Gastric Bypass Surgery - 14 Ways It Will Affect You

Reviewed by:  

John M. Rabkin, MD, FACS

Last Updated:  

12/12/2017

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

  • Feel full sooner when eating and eat less
  • Absorb fewer minerals
  • Lose up to 67% of their excess weight within 2 years
  • Have significant health improvement

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

01How Gastric Bypass Surgery Works
  • Reduced stomach size makes the patient feel full sooner while eating
  • Rearranged intestines causes the body to absorb fewer minerals
  • Dumping syndrome symptoms deter patients from eating unhealthy foods

laparoscopic gastric bypass surgery
laparoscopic gastric bypass surgery
1

Insert Instruments

4 to 6 small incisions made and laparoscopic instruments inserted.

laparoscopic gastric bypass surgery
2

Separate large portion of stomach

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.

laparoscopic gastric bypass surgery
3

Reduced hunger and weight loss

Separate top portion of small intestine from the bottom portion, then attach the bottom portion to the smaller stomach pouch. Attach the loose end of the top portion of the small intestine 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.

laparoscopic gastric bypass surgery
4

Feel full sooner, absorb fewer minerals, lose weight

Smaller stomach causes patient to feel less hungry and full sooner while eating, and rerouted small intestine causes the body to absorb fewer minerals. This combination leads to significant, rapid, and long-term weight loss.

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Why Gastric Bypass Works

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

Preparing for Surgery

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

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

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

  • The more weight you lose pre-op, the more weight you will lose after surgery
  • The lower your pre-op weight, the lower your risk of complications
  • Gastric bypass surgery will not work over the long-term if you slip back into old habits. For about 70% of gastric bypass patients, eating unhealthy foods also lead to vomiting, diarrhea and other uncomfortable symptoms (1). The sooner you can start establishing good diet and exercise habits, the more likely you will be to maintain them after surgery

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

How It’s Performed

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

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

Following are the steps your surgeon will perform:

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

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

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

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

02Weight Loss
  • Up to 65% of excess weight within 1 year

laparoscopic gastric bypass surgery

Enter your height & weight, then click the button:

Enter your height & weight, then click the button:

100%

Excess Weight Remains

Procedure Done

From Day 1: Feel Full Sooner While Eating & Absorb Fewer Minerals

Continued Weight Loss

Low Weight Reached Between Year 1 & Year 2

laparoscopic gastric bypass surgery

0 months

100%

Excess Weight Remains

Your Body Mass Index (BMI) is XXX.

gastric bypass is only available for patients with a BMI of 35 or higher.

However, you do qualify for other types of weight loss procedures.

Click here to learn your options.

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

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

Gastric Bypass Weight Loss Studies

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

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

See our Gastric Bypass Before and After Pictures page to get a better idea of how you’ll look after surgery.

References: (2) (3) (4) (5) (6) (7) (8) (9)

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03Health Benefits
  • Cures or improves diabetes, sleep apnea, hypertension, and at least 12 other conditions

laparoscopic gastric bypass surgery

SELECT A BENEFIT

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

Note that patients who have a strict follow-up schedule with their surgeon at 3-, 6-, and 12-months post-op see greater improvements in or remission of their diabetes, high blood pressure (hypertension), and high cholesterol than patients who skip these visits (10).

Mortality Reduction/Life Expectancy (5 year mortality)

89% reduction in risk of death vs obese patients who did not have bariatric surgery (11a, 11b)

Quality of Life Improvements

95% of patients (12)

Asthma

Completely resolved or improved in 80% to 100% of patients (13)

Cardiovascular Disease

Up to 79% reduction in cardiovascular risks (14)

Degenerative Joint Disease

Complete resolution in 43% of patients (15)

Depression

Improvement for majority of patients (16)

Diabetes

83% experience complete resolution by 1 year (17a, 17b)

Gastroesophageal Reflux Disease (GERD)

Completely resolved or improved in 80% to 100% of patients (19)

High Blood Pressure (hypertension)

Up to 69% of patients experience complete resolution by 1 year (20, 21)

Hyperlipidemia (high levels of fat in the blood)

73% experience improvement or complete resolution (22)

Joint Health

Gastric bypass weight loss improves joint health. For every pound of weight lost, there is a 4 pound reduction in pressure on the knee (23). This improves mobility and reduces pain in the knees.

Metabolic Syndrome

80% resolved (24)

Migraines

57% resolved (25)

Non-Alcoholic Fatty Liver Disease

90% improved steatosis, 37% resolution of inflammation, 20% resolution of fibrosis (26)

Obstructive Sleep Apnea

Up to 98% resolved (27, 28)

Polycystic Ovarian Syndrome

Improvement or resolution in nearly all women (29, 30)

Pregnancy

  • Infertility – Obesity-related infertility resolved in up to 100% of women (31,32)
  • Menstrual irregularities – reduced by 65%.
  • Gestational Diabetes – 25% less likely to develop
  • Pregnancy-Induced Hypertension – 73% less likely to develop

Pseudotumor cerebri

96% resolved (33)

Psoriasis & Psoriatic Arthritis

Significantly reduced risk and improved prognosis of psoriasis and psoriatic arthritis (34)

Stress Urinary Incontinence

Up to 88% resolved (35)

Venous Stasis Disease

Resolved in up to 95% of patients (36)

Cancer

88,000 participants were involved in data collection on cancer research. Results state that patients who undergo weight loss surgery have 33% less risk of developing cancer (37).

