
  • The loose part of the small intestine (the part that wasn’t just attached to the stomach) is then attached to the small intestine so the digestive juices it creates can mix with the food coming from the stomach.

Gastric Bypass vs. Duodenal Switch: Clearing Up the Misconception

Both the DS and gastric bypass reduce the size of the stomach and rearrange the intestines. Both lead to substantial weight loss and health improvement.

So they’re kind of the same thing, right?

In fact, gastric bypass and the DS are just as different as any other two procedures. Here’s how they’re different:

  • The DS stomach sleeve is much larger than the gastric bypass pouch
  • The DS completely removes a large part of the stomach, whereas the gastric bypass leaves the separated part of the stomach attached to the small intestine
  • Gastric bypass bypasses a much smaller portion of the small intestine, causing primarily mineral malabsorption. Calories are still largely absorbed after bypass. DS, on the other hand, bypasses a much longer portion of the small intestine, causing your body to absorb far fewer calories than after bypass. It also leads to much less absorption of minerals and fat soluble vitamins.
  • Gastric bypass also bypasses the pylorus (the muscle that separates the stomach from the small intestine which is responsible for regulating how much food passes through the stomach and into the small intestine). The DS does not.
  • Gastric bypass also bypasses the duodenum (the first portion of the small intestine where the digestive juices of the pancreas, liver, and gallbladder are secreted). The DS does not. Note that the duodenum is left in place after gastric bypass, but digestive juices secreted there “meet up” with the food much farther down the small intestines, greatly reducing their impact.
  • The gallbladder is removed during DS surgery but is left in place after gastric bypass. The gallbladder stores digestive bile produced by the liver and releases it when you eat to help your body break down fats for absorption. Removing the gallbladder leads to even less calorie absorption for DS patients.

What do these differences mean to you?

  • Gastric bypass has among the best weight loss and health improvement results among all procedures, but on average, DS is even better.
  • DS has a higher risk of vitamin deficiency and requires more diligent follow up by surgeon and a stricter adherence to a vitamin regimen by the patient.
  • Dumping syndrome is common for bypass patients and virtually non-existent for DS patients. Due to the much smaller stomach size and the bypassing of the pylorus and duodenum after gastric bypass, about 7 out of 10 gastric bypass patients experience dumping syndrome. Since the DS stomach sleeve is much larger and since the DS maintains the function of the pylorus and duodenum, DS patients do not experience dumping syndrome.
  • DS is more complicated to perform. As a result, there are fewer experienced surgeons available to perform it. With all else being equal, whether or not DS has a higher risk of complications is unclear. Available research does show a higher DS complication rate, but:
    • DS is more commonly performed on heavier patients who have an inherently higher risk of complications
    • The more experienced the surgeon, the lower the risk of complications. Since the DS is much less common, surgeons often do not have as much experience performing it, leading to higher complication rates.
    In short, if you’re interested in the DS, find an experienced DS surgeon and cross the bypass vs. DS complication rate debate off your list of concerns.

Is Dumping Syndrome Always a Bad Thing?

For about 95% of patients experiencing dumping syndrome, symptoms are relatively minor (5). 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.

Lap-Band

Lap-Band-Surgery
Why Lap-Band Surgery Works
  • A band wraps around and squeezes a narrow section in the upper-middle part of the stomach. This creates a smaller stomach “section” above the band which fills up quicker after eating, causing the patient to feel full sooner and eat less.
How Lap-Band Surgery Is Performed

The Lap-Band, also called the gastric band or laparoscopic adjustable gastric band, has been used in Europe since the 90’s but wasn’t approved by the FDA in the States until 2001. It has since fallen out of favor in many practices due to its high long-term failure rate.

Apollo Endosurgery, Inc., the maker of the Lap-Band, insists that long-term failures are the result of patients not adhering to the strict follow up that is more typical among other procedures. They say they are reinventing their support process to improve Lap-Band’s reputation.

The Lap-Band surgery procedure involves the sewing of a silicone and Silastic band around the top of the stomach. A balloon around the inner surface of the band (imagine the inside of a bicycle tire) is connected to a tube that leads to a half-dollar-sized port above the abdominal muscles but below the skin.

During follow up visits, your doctor will add or remove saline solution (salt water) to make it tighter or looser. The tighter it is, the less hungry you feel and vice-versa.

vBloc Therapy

vBloc Therapy
Why vBloc Therapy Works
  • Implanted device periodically blocks the vagal nerve and prevents it from delivering hunger signals to the brain, making you feel full between meals and full sooner after smaller meals.
How vBloc Device Implantation Is Performed

Your surgeon will implant the vBloc Therapy device below your rib cage just under the skin. She will then attach the device to your vagal nerve, just above the stomach, via two leads (wires). The whole procedure usually takes between 60 and 90 minutes.

Gastric Balloon

Intragastric Balloon
Why the Gastric Balloon Works
  • An inflated balloon in the stomach leaves less room for food and causes patients to feel full sooner and eat less.
How the Gastric Balloon Is Inserted

The gastric balloon procedure is performed as follows:

  • Surgeon numbs throat using a spray
  • Patient may receive a sedative
  • Plastic mouth guard is inserted in patient’s mouth for the scope to pass through
  • Scope is passed through mouth and into stomach
  • Scope is removed and balloon is passed into patient’s stomach
  • Balloon is inflated with air or saline solution (depending on balloon type)
  • Scope is passed into stomach again to confirm proper balloon positioning

Since it usually must be removed within 6 months, the balloon is only a temporary solution intended to “jump start” a long-term, medically-supervised diet and exercise program.

Recovery – In Hospital
6 Hours – 4 Days; Back to Work: 3 – 14 Days

Recovery – In Hospital: 6 Hours – 4 Days; Back to Work: 3 – 14 Days

Quickest Recovery

  • Winner: (Tie) vBloc Therapy & Gastric Balloon

  • Runners Up: Lap-Band

The amount of time you’ll spend in the hospital and the recovery time depends on how “involved” your procedure is (how complicated the procedure is, whether part of stomach is removed or digestive system rearranged, etc).

