Gastric Sleeve Vs. Bypass - All You Need to Know

Last Updated:  

09/26/2017

The most important takeaways when evaluating gastric sleeve vs bypass include:

  • How they work: Both make you feel full sooner while eating. Only sleeve makes you feel less hungry generally, and only bypass reduces the amount of minerals your body absorbs.
  • Qualify: Same requirements (30+ BMI with health problems, 40+ without)
  • Hospital & recovery: Sleeve is a less complicated procedure with a shorter operating time. In-hospital and post-op recovery is similar.
  • Weight loss & health improvement: Similar at 2 years post-op, but bypass patients tend to keep more weight off over the long-term.
  • Insurance: Same (if your policy covers bariatric surgery, both sleeve and bypass will be covered).
  • Cost: Same with insurance, bypass is about 25% more expensive without insurance.
  • Diet & life after: Similar diet and exercise regimen, but bypass requires stricter supplementation and vitamin level monitoring.
  • Complications & side effects: Both have a 99.8% survival rate. Bypass has a higher risk of complications and side effects.
Gastric Sleeve Vs Bypass

Read and click the sections below for everything you need to know to decide which procedure is best for you.

01How They Work
  • Sleeve: Feel less hungry & feel full sooner while eating
  • Bypass: Feel full sooner while eating & absorb fewer minerals

Understanding gastric sleeve surgery vs gastric bypass surgery starts with the fundamental differences in how each alters your anatomy:

Gastric Sleeve

Gastric Sleeve

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

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:

  1. Cut and staple the top portion of the stomach to create a small pouch at the end of the esophagus
  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
  4. 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.

02Weight Loss
  • Gastric sleeve vs bypass: Similar 2-year weight loss
  • Bypass patients tend to regain less weight after 2 years

Patients lose weight quickly after gastric bypass and gastric sleeve, with the low point coming 12 to 18 months after the surgery:

  • 3 months: Lose 30% of excess weight
  • 6 months: Lose 50% of excess weight
  • 1.5 years: Lose 65% to 70% of excess weight

However, bypass patients tend to regain less weight 2+ years after the procedure because:

  • The gastric bypass pouch is smaller and therefore less able to stretch out
  • Gastric bypass is “mineral malabsorptive” while gastric sleeve is not (body absorbs fewer minerals after gastric bypass)
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03Health Benefits
  • Gastric Sleeve Vs Bypass: Bypass slightly better

Studies evaluating gastric bypass vs. gastric sleeve have found very similar health improvement for diabetes, hypertension, sleep apnea, and most other obesity-related health problems, depending on which study is referenced.

However, gastric bypass:

  • Has a longer list of improved health conditions
  • Is more likely to improve most obesity-related health conditions

The chart below compares study results by condition for each procedure:

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 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%

04Qualify
  • Gastric Bypass Vs. Sleeve: Same BMI requirements
  • Click here to calculate your BMI

gastric sleeve vs bypass

Enter your height & weight, then click the button:

Enter your height & weight, then click the button:

30+

GASTRIC SLEEVE & BYPASS
Required BMI

  • Below 18.5Underweight

  • 18.5 – 24.9Healthy Weight

  • 25.0 – 29.9Overweight

  • 30.0 – 34.9Obese

  • 35.0 – 39.9Severely Obese

  • 40.0 – 49.9Morbidly Obese

  • 50 or higherSuper Obese

Click to Collapse SectionClick to Learn More

In order to have gastric bypass surgery or gastric sleeve surgery, your body mass index (BMI) must fall within one of the following ranges:

  • Body mass index 40 or above or
  • Body mass index from 35 to 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.
  • Body mass index from 30 to 35 may be accepted if certain health issues are present

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

05Insurance
  • Gastric Sleeve Vs. Bypass: Both are covered, as long as your policy includes bariatric surgery
  • Click here to check your insurance

gastric sleeve vs bypass

GASTRIC SLEEVE COST-AFTER-INSURANCE ESTIMATOR

Projected Out Of Pocket Costs After Insurance

PROJECTED OUT OF POCKET COSTS AFTER INSURANCE

Click Below to Update Your Plan's Details from U.S. Averages

Data is for illustrative purposes only. Please check with your insurance company for specific costs and benefit information.

The following variables may or may not impact your projected out of pocket costs.

GASTRIC SLEEVE/BYPASS
INSURANCE TOOLS

Cost-After-Insurance Estimator

Check My Insurance Tool

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.

Click to Collapse SectionClick to Learn More

As long as your specific insurance policy includes weight loss surgery, gastric sleeve surgery and gastric bypass surgery will be covered.

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 (insurance companies will usually not cover BMI’s below 35):
      • 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 legwork for you. They are 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 find a top gastric sleeve or gastric bypass surgeon near you 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.

06Cost Without Insurance
  • Sleeve: ~$445/mo (~$19,000 total)
  • Bypass: ~$556/mo (~$24,000 total)

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

Still, if you don’t have insurance that covers bariatric surgery, there will be a noticeable difference in gastric bypass vs gastric sleeve cost:

  • Gastric sleeve: Average cost is about $19,000
  • Gastric bypass: Average cost is about $24,000

Surgeons in your area may charge as low as $10,000 for gastric sleeve or $15,000 for gastric bypass.