Risk rates were even further reduced for obesity-related cancers, including (38):

  • Colon cancer
  • Postmenopausal breast cancer
  • Endometrial cancer
  • Pancreatic cancer

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

References: (39) (40) (41) (42) (43) (44) (45)

04Qualify
  • 30+ body mass index (BMI) required
  • Click here to calculate your BMI

laparoscopic gastric bypass surgery

Enter your height & weight, then click the button:

Enter your height & weight, then click the button:

30+

gastric 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

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

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

Serious obesity-related health problems most commonly include:

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

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

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

05Insurance
  • Gastric bypass is covered if your policy includes bariatric surgery
  • Click here to use our Check My Insurance Tool

gastric bypass

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PROJECTED OUT OF POCKET COSTS AFTER INSURANCE

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United States: Covered If Your Plan Includes Bariatric Surgery

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

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Choose your plan, state, and insurance company below.

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

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

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

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

Click the links below for more information:

If Your Policy Covers It: Ask for Free Insurance Check

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

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

If Your Policy Does NOT Cover It: Seek Partial Coverage

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

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

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

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

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

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

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

The U.S. Insurance Approval Process

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

Following are the typical steps:

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

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

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

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

Disability Insurance During Recovery

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

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

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

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

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

Canada: Covered, But Long Wait Times

Gastric bypass surgery is currently covered in the following provinces:

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

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

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

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

Australia: Covered by Medicare & Private Insurance

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

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

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

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

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

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

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

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

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

06Cost Without Insurance
  • Total Cost: $24,000, on average
  • Loan Payment: $556/month, on average
  • Discounts & Tax Savings: Usually available

laparoscopic gastric bypass surgery

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about discounts:

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DISCOUNTS
6 Discounts to Ask Your Surgeon About

Talk with your surgeon about whether any of these discounts are available:

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

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

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

  • Whether your procedure is open or laparoscopic – open gastric bypass surgery tends to cost about $2,500 more than laparoscopic surgery, on average (46)
  • Which hospital you have the surgery in
  • Whether or not you have insurance – if your surgeon and hospital are covered by your insurance, it is likely that a discount has been negotiated to allow that surgeon and hospital to participate in your insurance company’s network
  • Whether you obtain financing for some or all of the costs
  • Specific fees your bariatric surgeon and other professionals charge for the various pre-op, surgical, and post-op services.