Less Involved Procedures

Less Involved Procedures

  • Gastric balloon
  • vBloc Therapy

The less involved procedures, including gastric balloon and vBloc Therapy, have the shortest hospital times (return home the same day as surgery) and recovery times (back to work in 3 to 4 days).

More Involved Procedures

More Involved Procedures

  • Lap-Band
  • Gastric sleeve
  • Gastric bypass
  • Duodenal switch

The moderately involved procedure, Lap-Band, will require a 1 day hospital stay and will have you back to work in 2 weeks.

The most involved procedures, including gastric sleeve, gastric bypass, and duodenal switch, typically require 2 to 3 days in the hospital, although you should still be able to return to work within 2 weeks.

Recovery: What to Expect

Recovery: What to Expect

For all procedures except gastric balloon, here’s what to expect during your hospital stay and recovery:

  1. Wake Up: When you first awake after surgery, you’ll be sore and a little “out of it.” You’ll be on medication to control the pain.
  2. Move Around: Your surgeon will have you up and walking around as soon as possible after you wake up to reduce the risk of blood clots and jump-start your body’s healing process. 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:
    • You are able to drink enough to stay hydrated
    • You can urinate normally after your catheter is removed
    • You have adequate pain relief from your pain meds
  4. Look for Warning Signs: Warning signs vary by procedure. Call your surgeon immediately if you experience any of the following:
    • Fever
    • No improvement or worsening of pain
    • Signs of incision infection (pus, swelling, heat, or redness)
    • Difficulty swallowing
    • Ongoing nausea or vomiting
  5. Transition Your Diet: Since you’ll be eating less, you may feel tired and lethargic until your body adjusts. For all procedures other than vBloc and gastric balloon, your smaller or constricted stomach will be sensitive, especially at first. 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 & Life After section of this page).
  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.
  8. Have Follow-Up Visits During First Year: Follow-ups with your surgeon’s team will happen about one week post-op, then around 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 (6). 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.

Gastric balloon surgery recovery is unique in that it does not require any incisions. As a result, recovery is much faster than after the more involved procedure and generally focuses on diet changes:

  1. Day 1 – Clear Liquids Only
  2. Days 2 through 7 – Liquid Diet
  3. Days 7 through 14 – Pureed Food Diet
  4. Days 15+ – “New Normal” Diet – Restrictions include foods that may stick to your balloon, such as pasta. Sip water after you eat to rinse your balloon.

Diet Changes
Ranges from Moderate to Significant

Diet Changes: Ranges from Moderate to Significant

Best Post-Op Diet

  • Winner: Depends on Patient’s Goals

The “best” long-term diet after weight loss surgery means different things to different people. For example, “best” could mean:

  • Most weight loss, regardless of sacrifices
  • Fewest long-term diet changes, even if less weight loss
  • Anywhere in between

Unfortunately, you can’t have it all, so the following sections provide an overview of what to expect after each procedure.

Food & Drink: Varies by Procedure

Food & Drink: Varies by Procedure

The more involved procedures, including gastric sleeve, gastric bypass, duodenal switch, and Lap-Band, have very similar diet requirements before and after surgery. Gastric balloon and vBloc Therapy have their own guidelines.

The following sections compare each aspect of your diet after surgery.

Diet Stages & Timing By Procedure

Following is a general overview and timing of each stage before and after surgery:

Timing Your Dieting by Procedure

 
 
Practice your post-surgery diet
Practice your post-surgery diet
High protein, low sugar, low carbs
High protein, low sugar, low carbs
Stop or change some medications
Stop or change some medications
Clear liquids only
Clear liquids only
Nothing to eat or drink
Nothing to eat or drink
Sugar-free clear liquids only
Sugar-free clear liquids only
Add thicker drinks & smooth foods
Add thicker drinks & smooth foods
Slowly test pureed foods & soft solid foods
Slowly test pureed foods & soft solid foods
Slowly test solid foods
Slowly test solid foods
 
Sleeve, Bypass, DS, Band
Practice your post-surgery diet
2+ Weeks Before
High protein, low sugar, low carbs
2 Weeks Before
Stop or change some medications
1 Week Before
Clear liquids only
2 Days Before
Nothing to eat or drink
Midnight Before Surgery
Sugar-free clear liquids only
In Hospital to 7 Days After Surgery (Varies by Surgeon)
Add thicker drinks & smooth foods
Day 1 to Week 2 After Surgery (Varies by Surgeon)
Slowly test pureed foods & soft solid foods
Day 2 to Week 3 After Surgery (Varies by Surgeon)
Slowly test solid foods
Day 3 to Weeks 4+ After Surgery (Varies by Surgeon)
 
vBloc
Practice your post-surgery diet
High protein, low sugar, low carbs
Stop or change some medications
Clear liquids only
Nothing to eat or drink
Midnight Before Until After Surgery
Sugar-free clear liquids only
Until After Surgery
Add thicker drinks & smooth foods
Slowly test pureed foods & soft solid foods
Slowly test solid foods
 
Balloon
Practice your post-surgery diet
2+ Weeks Before
High protein, low sugar, low carbs
Stop or change some medications
Clear liquids only
Nothing to eat or drink
Midnight Before Until After Balloon Placement
Sugar-free clear liquids only
Until After Balloon Placement
Add thicker drinks & smooth foods
Day 2 through 7
Slowly test pureed foods & soft solid foods
Day 6 through 14
Slowly test solid foods
Weeks 3+

Foods to Avoid By Procedure

For all procedures other than vBloc Therapy, your dietitian is likely to recommend the following:

  • Test one food at a time to make sure you can tolerate it
  • Eat proteins first, in solid form (e.g. not protein shakes)
  • Eat healthy “whole” foods
  • Avoid processed foods
  • Avoid sugary foods or drinks
  • Eat slowly and chew thoroughly
  • No starchy foods like rice, bread, and pasta
  • Avoid any food that is difficult to digest (may be able to tolerate over time), such as:
    • Fibrous vegetables like broccoli, celery, and corn
    • Nuts
    • Seeds
    • Skin of any meat
    • Tough meats
  • Avoid whole milk products
  • Drink 64+ oz (2+ liters) of fluids spread throughout the day
  • No drinking 30 minutes before or after meals (other than gastric balloon)

In addition to the above, following are procedure-specific foods to avoid:

  • Gastric bypass
    • Avoid foods that are likely to cause dumping, including sugar, unnecessary fat, or refined carbohydrates.
  • Gastric balloon
    • Avoid foods that may stick to your balloon and cause vomiting, such as pasta. To reduce risk of vomiting, drink liquids after eating to rinse your balloon.

Vitamins & Supplements

Vitamins & Supplements

All Types of Bariatric Surgery

Since you will be eating less after any type of weight loss surgery, you will likely need to supplement your diet with:

  • Daily multivitamin
    • 1 to 2 per day, forever
    • Chewable or liquid versions are best (instead of tablets)
    • Take with food (except dairy) to maximize absorption
    • At least 200% of the Recommended Dietary Allowance (RDA) of iron, folic acid, thiamine, copper, selenium and zinc
  • Daily calcium supplement, in the form of calcium citrate
    • Must be calcium citrate (NOT other forms of calcium)
    • 1000-1500 mg. daily, forever
    • Chewable and liquid versions are best (instead of tablets)
    • Try to find one that includes Vitamin D
    • Take 2 hours apart from Iron supplements (or Multivitamin that contains Iron) to maximize absorption

Gastric Sleeve, Gastric Bypass, Duodenal Switch, & Lap-Band Only

The more involved procedures, including the sleeve, bypass, DS, and band, may also require one or more of the following supplements, depending on your situation:

  • Folate (folic acid)
  • Iron
  • Thiamin (Vitamin B1)
  • Vitamin D

Gastric Bypass and Duodenal Switch Only

In addition to the above, Thiamin (Vitamin B1) supplementation is more likely to be required after gastric bypass and DS surgery given their higher levels of malabsorption than the other procedures.

Duodenal Switch Only

In addition to all of the above, since DS surgery is the only true malabsorptive procedure (malabsorption of calories, minerals, and fat-soluble vitamins vs only minerals after gastric bypass), DS patients also require daily fat-soluble vitamin supplements (including Vitamins A, D, E, and K).

This will typically include one additional tablet taken 3 times each day.

Exercise: Same for All Procedures

Exercise: Same for All Procedures

Following recovery, exercise should be the same for all procedures: 2.5 hours per week, spread out over 2 to 4 days. Keep in mind that patients who exercise regularly:

  • Lose more weight
  • Are more physically and mentally healthy

Learn more on our Exercise After Weight Loss Surgery page.

Your Brain: Less Hungry After Some Procedures, Careful About Food Addiction

Your Brain: Less Hungry After Some Procedures, Careful About Food Addiction

Reduced Hunger: Sleeve, DS, & vBloc Therapy

You may feel less hungry following the 2 procedures that completely remove a large portion of the stomach – gastric sleeve and duodenal switch.

When your stomach is empty, it secretes a hormone called ghrelin into your bloodstream which causes your brain to generate hunger impulses. After you eat, the amount of secreted ghrelin drops then slowly rises until your next meal. Since your stomach will be significantly smaller following these two procedures, the amount of ghrelin the stomach secretes – and your resulting feelings of hunger – may also go down.

vBloc Therapy is all about controlling hunger but goes about it differently. Instead of removing part of the stomach to control hormones, it uses an implanted device to block hunger signals altogether during certain parts of the day.

The other procedures leave the stomach in place and do not utilize a hunger-blocking device, so changes to hunger will remain largely unaffected.

Food Addiction

Regardless of which procedure you have, food addiction could be a problem.

Our bodies secrete certain hormones, like ghrelin mentioned above, that tell us when we’re hungry and full, but hyperpalatable food (like junk food) may be overriding those hormone signals by overstimulating our reward centers, much like our bodies and brains react to an addictive drug.

You may have a bona fide food addiction if your desire for food takes priority over other parts of your life that you acknowledge to be more important, such as personal health, family, friends, work, your appearance, or avoiding obesity related health issues like hypertension, sleep apnea, or diabetes.

If left unchecked, food addiction can lead to obesity. For weight loss surgery patients, if not addressed prior to surgery, it can also lead to weight regain.

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

Relationships After Weight Loss

Significant weight loss after any type of bariatric surgery can lead to big changes with everyone around you.

While many of those changes are positive, some can also be extremely challenging and unexpected.

See our Relationships After Weight Loss Surgery page for important changes to prepare for.

Downsides
Risk of Complications, Side Effects, & Weight Regain

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

Fewest Risks & Side Effects

  • Winner: vBloc Therapy

  • Runners Up: (Tie) Gastric Balloon & Gastric Sleeve

Generally speaking, the types of bariatric surgery that result in more weight loss are often accompanied by higher risk and additional lifestyle changes.

The following chart highlights which complications are possible. Note that many complications listed below are associated with any type of surgery, bariatric or otherwise, and are relatively rare. For complications with procedure-specific research, we have included specific percentages.