Financing may also be available, depending on your credit. Payments are likely to be around the following if your procedure is financed over 5 years:

  • Gastric sleeve: $445/mo
  • Gastric bypass: $556/mo

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 gastric bypass and gastric sleeve 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 (1).

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 (2). 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 (3).

07Recovery
  • Gastric bypass vs sleeve: Same pain, diet & activity, time off work, and time to full recovery

Recovery from both gastric sleeve surgery and gastric bypass surgery includes:

  • Timeline: 4 to 6 weeks to full recovery
    • Hospital Stay: 2 to 3 days
    • Time Off Work: 1 to 3 weeks
  • Pain: Same as experienced after any laparoscopic surgery, managed with medication
  • Diet: Slow transition from clear liquids to solid foods
  • Activity: Slow transition back to regular activity and exercise

See the following pages for more information about gastric bypass vs gastric sleeve recovery:

08Diet & Life After
  • Gastric bypass vs sleeve: Similar diet and exercise regimen
  • Gastric sleeve: You’ll feel less hungry
  • Gastric bypass: Requires more robust vitamin/mineral supplementation

Diet: Gastric Sleeve Vs. Bypass

Your gastric sleeve vs gastric bypass diet transition is virtually identical:

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

The foods you’ll need to avoid are also very similar, although gastric bypass has some additional diet-related aspects to consider.

Diet issues unique to gastric bypass include:

  • Avoid foods that are likely to cause dumping, including sugar, unnecessary fat, or refined carbohydrates (although you should avoid these after gastric sleeve as well, they won’t cause dumping for sleeve patients).
  • Patients who undergo the bypass procedure are at especially high risk of developing Alcohol Use Disorder (AUD) (4) (5) (6)

Following are dietary guidelines for both gastric bypass and gastric sleeve:

  • 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)
  • Alcohol only in moderation

See the following pages for more information:

Vitamins: Gastric Sleeve Vs Bypass

Due to gastric bypass surgery’s higher levels of malabsorption, gastric bypass patients:

  • Are much more likely than gastric sleeve patients to require Thiamin (Vitamin B1) supplementation
  • Must be more vigilant in confirming no vitamin or mineral deficiencies

The rest of the vitamin requirements are usually the same for gastric bypass and gastric sleeve, including:

  • 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

For either procedure, you may be required to take one or more of the following depending on your vitamin levels:

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

Exercise: Gastric Sleeve Vs Gastric Bypass

After you’ve full recovered from surgery (4 to 6 weeks), recommended exercise is the same for both gastric bypass and gastric sleeve patients: 2.5 hours per week, spread out over 2 to 4 days.

Following this regimen will cause you to:

  • Lose more weight
  • Be more physically and mentally healthy

Learn more on our Exercise After Weight Loss Surgery page.

Hunger: Gastric Bypass Vs Sleeve

After gastric sleeve, you are likely to feel less hungry as a result of 80% of your stomach being removed. This is not the case after gastric bypass because all of the stomach remains in place (although the stomach will be separated into two parts).

Here’s why gastric sleeve reduces hunger:

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 after gastric sleeve surgery, the amount of ghrelin the stomach secretes – and your resulting feelings of hunger – may also go down.

Food Addiction: Gastric Bypass Vs Sleeve

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.

09Downsides
  • Gastric sleeve vs bypass: Many complications/side effects are the same
  • Bypass has additional side effects/complications risks
  • Sleeve patients more likely to regain weight

Gastric sleeve vs bypass challenges are similar, with a few exceptions.

After each procedure:

  • Most side effects like nausea, digestive issues, and body changes go away over time or after adjusting diet/lifestyle habits.
  • Sagging skin is an issue for some patients, depending how much weight is lost, age, and whether the patient is a smoker

The following challenge is unique to gastric sleeve:

  • Weight regain is more likely after sleeve due to the larger sleeve stomach and since it does not include a malabsorptive component

The following challenges are unique to gastric bypass:

  • Dumping syndrome is an issue for most patients when they eat the wrong foods. It happens as a result of food (especially sugar) moving too quickly from the stomach into the small intestines and includes symptoms like nausea, diarrhea, bloating, fainting, anxiety, and weakness. It is usually treated effectively by diet changes and/or lying down after eating.
  • More likely to develop a vitamin or mineral deficiency, so your surgeon will monitor your vitamin levels more closely and prescribe additional supplements as necessary.
  • More likely to experience dental problems due to mineral malabsorption.