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

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

Click here to see Costs by each US State

RegionRegion
Average CostAverage Cost
RegionALABAMA
Average Cost$21,650

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

RegionALASKA
Average Cost$56,820

ALASKA surgeons surveyed are located in Anchorage

RegionARIZONA
Average Cost$24,621

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

RegionARKANSAS
Average Cost$15,117

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

RegionCALIFORNIA
Average Cost$21,600

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

RegionCOLORADO
Average Cost$20,710

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

RegionCONNECTICUT
Average Cost$23,864

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

RegionDELAWARE
Average Cost$19,242

DELAWARE surgeons surveyed are located in Dover, Newark and Wilmington

RegionFLORIDA
Average Cost$21,801

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

RegionGEORGIA
Average Cost$20,264

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

RegionHAWAII
Average Cost$21,277

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

RegionIDAHO
Average Cost$19,681

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

RegionILLINOIS
Average Cost$24,432

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

RegionINDIANA
Average Cost$25,591

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

RegionIOWA
Average Cost$25,908

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

RegionKANSAS
Average Cost$22,167

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

RegionKENTUCKY
Average Cost$25,201

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

RegionLOUISIANA
Average Cost$21,650

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

RegionMAINE
Average Cost$29,436

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

RegionMARYLAND
Average Cost$30,125

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

RegionMASSACHUSETTS
Average Cost$26,591

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

RegionMICHIGAN
Average Cost$25,875

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

RegionMINNESOTA
Average Cost$23,161

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

RegionMISSISSIPPI
Average Cost$21,850

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

RegionMISSOURI
Average Cost$23,150

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

RegionMONTANA
Average Cost$28,167

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

RegionNEBRASKA
Average Cost$23,050

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

RegionNEVADA
Average Cost$16,375

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

RegionNEW HAMPSHIRE
Average Cost$31,500

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

RegionNEW JERSEY
Average Cost$26,467

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

RegionNEW MEXICO
Average Cost$17,640

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

RegionNEW YORK
Average Cost$32,194

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

RegionNORTH CAROLINA
Average Cost$28,312

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

RegionNORTH DAKOTA
Average Cost$35,000

NORTH DAKOTA surgeons surveyed are located in Bismarck and Grand Forks

RegionOHIO
Average Cost$23,083

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

RegionOKLAHOMA
Average Cost$19,300

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

RegionOREGON
Average Cost$34,433

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

RegionPENNSYLVANIA
Average Cost$23,390

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

RegionSOUTH CAROLINA
Average Cost$25,167

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

RegionSOUTH DAKOTA
Average Cost$25,500

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

RegionTENNESSEE
Average Cost$25,045

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

RegionTEXAS
Average Cost$17,490

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

RegionUTAH
Average Cost$18,148

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

RegionVERMONT
Average Cost$26,400

VERMONT surgeons surveyed are located in Burlington, Montpelier and Springfield

RegionVIRGINIA
Average Cost$20,625

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

RegionWASHINGTON
Average Cost$25,567

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

RegionWASHINGTON DC
Average Cost$20,463
RegionWEST VIRGINIA
Average Cost$19,104

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

RegionWISCONSIN
Average Cost$26,333

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

RegionWYOMING
Average Cost$29,375

WYOMING surgeons surveyed are located in Afton, Cheyenne and Riverton

Click here to see Costs by each Australian State/Territory

RegionRegion
Average CostAverage Cost
RegionNEW SOUTH WALES
Average Cost$4,500

NEW SOUTH WALES surgeons surveyed are located in Sydney

RegionQUEENSLAND
Average Cost$5,246

QUEENSLAND surgeons surveyed are located in Brisbane and Gold Coast

RegionSOUTH AUSTRALIA
Average Cost$3,250

SOUTH AUSTRALIA surgeons surveyed are located in Adelaide and Barossa Valley

TASMANIA surgeons surveyed are located in Hobart

RegionVICTORIA
Average Cost$5,160

VICTORIA surgeons surveyed are located in Melbourne

WESTERN AUSTRALIA surgeons surveyed are located in Perth

Total surgery costs can be further complicated by:

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

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

Pre-Op (Costs Before Surgery)

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

Costs During Surgery

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

Post-Op (Costs After Surgery)

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

Gastric Bypass Costs Vs. Cost of Not Having Surgery

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

Compared to morbidly obese people who don’t have surgery, bariatric patients pay off their entire surgery and start getting ahead financially after only 2 years (47).

Fewer prescription drugs alone have been found to save patients $3,000 or more per year (48).

A study published by the American Journal of Managed Care (AJMC) found that bariatric patients pay as much as $900 less per month as soon as 13 months after surgery than similar people who didn’t have surgery (49). That’s almost $11,000 per year in total medical costs saved for bariatric patients versus morbidly obese people who do not have surgery.

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

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

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

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

Financing Options

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

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

Taxes: Several Ways to Save

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

United States: Might Be Deductible

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

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

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

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

Canada: Is Deductible

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

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

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

Australia: Might Be Deductible

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

According to the ATO:

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

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

07Recovery
  • Hospital Stay: 2 to 3 days
  • Time Off Work: 1 to 3 weeks
  • Full Recovery: 4 to 6 weeks
  • Pain: Manageable – same as any laparoscopic surgery
  • Diet & Activity: Slow transition back to normal

laparoscopic gastric bypass surgery

GASTRIC BYPASS SURGERY RECOVERY

Hospital Stay: 2 to 3 Days

Most gastric bypass patients stay in the hospital for 2 to 3 days to get through the initial healing process.

Recovery

Plan for a full 2 weeks off of work, and have family or friends available for daily help for at least the first week. Full recovery typically takes 6 weeks.

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Gastric bypass surgery recovery includes:

  • Timeline: 4 to 6 weeks to full recovery
    • Hospital Stay: 1 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
  • Challenges: Dumping syndrome, digestive issues & weight regain if you “cheat” on your diet, potential dental issues, gallstones, kidney stones, & short-term hair loss, and sagging skin from rapid weight loss

See our Gastric Bypass Recovery page for an in-depth recovery timeline and details about each aspect of recovery.

08Diet & Life After
  • Restricted diet with lifelong supplementation
  • Patient will feel full sooner while eating
  • Regular exercise
  • Personal relationships may change

laparoscopic gastric bypass surgery
FOOD & DRINK

Focus on eating proteins first, in solid form (not shakes). Get the majority of your calories from solid foods to avoid weight regain. Eat healthy "whole" foods (avoid processed foods). Drink 64+ oz (2+ liters) of liquids per day, but no drinking 30 minutes before or after meals.

VITAMINS & SUPPLEMENTS

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

YOUR BRAIN

After surgery you will feel less hungry, but that won't fix food addiction. Food addiction issues should be addressed before surgery. Rapid weight loss will also affect relationships with family, friends, coworkers, and strangers - both positively and negatively.

EXERCISE

Exercise is almost as important as diet for long-term success. Plan to exercise 2.5 hours per week spread out over 3 or 4 days. Patients who do so lose more weight and report a much higher quality of life.

FOOD & DRINK
VITAMINS & SUPPLEMENTS
YOUR BRAIN
EXERCISE
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Gastric bypass leads to impressive weight loss and health improvement, but what will day-to-day life be like? What are the tradeoffs?

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

Following is what to expect…

Food & Drink: Significant Changes

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

Timeframe Range
2+ Weeks Before Surgery

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

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

Long-Term Habits to Begin Before Surgery

Food

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

Drinks

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

Other Habits

2 Weeks Before Surgery

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

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

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

The typical 2 week pre-op meal plan includes:

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

The purpose of this diet is to:

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

Click the buttons below for more information:

1 Week Before Surgery

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

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

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

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

2 Days Before Surgery

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

Clear liquids options include:

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

Do NOT consume…

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

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

A clean digestive system is especially important for patients with gastroesophageal reflux disease (GERD) or gastric paresis (paralysis of the stomach). (50)

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

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

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

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

Drinks that your nurse will provide may include:

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

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

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

Take all vitamins and supplements recommended by your surgeon.

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

Other Habits

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

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

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

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

You can also drink clear liquids between meals.