Expand Complications Chart

Compli­cation
Compli­cation
Abdominal hernia
Abdominal hernia
Abscess
Abscess
Anemia
Anemia
Band Problems (band erosion, band infection, band intolerance, band leak, band slippage)
Band Problems (band erosion, band infection, band intolerance, band leak, band slippage)
Blood Clots
Blood Clots
Body Aches
Body Aches
Body Feeling Changes (feeling cold, feeling weak/tired, feeling bloated, etc.)
Body Feeling Changes (feeling cold, feeling weak/tired, feeling bloated, etc.)
Bowel Function Changes (diarrhea, constipa­tion, foul-­smelling bowel move­ments and flatulence, difficulty swallowing, gurgling noises)
Bowel Function Changes (diarrhea, constipa­tion, foul-­smelling bowel move­ments and flatulence, difficulty swallowing, gurgling noises)
Bowel Obstruction
Bowel Obstruction
Deep Vein Thrombosis
Deep Vein Thrombosis
Dehyd­ration
Dehyd­ration
Dental Problems
Dental Problems
Dyspepsia (Indiges­tion)
Dyspepsia (Indiges­tion)
Dumping Syndrome
Dumping Syndrome
Esophagitis
Esophagitis
Esophageal Dilation
Esophageal Dilation
Eviscera­tion & Incisional Hernia
Eviscera­tion & Incisional Hernia
Food Trapping
Food Trapping
Gallstones
Gallstones
Gastric Fistula
Gastric Fistula
Gastritis
Gastritis
Gastroeso­phageal Reflux Disease (GERD)
Gastroeso­phageal Reflux Disease (GERD)
Gastroin­testinal Leaks
Gastroin­testinal Leaks
General Anesthesia Compli­cations
General Anesthesia Compli­cations
Hair Loss
Hair Loss
Heart Attack
Heart Attack
Hemorr­hage (Bleeding)
Hemorr­hage (Bleeding)
Hiatal Hernia
Hiatal Hernia
Hypogly­cemia
Hypogly­cemia
Infection
Infection
Intole­rance to Certain Foods
Intole­rance to Certain Foods
Kidney Stones
Kidney Stones
Marginal Ulcers
Marginal Ulcers
Nausea, Vomiting and/or Stomach Cramps
Nausea, Vomiting and/or Stomach Cramps
Organ Injury During Surgery
Organ Injury During Surgery
Peritonitis
Peritonitis
Pneumonia
Pneumonia
Port Problems (port flip/ inver­sion or dislodge­ment, port leak, port infec­tion, port disloca­tion)
Port Problems (port flip/ inver­sion or dislodge­ment, port leak, port infec­tion, port disloca­tion)
Pouch Dila­tion
Pouch Dila­tion
Pulmonary Embolism
Pulmonary Embolism
Respira­tory Failure
Respira­tory Failure
Skin Changes (e.g. acne, dry skin, sagging skin, etc.)
Skin Changes (e.g. acne, dry skin, sagging skin, etc.)
Stoma Obstruc­tion
Stoma Obstruc­tion
Stenosis/ Stric­ture
Stenosis/ Stric­ture
Stroke
Stroke
Thrombo­phlebitis
Thrombo­phlebitis
Thrush (Yeast Infec­tion)
Thrush (Yeast Infec­tion)
Vitamin & Mineral Deficiency / Malnutri­tion / Malabsorp­tion
Vitamin & Mineral Deficiency / Malnutri­tion / Malabsorp­tion
Weight Regain
Weight Regain
Wound Reopen­ing
Wound Reopen­ing
Wound Sepsis
Wound Sepsis
Compli­cation
Compli­cation or Side­ Effect
Body Feeling Changes (feeling cold, feeling weak/tired, feeling bloated, etc.)
Side Effect
General Anesth­esia Complica­tions
Complica­tion
Stroke
Complica­tion
Anemia
Side Effect
Blood Clots
Complica­tion
Deep Vein Throm­bosis
Complica­tion
Heart Attack
Complica­tion
Hemorr­hage (Bleed­ing)
Complica­tion
Hypogly­cemia
Complica­tion
Thrombo­phlebitis
Complica­tion
Band Problems (band ero­sion, band infec­tion, band intole­rance, band leak, band slipp­age)
Complica­tion
Port Problems (port flip/ inver­sion or dislodge­ment, port leak, port infec­tion, port disloca­tion)
Complica­tion
Intole­rance to Certain Foods
Side Effect
Marginal Ulcers
Side Effect
Nausea, Vomiting and/or Stomach Cramps
Side Effect
Stoma Obstruc­tion
Complica­tion
Abdominal hernia
Complica­tion
Bowel Function Changes (diarrhea, constipa­tion, foul-smell­ing bowel move­ments and flatu­lence, diffi­culty swallow­ing, gurgling noises)
Side Effect
Bowel Obstruc­tion
Complica­tion
Dyspepsia (Indiges­tion)
Side Effect
Dumping Syndrome
Side Effect
Esophagi­tis
Side Effect
Esopha­geal Dilation
Side Effect
Food Trapp­ing
Side Effect
Galls­tones
Side Effect
Gastric Fistula
Complica­tion
Gastritis
Side Effect
Gastroeso­phageal Reflux Disease (GERD)
Side Effect
Gastroin­testinal Leaks
Complica­tion
Hiatal Hernia
Complica­tion
Kidney Stones
Side Effect
Pouch Dilation
Complica­tion
Stenosis/Stric­ture
Complica­tion
Vitamin & Mineral Defici­ency / Malnutri­tion / Malabsorp­tion
Side Effect
Weight Regain
Side Effect
Organ Injury During Surgery
Complica­tion
Dehydra­tion
Side Effect
Infection
Complica­tion
Skin Changes (e.g. acne, dry skin, sagging skin, etc.)
Side Effect
Abscess
Complica­tion
Hair Loss
Side Effect
Thrush (Yeast Infec­tion)
Side Effect
Wound Reopen­ing
Complica­tion