Full Gastric Bypass Vs Sleeve Downsides Comparison

Issue
Issue
Abdominal Discomfort
Abdominal Discomfort
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
Body Feeling Changes
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
Dumping Syndrome
Dumping Syndrome
Dyspepsia (Indigestion)
Dyspepsia (Indigestion)
Esophageal Dilation
Esophageal Dilation
Esophagitis
Esophagitis
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.)
Stenosis/­Stricture
Stenosis/­Stricture
Stoma Obstruc­tion
Stoma Obstruc­tion
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
Issue
Sleeve
Abdominal Discomfort
Abdominal hernia
Yes
Abscess
Yes
Anemia
Band Problems (band erosion, band infection, band intolerance, band leak, band slippage)
Blood Clots
Yes
Body Aches
Yes
Body Feeling Changes
Yes
Bowel Function Changes (diarrhea, constipation, foul-smelling bowel movements and flatulence, difficulty swallowing, gurgling noises)
Yes
Bowel Obstruction
Yes
Deep Vein Thrombosis
Yes
Dehy­dration
Yes
Dental Problems
Dumping Syndrome
Dyspepsia (Indigestion)
Yes
Esophageal Dilation
Yes
Esophagitis
Yes
Eviscera­tion & Incisional Hernia
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
General Anesthesia Complica­tions
Yes
Hair Loss
Yes
Heart Attack
Yes
Hemorr­hage (Bleeding)
About 1% of patients
Hiatal Hernia
Yes
Hypogly­cemia
Infection
Yes
Intole­rance to Certain Foods
Yes
Kidney Stones
Marginal Ulcers
Yes
Nausea, Vomiting and/or Stomach Cramps
Yes
Organ Injury During Surgery
Yes
Peritonitis
Yes
Pneumonia
Yes
Port Problems (port flip/ inver­sion or dislodge­ment, port leak, port infec­tion, port disloca­tion)
Pouch Dila­tion
Pulmonary Embolism
Yes
Respira­tory Failure
Yes
Skin Changes (e.g. acne, dry skin, sagging skin, etc.)
Yes
Stenosis/­Stricture
About 1% of patients
Stoma Obstruc­tion
Stroke
Yes
Thrombo­phlebitis
Yes
Thrush (Yeast Infec­tion)
Yes
Vitamin & Mineral Deficiency / Malnutri­tion / Malabsorp­tion
Yes
Weight Regain
Yes
Wound Reopen­ing
Yes
Wound Sepsis
Yes
Issue
Bypass
Abdominal Discomfort
Abdominal hernia
Yes
Abscess
Yes
Anemia
Yes
Band Problems (band erosion, band infection, band intolerance, band leak, band slippage)
Blood Clots
Yes
Body Aches
Yes
Body Feeling Changes
Yes
Bowel Function Changes (diarrhea, constipation, foul-smelling bowel movements and flatulence, difficulty swallowing, gurgling noises)
Yes
Bowel Obstruction
About 3% of patients
Deep Vein Thrombosis
Yes
Dehy­dration
Yes
Dental Problems
Yes
Dumping Syndrome
About 70% of patients
Dyspepsia (Indigestion)
Yes
Esophageal Dilation
Yes
Esophagitis
Yes
Eviscera­tion & Incisional Hernia
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
General Anesthesia Complica­tions
Yes
Hair Loss
Yes
Heart Attack
Yes
Hemorr­hage (Bleeding)
About 2% of patients
Hiatal Hernia
Yes
Hypogly­cemia
Yes
Infection
About 3% of patients
Intole­rance to Certain Foods
Yes
Kidney Stones
Yes
Marginal Ulcers
Yes
Nausea, Vomiting and/or Stomach Cramps
Up to 70% of patients
Organ Injury During Surgery
Yes
Peritonitis
Yes
Pneumonia
Yes
Port Problems (port flip/ inver­sion or dislodge­ment, port leak, port infec­tion, port disloca­tion)
Pouch Dila­tion
Pulmonary Embolism
Yes
Respira­tory Failure
Yes
Skin Changes (e.g. acne, dry skin, sagging skin, etc.)
Yes
Stenosis/­Stricture
About 5% of patients
Stoma Obstruc­tion
Stroke
Yes
Thrombo­phlebitis
Yes
Thrush (Yeast Infec­tion)
Yes
Vitamin & Mineral Deficiency / Malnutri­tion / Malabsorp­tion
Yes
Weight Regain
Yes
Wound Reopen­ing
Yes
Wound Sepsis
Yes

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

10Summary
  • Gastric sleeve vs bypass: Winner & Loser by Category
  • Overall Winner: Depends on your situation

Your individual situation will determine whether gastric bypass or gastric sleeve surgery is best for you. Following is a review of which procedure is “better” in each category discussed on this page.

  • Most Popular Procedure: Gastric Sleeve
  • Most Short-Term Weight Loss: Tie
  • Most Long-Term Weight Loss: Gastric Bypass
  • Best Health Improvement Gastric Bypass
  • Easiest to Qualify: Tie
  • Low-Cost Procedure (With Insurance): Tie
  • Low-Cost Procedure (Without Insurance): Gastric Sleeve
  • Best Post-Op Diet: Gastric Sleeve
  • Fewest Risks & Side Effects: Gastric Sleeve

Discuss each of the pros and cons with your surgeon before making a final decision. Click here to find a top surgeon.

11Help & Support
  • Patient Experiences
  • Ask the Expert

If you still have questions about gastric sleeve vs gastric bypass, our experts are happy to answer them. We (and other patients) would also love to hear about your experiences.

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

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