While drinking anything:

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

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

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

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

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

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

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

General diet guidelines during this stage include:

Food

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

Drinks

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

Other Habits

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

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

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

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

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

  • Test one food at a time to make sure you can tolerate it
  • Eat healthy “whole” foods (avoid processed foods)
  • Eat slowly and chew thoroughly
  • No starchy foods like rice, bread, and pasta
  • No whole milk products
  • 64+ oz (2+ liters) of fluids spread throughout the day
  • No drinking 30 minutes before or after meals
  • Higher rate of alcohol issues with Gastric Bypass
Diet Requirements
Timeframe Range – Diet Requirements
Practice your post-bypass diet
2+ Weeks Before Surgery – Practice your post-bypass diet
High protein, low sugar, low carbs
2 Weeks Before Surgery – High protein, low sugar, low carbs
Stop or change some medications
1 Week Before Surgery – Stop or change some medications
Clear liquids only
2 Days Before Surgery – Clear liquids only
Nothing to eat or drink
Midnight Before Surgery to 7 Days After Surgery (Varies by Surgeon) – Nothing to eat or drink
Clear liquids only
In Hospital (1 -2 Days) thru Day 7 After Surgery Clear liquids only
Add thicker drinks & smooth foods (no chunks)
Week 2 After Surgery – Add thicker drinks & smooth foods (no chunks)
Slowly test pureed & soft solid foods
Week 3 After Surgery – Slowly test pureed & soft solid foods
Slowly test solid foods (avoid alcohol)
Day 3 to Weeks 4+ After Surgery (Varies by Surgeon) Slowly test solid foods (avoid alcohol)

For more information, see our Gastric Bypass Diet page.

Vitamins & Supplements: Lifelong & Crucial

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

Vitamins
Multivitamin (51) (52)
Calcium (53)
Folate (folic acid) (54)
Iron (55) (56)
Thiamin (Vitamin B1)
Vitamin D (57) (58) (59)
Vitamin B12
Body Part Affected
Vitamins – Body Part Affected
Entire body
Multivitamin (51) (52) – Entire body
Bone
Calcium (53) – Bone
Blood
Folate (folic acid) (54) – Blood
Blood
Iron (55) (56) – Blood
Entire Body
Thiamin (Vitamin B1) – Entire Body
Entire Body
Vitamin D (57) (58) (59) – Entire Body
Brain/Nervous System
Vitamin B12 – Brain/Nervous System

For more information, see our Bariatric Vitamins page.

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

gastric bypass surgery

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

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

How much exercise do you need to for noticeable results?

One study found that exercising 2.5 hours per week leads to 5.7% more weight loss (60). Another showed that gastric bypass patients who exercise at least 30 minutes a day, 3 days per week have a 4+% lower body mass index (61).

Further, regular exercise leads to quicker improvement in obesity-related health problems following surgery (62).

To help you stay on track:

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

Exercise Types

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

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

See our Exercise After Bariatric Surgery page for more information.

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

gastric bypass surgery

Ghrelin Hormone & Hunger

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

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

Food Addiction

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

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

Relationships After Weight Loss

09Downsides
  • Moderate risk of non-serious complications
  • Side effects may include digestion issues, dental problems, & sagging skin
  • Some weight regain possible

laparoscopic gastric bypass surgery
Complications
  • Very high survival rate (99.7%)
  • General anesthesia risks exist, as with any procedure
  • 5 most prevalent but still relatively uncommon: Stomal stenosis (5% of patients), wound infection (3%), bowel obstruction (3%), leak (2%), & gastrointestinal bleeding (2%)
Side Effects
  • Dumping syndrome (70% of patients) usually goes away with proper diet
  • Digestive issues, such as difficulty swallowing, indigestion, diarrhea, constipation, or intolerance to certain foods are usually fixed by changing diet or eating habits
  • Dental problems occur in some patients
  • Gallstones as a result of rapid weight loss
  • Kidney stones as a result of not drinking enough fluids
  • Hair loss may be an issue for the first 3 to 6 months after surgery
  • Sagging skin as a result of rapid weight loss
  • Weight regain possible if don’t change diet & lifestyle after balloon removal
Click to Collapse SectionClick to Learn More

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

However, complications are more common, with about to 1 out of 7 patients experiencing one or more over the long-term (64, 65).

Preventing Gastric Bypass Complications

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

  1. Select the surgery that is most appropriate for your situation. Different surgeries carry different risks for different people. Our Types of Bariatric Surgery page compares and contrasts the safest and most effective procedures.
  2. Choose an experienced surgeon, since more experienced surgeons tend to have better outcomes. For example, one study evaluated a surgeon over his first 300 laparoscopic gastric bypass patients. Following were his results as he gained experience (66):
    Group
    Group
    First 100 patients
    First 100 patients
    Second 100 patients
    Second 100 patients
    Third 100 patients
    Third 100 patients
    Group
    Time in surgery
    First 100 patients
    163 minutes
    Second 100 patients
    119 minutes
    Third 100 patients
    94 minutes
    Group
    Number of reoperations
    First 100 patients
    9
    Second 100 patients
    2
    Third 100 patients
    1
    Group
    Number of conversions to open surgery
    First 100 patients
    2
    Second 100 patients
    1
    Third 100 patients
    1

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

    A separate and much larger study of over 15,000 patients in Michigan had similar findings (67):

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

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

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

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

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

Possible Gastric Bypass Complications

The most common complications, which occur in greater than 1% of patients, include (68):

Stomal Stenosis – About 5% of patients

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

Wound Infection – About 3% of patients

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

Bowel Obstruction – About 3% of patients

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

Leak – About 2% of patients

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

Gastrointestinal bleeding – About 2% of patients

A copious discharge of blood from the blood vessels. After the surgeon determines the type and severity of internal bleeding, it can be resolved in a number of ways: on its own, replenishing bodily fluids, stopping the use of all anticoagulation drugs and (rarely) by transfusion or reoperation (69).