Wound Sepsis
Complica­tion
Body Aches
Side Effect
Eviscera­tion & Incisional Hernia
Complica­tion
Peri­tonitis
Complica­tion
Pneu­monia
Complica­tion
Pulmonary Embolism
Complica­tion
Respiratory Failure
Complica­tion
Dental Problems
Side Effect
Complica­tion
System
Body Feeling Changes (feeling cold, feeling weak/tir­ed, feeling bloat­ed, etc.)
Central Nervous
General Anesthe­sia Complica­tions
Central Nervous
Stroke
Central Nervous
Anemia
Circula­tory
Blood Clots
Circula­tory
Deep Vein Thrombosis
Circula­tory
Heart Attack
Circula­tory
Hemorr­hage (Bleed­ing)
Circula­tory
Hypogly­cemia
Circula­tory
Thromboph­lebitis
Circula­tory
Band Problems (band erosion, band infec­tion, band intole­rance, band leak, band slipp­age)
Device
Port Problems (port flip/inver­sion or dislodge­ment, port leak, port infec­tion, port disloca­tion)
Device
Intole­rance to Certain Foods
Digestive
Marginal Ulcers
Digestive
Nausea, Vomiting and/or Stomach Cramps
Digestive
Stoma Obstruc­tion
Digestive
Abdo­minal hernia
Digestive
Bowel Function Changes (diarrhea, constipa­tion, foul-smell­ing bowel move­ments and flatu­lence, diffi­culty swallow­ing, gurgl­ing noises)
Digestive
Bowel Obstruc­tion
Digestive
Dyspepsia (Indiges­tion)
Digestive
Dumping Syndrome
Digestive
Esopha­gitis
Digestive
Esopha­geal Dila­tion
Digestive
Food Trapp­ing
Digestive
Galls­tones
Digestive
Gastric Fistula
Digestive
Gastritis
Digestive
Gastroesophageal Reflux Disease (GERD)
Digestive
Gastroin­testinal Leaks
Digestive
Hiatal Hernia
Digestive
Kidney Stones
Digestive
Pouch Dila­tion
Digestive
Stenosis/Stric­ture
Digestive
Vitamin & Mineral Defici­ency / Malnutri­tion / Malabsorpt­ion
Digestive
Weight Regain
Full body
Organ Injury During Surgery
Full body
Dehydra­tion
Full body
Infection
Full body (Immune)
Skin Changes (e.g. acne, dry skin, sagging skin, etc.)
integu­mentary (Skin)
Abscess
integu­mentary (Skin)
Hair Loss
integu­mentary (Skin)
Thrush (Yeast Infec­tion)
integu­mentary (Skin)
Wound Reopen­ing
integu­mentary (Skin)
Wound Sepsis
integu­mentary (Skin)
Body Aches
Muscular
Evisce­ration & Incisional Hernia
n/a
Perito­nitis
n/a
Pneumonia
respira­tory
Pulmonary Embolism
respira­tory
Respira­tory Failure
respira­tory
Dental Problems
Skeletal
Complica­tion
Sleeve
Body Feel­ing Changes (feel­ing cold, feeling weak/tir­ed, feeling bloated, etc.)
Yes
General Anesthe­sia Complica­tions
Yes
Stroke
Yes
Anemia
Blood Clots
Yes
Deep Vein Thrombo­sis
Yes
Heart Attack
Yes
Hemorr­hage (Bleed­ing)
About 1% of patients
Hypogly­cemia
Thrombo­phlebitis
Yes
Band Problems (band erosion, band infec­tion, band intole­rance, band leak, band slipp­age)
Port Problems (port flip/inver­sion or dislodge­ment, port leak, port infec­tion, port disloca­tion)
Intole­rance to Certain Foods
Yes
Marginal Ulcers
Yes
Nausea, Vomit­ing and/or Stomach Cramps
Yes
Stoma Obstruc­tion
Abdominal hernia
Yes
Bowel Function Changes (diarrhea, constipa­tion, foul-smell­ing bowel move­ments and flatu­lence, diffi­culty swallow­ing, gurgl­ing noises)
Yes
Bowel Obstruc­tion
Yes
Dyspepsia (Indiges­tion)
Yes
Dumping Syndrome
Esopha­gitis
Yes
Esopha­geal Dilation
Yes
Food Trapp­ing
Galls­tones
Up to 1/3 of bariatric patients
Gastric Fistula
Yes
Gastritis
Yes
Gastroe­sophageal Reflux Disease (GERD)
About 20% after 1 year; About 3% after three years
Gastroin­testinal Leaks
About 2% of patients
Hiatal Hernia
Yes
Kidney Stones
Pouch Dilation
Stenosis/Stric­ture
About 1% of patients
Vitamin & Mineral Deficiency / Malnutri­tion / Malabsorp­tion
Yes
Weight Regain
Yes
Organ Injury During Surgery
Yes
Dehydra­tion
Yes
Infection
Yes
Skin Changes (e.g. acne, dry skin, sagging skin, etc.)
Yes
Abscess
Yes
Hair Loss
Yes
Thrush (Yeast Infec­tion)
Yes
Wound Reopen­ing
Yes
Wound Sepsis
Yes
Body Aches
Yes
Eviscera­tion & Inci­sional Hernia
Yes
Peritonitis
Yes
Pneumonia
Yes
Pulmonary Embolism
Yes
Respira­tory Failure
Yes
Dental Problems
Complica­tion
Bypass
Body Feeling Changes (feeling cold, feeling weak/tir­ed, feel­ing bloa­ted, etc.)
Yes
General Anesth­esia Complica­tions
Yes
Stroke
Yes
Anemia
Yes
Blood Clots
Yes
Deep Vein Throm­bosis
Yes
Heart Attack
Yes
Hemorr­hage (Bleed­ing)
About 2% of patients
Hypogly­cemia
Yes
Throm­bophlebitis
Yes
Band Problems (band erosion, band infec­tion, band intole­rance, band leak, band slipp­age)
Port Problems (port flip/inver­sion or dislodge­ment, port leak, port infec­tion, port disloca­tion)
Intole­rance to Certain Foods
Yes
Marginal Ulcers
Yes
Nausea, Vomiting and/or Stomach Cramps
Up to 70% of pati­ents
Stoma Obstruc­tion