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

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

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

Digestion & Diet Issues

  • Dumping syndrome is experienced by 7 out of 10 gastric bypass patients, although for 95% of these patients, symptoms are relatively minor (70). Symptoms may include weakness, dizziness, flushing and warmth, nausea and palpitation immediately or shortly after eating. They are caused by abnormally rapid emptying of the stomach especially in individuals who have had part of the stomach removed.

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

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

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

  • Intolerance to certain foods, beverages and drugs – With a changed stomach size and digestive system, there will be certain foods, beverages and drugs that you’ll need to avoid and certain diet habits you’ll need to maintain (71). It is important to talk with your doctor before taking ANY drugs, as they can damage your stomach pouch after gastric bypass surgery and cause ulcers (including over the counter pain relievers – Motrin, Advil, aspirin, Aleve).

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

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

  • Nausea and vomiting is one of the most common gastric bypass side effects and is experienced in up to 70% of patients. Following your doctor’s bariatric diet recommendations exactly will typically fix or improve the problem. While in the hospital, receiving a larger amount of IV fluids at a faster rate may make you less likely to feel nauseous or vomit (72). Keeping a food journal for a couple of days may help you to pinpoint the foods which seem to cause nausea and vomiting.
  • Change in bowel habits – bowel function after bariatric surgery may change in a number of ways, including (73)…
    • Diarrhea or loose stools – usually completely dependent on diet – you will need to figure out and avoid foods that “trigger” diarrhea. It could also be the result of lactose intolerance (not a side effect of surgery, but surgery can make you more sensitive to a problem that you didn’t know you had) which would require dairy products to be removed from the diet.
    • Constipation – usually fixed by increasing the amount of water you are drinking and by taking fiber supplements.

Dental Problems

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

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

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

Sagging Skin

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

Sagging skin can cause several mental and physical issues including:

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

Options for addressing sagging skin include:

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

Alcohol Abuse

The physiological effects of alcohol are amplified following gastric bypass. This is supported by a study suggesting gastric bypass patients will have a higher blood alcohol content than control subjects after consuming the same amount of alcohol (74). Instances of individuals receiving Driving Under the Influence charges after consuming small amounts of alcohol have been reported.

Studies also indicate that patients who’ve undergone gastric bypass have an increased risk of developing an alcohol use disorder after surgery (75). Researchers have not conclusively determined why, but some experts suggest it is related to changes in the “pleasure center” of the brain. Faster absorption and increased potency of alcohol after gastric bypass may influence reward circuitry in the brain, effectively increasing the likelihood of developing alcohol related issues.

For individuals with a pre-existing alcohol abuse disorder, surgeons may advise an extended period of sobriety prior to receiving gastric bypass. Patients with a history of alcohol abuse disorders may be at higher risk of additional alcohol related problems after gastric bypass.

Other Potential Side Effects

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

Weight Regain: Half of All Bypass Patients After 2 Years

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

After five years, the average bypass patient gains back about 8% of their weight compared to their 18-month to 2-year “low point.” (76)

Another study found that up to 20% of morbidly obese patients (40 – 50 BMI) and up to 35% of super obese patients (BMI over 50) gained back more than 50% of their excess weight after 10 years (77).

Equally concerning, the more weight you gain back, the more likely your health problems are to come back. For example, one study showed that after gastric bypass surgery, all patients with Type 2 Diabetes experienced improvement or complete resolution. However, after 3 years, about 1 out of 4 of those patients saw their diabetes worsen or come back (78).

Why do patients gain back weight?

Usually it’s the patient’s fault. They veer off course and consume foods or beverages they shouldn’t, causing their stomach pouch or the connection between their stomach and small intestines (called the “stoma”) to stretch out (79).

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

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

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

10Gastric Bypass Vs. 6 Other Weight Loss Procedures
  • One of the best for weight loss & health improvement
  • Similar or higher risks than other procedures that result in 50%+ excess weight loss
  • One of 3 procedures that is not reversible

Picture of Procedure

Video of Procedure

Avg Excess Weight Loss

Health Improvement

BMI Needed to Qualify

Covered by Insurance?

Financing Available

Avg Total Cost With Insurance (U.S.)

Avg Total Cost Without Insurance (U.S.)

Procedure Type

Years of Peer-Reviewed Research

Device Placed In Body?

Reversible?

Time Until Removed

Path of Digestion

Procedure Time (Approx)

Complication Rate

Survival Rate

Hospital Stay (Avg)

Recovery Time
(Avg Back to Work)

Difficulty Swallowing?

Digestion & Bowel Movement Problems

Diet Risks

Food Cravings Decreased

Lifelong Vitamins Required

Qualified Surgeons

Patient Guides

The average gastric bypass patient loses between 65% and 75% of their excess weight within 2 years and has kept most of the weight off after 5 years.
Gastric bypass surgery improves or cures at least 15 obesity-related health problems, including diabetes, hypertension, sleep apnea, and many others.
35 - 39.9 with health problems; 40+ without
For policies that cover weight loss surgery, gastric bypass is included
Gastric bypass financing is available, subject to credit approval

$3,500

Actual out of pocket costs depend on your insurance plan.

$24,000

Costs vary by surgeon and hospital.
Most gastric bypass procedures are performed laparoscopically.
Gastric bypass surgery is backed by a significant amout of long-term research.
No external device is used (other than materials for "sealing" the smaller stomach pouch and establishing the new intenstinal route).
Not usually reversed
not applicable (gastric bypass is not usually reversed)
Part of the small intestines are bypassed after gastric bypass surgery.
Gastric bypass surgery usually takes about 4 hours to perform.
Non-severe complications are much more common than severe complications. Learn Risks & How to Minimize
Gastric bypass mortality risk is equal to that of any other routine surgical procedure.
Most gastric bypass patients remain in the hospital for 2 to 3 days.
Most gastric bypass patients are able to return to work within 2 weeks.
Can be caused by eating too quickly, too much or not chewing food enough and can usually be fixed by avoiding these issues.
Dumping syndrome occurs in ~80% of patients who eat sugar, refined fats, or carbs.
Potential problem foods: Sugars, Refined fats, Carbs, Dairy. Malabsorption will require life-long vitamin supplementation.
Food cravings may be reduced after gastric bypass surgery due to fewer hunger-causing hormones being released by the smaller stomach pouch.
Lifelong vitamins will need to be taken to compensate for patients eating less food as a result of a smaller stomach and for the lack of absorption resulting from the rerouted intestine.
The gastric balloon is a temporary procedure. Depending on the balloon type you choose, it must be removed 3 months, 6 months, or 1 year after insertion.
Gastric balloon patients are more likely to see health improvements than people of similar weight who do not have the procedure.
Between 30 & 40 in U.S. (above 27 elsewhere)
Gastric balloon is not usually covered by insurance
Gastric balloon financing is available, subject to credit approval

$8,150

Gastric balloon is usually not covered by insurance.

$8,150

Costs vary by surgeon and hospital.
Gastric balloon requires no incisions.
The gastric balloon is a relatively new procedure so long-term studies are limited.
An inflated silicon balloon remains in the stomach for 6 months.
The balloon must be removed after 6 months (Orbera and ReShape balloons).
The balloon must be removed after 6 months (Orbera and ReShape balloons).
The path of digestion is unchanged with the gastric balloon.
Gastric balloon usually takes about 30 minutes to perform.
Non-severe complications are much more common than severe complications. Learn Risks & How to Minimize
Gastric balloon survival rate is very high since the procedure requires no incisions and since complication risks are very low.
Most balloon patients leave the hospital the same day as the procedure.
Most balloon patients are able to return to work within a few days.
Can be caused by eating too quickly, too much or not chewing food enough and can usually be fixed by avoiding these issues.
Vomiting possible (but often avoidable with proper habits). “Feeling bloated” reported by some patients.
Potential Problem Foods: Pasta and other foods that might stick to balloon in stomach.
Food cravings will remain the same with the gastric balloon.
The balloon must be removed after 6 months (Orbera and ReShape balloons), so lifelong vitamins are not required.
The average gastric sleeve patient loses between 65% and 75% of their excess weight within 2 years and has kept most of the weight off after 5 years.
Gastric sleeve surgery improves or cures at least 15 obesity-related health problems, including diabetes, hypertension, sleep apnea, and many others.
35 - 39.9 with health problems; 40+ without
For policies that cover weight loss surgery, gastric sleeve is included
Gastric sleeve financing is available, subject to credit approval

$3,500

Actual out of pocket costs depend on your insurance plan.

$19,000

Costs vary by surgeon and hospital.
Most gastric sleeve procedures are performed laparoscopically.
Gastric sleeve surgery is backed by a significant amout of long-term research.
No external device is used (other than materials for "sealing" the smaller stomach).
Not usually reversed
not applicable (gastric sleeve is not usually reversed)
The path of digestion remains the same after gastric sleeve (although part of the stomach is removed).
Gastric sleeve surgery usually takes about 2 hours to perform.
Non-severe complications are much more common than severe complications. Learn Risks & How to Minimize
Gastric sleeve mortality risk is equal to that of any other routine surgical procedure.
Most gastric sleeve patients remain in the hospital for 2 to 3 days.
Most gastric sleeve patients are able to return to work within 2 weeks.
Can be caused by eating too quickly, too much or not chewing food enough and can usually be fixed by avoiding these issues.
GERD (reflux) in ~1 out of 5 patients after 1 year, drops to 1~ out of 33 patients after 3 year. Some patients experience diarrhea.
Potential problem foods: Dairy
Food cravings may be reduced after gastric sleeve surgery due to fewer hunger-causing hormones being released by the smaller stomach.
Lifelong vitamins will need to be taken to compensate for patients eating less food as a result of a smaller stomach.
The average duodenal switch patient loses between 65% and 90% of their excess weight within 2 years and has kept most of the weight off after 5 years.
Duodenal switch surgery improves or cures at least 15 obesity-related health problems, including diabetes, hypertension, sleep apnea, and many others.
35 - 39.9 with health problems; 40+ without (but more common for 50+)
For policies that cover weight loss surgery, duodenal switch is included
Duodenal switch financing is available, subject to credit approval

$3,500

Actual out of pocket costs depend on your insurance plan.