Abdominal hernia
Yes
Bowel Function Changes (diarrhea, constipa­tion, foul-smell­ing bowel move­ments and flatu­lence, diffi­culty swallow­ing, gurgl­ing noises)
Yes
Bowel Obstruc­tion
About 3% of patients
Dyspep­sia (Indiges­tion)
Yes
Dumping Syndrome
About 70% of patients
Esopha­gitis
Yes
Esopha­geal Dilation
Yes
Food Trapping
Up to 2% of patients
Gallstones
Up to 1/3 of bariatric patients
Gastric Fistula
Yes
Gastritis
Yes
Gastroe­sophageal Reflux Disease (GERD)
Yes
Gastroin­testinal Leaks
About 2% of patients
Hiatal Hernia
Yes
Kidney Stones
Yes
Pouch Dila­tion
Stenosis/Stric­ture
About 5% of patients
Vitamin & Mineral Defi­ciency / Malnutri­tion / Malabsorp­tion
Yes
Weight Regain
Yes
Organ Injury During Surgery
Yes
Dehydra­tion
Yes
Infec­tion
About 3% of patients
Skin Changes (e.g. acne, dry skin, sagg­ing skin, etc.)
Yes
Abscess
Yes
Hair Loss
Yes
Thrush (Yeast Infec­tion)
Yes
Wound Reopen­ing
Yes
Wound Sepsis
Yes
Body Aches
Yes
Eviscera­tion & Inci­sional Hernia
Yes
Peri­tonitis
Yes
Pneumonia
Yes
Pulmonary Embo­lism
Yes
Respira­tory Failure
Yes
Dental Problems
Yes
Complica­tion
Balloon
Body Feeling Changes (feeling cold, feeling weak/tir­ed, feeling bloat­ed, etc.)
Yes
General Anes­thesia Complica­tions
Stroke
Anemia
Blood Clots
Deep Vein Thrombo­sis
Heart Attack
Hemorr­hage (Bleed­ing)
Hypog­lycemia
Thrombo­phlebitis
Band Problems (band erosion, band infec­tion, band intole­rance, band leak, band slipp­age)
Port Problems (port flip/inver­sion or dislodge­ment, port leak, port infec­tion, port disloca­tion)
Intole­rance to Certain Foods
Yes
Marginal Ulcers
Yes
Nausea, Vomit­ing and/or Stomach Cramps
Yes
Stoma Obstruc­tion
Yes
Abdominal hernia
Bowel Function Changes (diarrhea, constipa­tion, foul-smelling bowel move­ments and flatu­lence, diffi­culty swallow­ing, gurgling noises)
Bowel Obstruc­tion
Dyspepsia (Indiges­tion)
Dumping Syndrome
Esopha­gitis
Esopha­geal Dilation
Food Trapp­ing
Gallstones
Gastric Fistula
Gastritis
Gastroe­sophageal Reflux Disease (GERD)
Gastroin­testinal Leaks
Hiatal Hernia
Kidney Stones
Pouch Dila­tion
Stenosis/Stric­ture
Vitamin & Mineral Defici­ency / Malnutri­tion / Malabsorp­tion
Weight Regain
Yes
Organ Injury During Surgery
Yes
Dehydra­tion
Infec­tion
Skin Changes (e.g. acne, dry skin, sagg­ing skin, etc.)
Depends on Amount of Weight Loss
Abscess
Hair Loss
Thrush (Yeast Infec­tion)
Wound Reopen­ing
Wound Sepsis
Body Aches
Eviscera­tion & Inci­sional Hernia
Peri­tonitis
Pneumo­nia
Pulmonary Embolism
Respira­tory Failure
Dental Problems
Complica­tion
Band
Body Feeling Changes (feeling cold, feeling weak/tir­ed, feeling bloat­ed, etc.)
Yes
General Anesthe­sia Complica­tions
Yes
Stroke
Yes
Anemia
Blood Clots
Yes
Deep Vein Throm­bosis
Yes
Heart Attack
Yes
Hemorr­hage (Bleed­ing)
Yes
Hypogly­cemia
Thrombo­phlebitis
Yes
Band Problems (band erosion, band infec­tion, band intole­rance, band leak, band slippage)
Up to 18% of patients
Port Problems (port flip/inver­sion or dislodge­ment, port leak, port infec­tion, port disloca­tion)
About 21% of patients
Intole­rance to Certain Foods
Yes
Marginal Ulcers
Nausea, Vomiting and/or Stomach Cramps
Yes
Stoma Obstruc­tion
Yes
Abdominal hernia
Yes
Bowel Func­tion Changes (diarrhea, constipa­tion, foul-smelling bowel move­ments and flatu­lence, difficulty swallow­ing, gurgl­ing noises)
Yes
Bowel Obstruc­tion
Yes
Dyspepsia (Indiges­tion)
Yes
Dumping Syndrome
Esopha­gitis
Yes
Esophageal Dila­tion
About 14% of patients
Food Trapping
Gallstones
Up to 1/3 of bariatric patients
Gastric Fistula
Yes
Gastritis
Yes
Gastroe­sophageal Reflux Disease (GERD)
Yes
Gastroin­testinal Leaks
Hiatal Hernia
Yes
Kidney Stones
Pouch Dilation
Up to 17% of patients
Stenosis/Stric­ture
Vitamin & Mineral Deficie­ncy / Malnutri­tion / Malabsorp­tion
Yes
Weight Regain
Yes
Organ Injury During Surgery
Yes
Dehydra­tion
Yes
Infec­tion
Yes
Skin Changes (e.g. acne, dry skin, sagg­ing skin, etc.)
Yes
Abscess
Yes
Hair Loss
Yes
Thrush (Yeast Infec­tion)
Yes
Wound Reopen­ing
Yes
Wound Sepsis
Yes
Body Aches
Yes
Eviscera­tion & Inci­sional Hernia
Yes
Peri­tonitis
Pneumonia
Yes
Pulmonary Embolism
Yes
Respira­tory Failure
Yes
Dental Problems
Complica­tion
DS
Body Feeling Changes (feeling cold, feeling weak/tir­ed, feeling bloat­ed, etc.)
Yes
General Anesthe­sia Complica­tions
Yes
Stroke
Yes
Anemia
Yes
Blood Clots
Yes
Deep Vein Throm­bosis
Yes
Heart Attack
Yes
Hemorr­hage (Bleed­ing)
Yes
Hypogly­cemia
Thrombo­phlebitis
Yes
Band Problems (band erosion, band infec­tion, band intole­rance, band leak, band slipp­age)
 
Port Problems (port flip/inver­sion or dislodge­ment, port leak, port infec­tion, port disloca­tion)
 
Intole­rance to Certain Foods
Yes
Marginal Ulcers
Yes
Nausea, Vomi­ting and/or Stomach Cramps
Yes
Stoma Obstruc­tion
Abdominal hernia
Yes
Bowel Function Changes (diarrhea, constipa­tion, foul-smelling bowel move­ments and flatu­lence, diffi­culty swallow­ing, gurgling noises)
Yes
Bowel Obstruc­tion
About 3% of patients
Dyspepsia (Indiges­tion)
Yes
Dumping Syndrome
Esopha­gitis
Yes
Esopha­geal Dila­tion
Yes
Food Trapp­ing
Gallstones
Up to 1/3 of bariatric patients
Gastric Fistula
Yes
Gastritis
Yes
Gastroes­ophageal Reflux Disease (GERD)
Yes
Gastroin­testinal Leaks
Yes
Hiatal Hernia
Yes
Kidney Stones
Yes
Pouch Dila­tion
Stenosis/Stric­ture
Yes
Vitamin & Mineral Defi­ciency / Malnutri­tion / Malabsorp­tion
Yes
Weight Regain
Yes
Organ Injury During Surgery
Yes
Dehydra­tion
Yes
Infection
Yes
Skin Changes (e.g. acne, dry skin, sagging skin, etc.)
Yes
Abscess
Yes
Hair Loss
Yes
Thrush (Yeast Infec­tion)
Yes
Wound Reopen­ing
Yes
Wound Sepsis
Yes
Body Aches
Yes
Eviscera­tion & Incisional Hernia
Yes
Perito­nitis
Yes
Pneumonia
Yes
Pulmonary Embolism
Yes
Respira­tory Failure
Yes
Dental Problems
Yes
Complica­tion
vBloc
Body Feeling Changes (feel­ing cold, feel­ing weak/tir­ed, feeling bloat­ed, etc.)
Yes
General Anesth­esia Complica­tions
Yes
Stroke
Yes
Anemia
Blood Clots
Yes
Deep Vein Thrombo­sis
Heart Attack
Yes
Hemorr­hage (Bleed­ing)
Yes
Hypogly­cemia
Thrombo­phlebitis
Yes
Band Problems (band erosion, band infec­tion, band intole­rance, band leak, band slipp­age)
Port Problems (port flip/inver­sion or dislodge­ment, port leak, port infec­tion, port disloca­tion)
Intole­rance to Certain Foods
Marginal Ulcers
Nausea, Vomiting and/or Stomach Cramps
Stoma Obstruc­tion
Abdominal hernia
Bowel Function Changes (diarrhea, constipa­tion, foul-smell­ing bowel move­ments and flatu­lence, diffi­culty swallow­ing, gurgl­ing noises)
Bowel Obstruc­tion
Dyspepsia (Indiges­tion)
Dumping Syndrome
Esopha­gitis
Esophageal Dila­tion
Food Trapp­ing
Galls­tones
Gastric Fistula
Yes
Gastritis
Gastroes­ophageal Reflux Disease (GERD)
Gastro­intestinal Leaks
Hiatal Hernia
Kidney Stones
Pouch Dilation
Stenosis/Stric­ture
Vitamin & Mineral Defici­ency / Malnutri­tion / Malabsorp­tion
Weight Regain
Yes
Organ Injury During Surgery
Yes
Dehydra­tion
Infec­tion
Yes
Skin Changes (e.g. acne, dry skin, sagging skin, etc.)
Depends on Amount of Weight Loss
Abscess
Yes
Hair Loss
Thrush (Yeast Infec­tion)
Yes
Wound Reopen­ing
Yes
Wound Sepsis
Yes
Body Aches
Yes
Eviscera­tion & Inci­sional Hernia
Yes
Peritonitis
Pneumonia
Yes
Pulmonary Embolism
Yes
Respira­tory Failure
Yes
Dental Problems

For definitions of any issue in the chart, see our Bariatric Surgery Complications page.

Preventing Complications

Preventing Complications

In many cases, complications after any type of bariatric surgery arise because the patient didn’t follow their doctor’s instructions.