$27,000

Costs vary by surgeon and hospital.
Most duodenal switch procedures are performed laparoscopically.
Duodenal switch surgery is backed by a significant amout of long-term research.
No external device is used (other than materials for "sealing" the smaller stomach and establishing the new intestinal route).
Not usually reversed
not applicable (duodenal switch is not usually reversed)
Part of the small intestines are bypassed after duodenal switch surgery.
Duodenal switch surgery usually takes about 4 hours to perform.
Non-severe complications are much more common than severe complications Learn Risks & How to Minimize
Survival rate may be lower than other procedures because DS surgery tends to be performed on heavier patients who have higher risk.
Most DS patients remain in the hospital for 2 to 3 days.
Most duodenal switch patients are able to return to work within 2 weeks.
Can be caused by eating too quickly, too much or not chewing food enough and can usually be fixed by avoiding these issues.
Might be significant, including frequency, diarrhea, and/or foul-smelling stools/flatulence.
Malabsorption will require life-long vitamin supplementation.
Food cravings may be reduced after duodenal switch surgery due to fewer hunger-causing hormones being released by the smaller stomach.
Lifelong vitamins will need to be taken to compensate for patients eating less food as a result of a smaller stomach and for the lack of absorption resulting from the rerouted intestine.
Gastric Band surgery has highly variable results, with excess weight loss after 2 years ranging from 45% to 70%.
Gastric Band surgery improves or cures at least 15 obesity-related health problems, including diabetes, hypertension, sleep apnea, and many others.
35 - 39.9 with health problems; 40+ without
For policies that cover weight loss surgery, Gastric Band is included
Gastric Band financing is available, subject to credit approval

$3,500

Actual out of pocket costs depend on your insurance plan.

$15,000

Costs vary by surgeon and hospital.
Most Gastric Band procedures are performed laparoscopically.
Gastric Band surgery is backed by a significant amout of long-term research.
A silicone and silastic band is left around the top of the stomach, and a balloon around the inside of the band connects to a tube that leads to a round half-dollar-sized port just below the skin.
The Gastric Band can be removed.
Gastric Band removal is not required unless the patient develops a device-related complication.
The path of digestion is unchanged with the Gastric Band.
Gastric Band surgery usually takes about 1 hour to perform.
Non-severe complications are much more common than severe complications Learn Risks & How to Minimize
Gastric Band mortality risk is equal to that of any other routine surgical procedure.
Most Gastric Band patients leave the hospital the same day or the day after the procedure.
Most Gastric Band patients are able to return to work within 2 weeks.
Can be caused by eating too quickly, too much or not chewing food enough and can usually be fixed by avoiding these issues.
Reflux and vomiting common if band too tight (can be adjusted). Some patients experience constipation.
Potential problem foods: Dairy. Should not drink anything within 30 minutes before or after eating
Food cravings will remain the same after Gastric Band surgery.
Lifelong vitamins will need to be taken to compensate for patients eating less food as a result of the smaller stomach pouch created by the band.
The average vBloc patient loses 25% of their excess weight within 1 year. Longer-term studies are not yet available.
While studies are limited, vBloc Therapy has been found to improve hypertension, diabetes, and several obesity-related health factors.
35 - 39.9 with health problems; 40 - 45 without (none over 45)
vBloc Therapy is not usually covered by insurance
vBloc Therapy financing is available, subject to credit approval

$18,500

vBloc Therapy is not usually covered by insurance.

$18,500

Costs vary by surgeon and hospital.
Most vBloc procedures are performed laparoscopically.
vBloc Therapy is a relatively new procedure so long-term studies are limited.
The vBloc Therapy device is placed below the rib cage just under the skin. Leads (wires) connect the device to the vagal nerve, just above the stomach.
The vBloc Device can be removed.
vBloc device removal is not required unless the patient develops a device-related complication.
The path of digestion is unchanged with vBloc Therapy.
vBloc implant usually takes less than 90 minutes to perform.
Non-severe complications are much more common than severe complications Learn Risks & How to Minimize
vBloc mortality risk is equal to that of any other routine surgical procedure.
Most vBloc patients leave the hospital the same day as the procedure.
Most vBloc patients are able to return to work within a few days.
Most vBloc patients do not have any issue with swallowing.
Most vBloc patients do not experience digestion or bowel movement problems.
No medical risks, but healthier eating recommended for better results.
The vBloc device was specifically designed to control how often hunger impulses reach the brain.
vBloc device settings should be such that enough food will be eaten to provide the right amount of vitamins and minerals. Your doctor should monitor your vitamin levels.
AspireAssist studies are currently limited, but one study showed 31.5% excess weight loss after 4 years.
Early AspireAssist studies indicate a positive impact on diabetes, hypertension, and hyperlipidemia, but more reasearch is needed to confirm.
35 - 55, regardless of health problems
AspireAssist is not usually covered by insurance
AspireAssist financing is available, subject to credit approval

$10,500

AspireAssist is not usually covered by insurance.

$10,500

Costs vary by surgeon and hospital.
The AspireAssist procedure passes a tube through the mouth and down into the stomach. The tube is then pulled through the abdominal wall through a small incision.
AspireAssist is a relatively new procedure so long-term studies are limited.
A silicone “A-tube” connects the stomach to the Skin-Port™ located on the outside of your abdomen. The Skin-Port™ is the opening between your external device and the tube leading to your stomach. An Emergency Clamp component prevents any leakage of stomach contents if the A-tube and Skin-Port become disconnected.
The AspireAssist device can be removed.
AspireAssist removal is not required unless the patient develops a device-related complication.
The path of digestion is unchanged with AspireAssist (although some food is routed out of the body directly from the stomach).
The AspireAssist procedure usually takes about 15 minutes to perform.
Non-severe complications are much more common than severe complications. Learn Risks & How to Minimize
Available studies to date have shown zero deaths as a result of having the AspireAssist procedure.
Most AspireAssist patients leave the hospital the same day as the procedure.
Most AspireAssist patients are able to return to work within a few days.
Most AspireAssist patients do not have any issue with swallowing.
Low risk of vomiting (17% of patients), constipation (4.5% of patients), or diarrhea (4.5% of patients)
Potential malabsorption will require some monitoring and may result in a vitamin regimen
Food cravings will remain the same with the AspireAssist device.
Whether vitamins are required depends on each patient and how they are using the device. Your doctor should monitor your vitamin levels.
Click to Collapse SectionClick to Learn More