Behaviors that will dramatically reduce your risk of complications include:

  1. Pick a good surgeon
  2. Follow your surgical team’s advice to the letter
  3. Educate yourself
  4. Educate your family
  5. Lose as much weight as possible prior to surgery
  6. Eat a healthy diet in the months leading up to surgery
  7. Get tested for sleep apnea syndrome several weeks before surgery (and address the issue if it exists before moving forward)
  8. Plan for at least 2 weeks of recovery time
  9. Exercise as quickly as possible after surgery, starting slowly at first and working your way up
  10. Use compression stockings, pneumatic compression devices, and/or blood thinners after surgery (talk with your surgeon) to reduce risk of blood clots (for all procedures except gastric balloon)
  11. Have an effective support system of friends, family, and weight loss surgery support groups

Side Effects: Digestion & Sagging Skin

Side Effects: Digestion & Sagging Skin

Digestion Issues

Digestion issues are possible after all procedures except vBloc Therapy. Most of the following issues are avoidable with the right diet and lifestyle changes:

 
 
Bowel Movement Problems
Bowel Movement Problems
Difficulty Swallowing
Difficulty Swallowing
Indigestion (Dyspepsia)
Indigestion (Dyspepsia)
Gallstones
Gallstones
Gastroeso­phageal Reflux Disease (GERD)
Gastroeso­phageal Reflux Disease (GERD)
Intolerance to certain foods
Intolerance to certain foods
Nausea and vomiting
Intolerance to certain foods
Vitamin and/or mineral deficiency
Intolerance to certain foods
 
Sleeve
Bowel Movement Problems
Yes
Difficulty Swallowing
Yes
Indigestion (Dyspepsia)
Yes
Gallstones
Yes
Gastroesophageal Reflux Disease (GERD)
Yes
Intolerance to certain foods
Yes
Nausea and vomiting
Yes
Vitamin and/or mineral deficiency
Unlikely
 
Bypass
Bowel Movement Problems
Yes
Difficulty Swallowing
Yes
Indigestion (Dyspepsia)
Yes
Gallstones
Yes
Gastroesophageal Reflux Disease (GERD)
Yes
Intolerance to certain foods
Yes
Nausea and vomiting
Yes
Vitamin and/or mineral deficiency
Yes
 
DS
Bowel Movement Problems
Yes
Difficulty Swallowing
Yes
Indigestion (Dyspepsia)
Yes
Gallstones
Yes
Gastroesophageal Reflux Disease (GERD)
Yes
Intolerance to certain foods
Yes
Nausea and vomiting
Yes
Vitamin and/or mineral deficiency
Yes
 
Band
Bowel Movement Problems
Yes
Difficulty Swallowing
No
Indigestion (Dyspepsia)
Yes
Gallstones
Yes
Gastroesophageal Reflux Disease (GERD)
Yes
Intolerance to certain foods
Yes
Nausea and vomiting
Yes
Vitamin and/or mineral deficiency
Unlikely
 
Balloon
Bowel Movement Problems
Yes
Difficulty Swallowing
Yes
Indigestion (Dyspepsia)
No
Gallstones
No
Gastroesophageal Reflux Disease (GERD)
No
Intolerance to certain foods
Yes
Nausea and vomiting
Yes
Vitamin and/or mineral deficiency
No
 
vBloc
Bowel Movement Problems
No
Difficulty Swallowing
No
Indigestion (Dyspepsia)
No
Gallstones
No
Gastroesophageal Reflux Disease (GERD)
No
Intolerance to certain foods
No
Nausea and vomiting
No
Vitamin and/or mineral deficiency
No

Sagging Skin

Sagging skin is an issue for most patients who lose a lot of weight quickly, especially after the more involved procedures like gastric sleeve, gastric bypass, duodenal switch, and Lap-Band.

It is less likely after gastric balloon and vBloc therapy because patients tend to not lose as much weight after those procedures.

Weight Regain

Weight Regain

Five to ten percent weight regain is common after most procedures, although it is much less likely after duodenal switch surgery due to that procedure’s unique combination of restriction and malabsorption.

Weight regain is usually the result of patients not following proper diet guidelines.

Revision Surgery
Available for Most Procedures

Revision Surgery: Available for Most Procedures

Revision surgery may be an option for gastric sleeve, gastric bypass, duodenal switch, Lap-Band, or vBloc Therapy patients who:

  • Regain weight after surgery
  • Have a complication that requires it

Revisions are not available for gastric balloon patients because the balloon is removed after 6 months regardless of weight loss. However, many balloon patients convert to a more involved procedure to help continue weight loss after the balloon is removed.

Summary
Full Comparison & Procedure Patient Guides

Your individual situation will determine which type of bariatric surgery is best for you. Unfortunately, there is no “one size fits all” option. Following is a review of winners in each category:

Most Weight Loss

  • Winner: Duodenal Switch
  • Runners Up: (Tie) Gastric Sleeve & Gastric Bypass

Best Health Improvement

  • Winner: Duodenal Switch
  • Runners Up: (Tie) Gastric Sleeve & Gastric Bypass

Easiest to Qualify

  • Winner: No Clear Winner; Depends on Your Current BMI

Low-Cost Procedure (Without Insurance)

  • Winner: Gastric Balloon (but long-term costs likely higher than more expensive procedures)
  • Runners Up: Lap Band (but long-term costs likely higher than more expensive procedures)

Low-Cost Procedure (With Insurance)

  • Winner: 4-Way Tie – Gastric Sleeve, Gastric Bypass, Duodenal Switch, & Lap-Band
  • Runners Up: Gastric Balloon

Insurance Coverage

  • Winner: (4-Way Tie) Sleeve, Bypass, Band, & Duodenal Switch

Most Popular Procedure

  • Winner: Gastric Sleeve
  • Runners Up: Gastric Bypass

Quickest Recovery

  • Winner: (Tie) vBloc Therapy & Gastric Balloon
  • Runners Up: Lap-Band

Best Post-Op Diet

  • Winner: Depends on Patient’s Goals; Easier Diet’s Usually Mean Less Weight Loss

Fewest Risks & Side Effects

  • Winner: vBloc Therapy
  • Runners Up: (Tie) Gastric Balloon & Gastric Sleeve

Overall Winner for You

Help & Support
Patient Experiences & Ask the Expert

Patient Experiences & Ask the Expert

If you still have questions about the type of bariatric surgery, our experts are happy to answer them. We (and other patients) would also love to hear about your experiences with the balloon.

Please use the form below to share your experience or ask a question.

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