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

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

Gastric Bypass Positives

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

Gastric Bypass Negatives

  • Not reversible – Unlike Lap Band, gastric balloon, vBloc Therapy, and AspireAssist, gastric bypass surgery (along with gastric sleeve and duodenal switch) should be considered irreversible – once your stomach size is reduced and your intestines are rerouted, it is very it is very difficult and uncommon for the procedure to be reversed.
  • Weight loss (on average) is usually lower than duodenal switch (but higher or similar to all other procedures).
  • Health Improvement is generally not as significant as after duodenal switch (but is generally better than all other procedures).
  • While survival rate is extremely high at 998 out of every 1,000 patients, risk of gastric bypass complications is higher than all other procedures except duodenal switch. Early complications occur in about 1 out of 10 patients while late complications occur in about 1 out of 7 (80, 81).
  • The two primarily “malabsorptive” procedures, gastric bypass and duodenal switch, are more complicated to perform and include the rearranging your digestive system. As a result, they have a:
    • Longer recovery
    • Higher risk of vitamin deficiency (and therefore require more daily supplements)
    • Higher costs
  • Dumping syndrome is experienced by up to 7 out of 10 gastric bypass patients, although many patients report this being a “good thing” since it helps them keep their diet on track (see more in the Downsides section above).

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

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

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

These pages will help you better understand the differences between gastric bypass and other popular procedures:

11Start to Finish
  • 7 steps to long-term weight loss

01

Start Working with a Top Surgeon As Soon as Possible

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

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

02

Two Weeks Out: Prepare for Surgery

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

03

Surgery Day

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

04

Recovery

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

05

Adjust to Your New Post-Surgery Diet & Lifestyle

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

06

Attend Support Groups Regularly

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

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

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

07

Ongoing Doctor Visits

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

13Help & Support
  • Ask the expert
  • Patient experiences

laparoscopic gastric bypass surgery

Patient Experiences

Ask the Expert & Patient Experiences*

To meet face-to-face and in-person with other patients, talk with your surgeon about weight loss surgery support groups available in the area.

Our community would also love to read your experiences with the balloon. Your insights are invaluable to making sure other people have the tools to meet their goals.

In addition, we are happy to answer any questions you have about the procedure.

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

Ask the
Expert

Ask the Expert & Patient Experiences*

To meet face-to-face and in-person with other patients, talk with your surgeon about weight loss surgery support groups available in the area.

Our community would also love to read your experiences with the balloon. Your insights are invaluable to making sure other people have the tools to meet their goals.

In addition, we are happy to answer any questions you have about the procedure.

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

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Patient Experience & Ask the Expert*

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

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

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Questions From Other Visitors*

Click below to see contributions from other visitors to this page…

Gone After Gastric Bypass: Diabetes, High Blood Pressure, Sleep Apnea, Low Self Esteem & 110 Lbs*

I am about 15 months post gastric bypass surgery and have lost about 110 lbs to date. The weight loss has tapered off and I feel that the remainder of…


Will Bowel Movements Change After Gastric Bypass?*

Does food move through rapidly and cause loose stools or diarrhea after RNY Gastric Bypass surgery?I had an RNY Gastric Bypass done in July of last year... is it normal…


I have lost 215 pounds since my gastric bypass surgery*

My life is considerably better since my surgery although I have been unable to work to my full ability because of complications.I had the RNY Gastric Bypass. My beginning weight…


All of my co-morbidities are GONE after bariatric surgery... and so is 140 pounds!*

I had Laproscopic RNY Gastric Bypass January 22nd, 2009. At my heaviest I weighed in at 270 pounds with a list a mile long of co-morbidities and health issues.I had…


Not Enough Weight Loss 3 Months After Gastric Bypass?*

I had Roux en Y gastric bypass surgery on July 1 (about 3 months ago). I had been having difficulty getting enough protein until this week but I'm concerned that…


Eating Seeds & Nuts After RNY Gastric Bypass Surgery*

After having RNY gastric bypass is it okay to eat seeds and nuts, including sunflower seeds? How should sunflower seeds and other types of seeds and nuts fit into my…


Weight Loss Plateau 10 Months After Gastric Bypass Surgery*

I had gastric bypass surgery 6-14-12. I have had my ups and down... Lord knows I had some stalls, but I got through them. So going on my ten months…


Chronic Hunger After Gastric Bypass Surgery*

Since the day after having Roux-en-Y gastric bypass surgery, I'm always hungry. I never fell full. But I'm following the guidelines, measuring, eating slow, no sugars, etc. (I've only dumped…


What's the Definition of a Gastric Bypass?*

Dear Bariatric Surgery Source, My name is David. I am fairly new to gastric surgery and have what I think is a pretty basic question for you: I've been looking…


Roux-En-Y Gastric Bypass Anatomy and Concerns*

Hello, I am considering the roux-en-y gastric bypass. I found it doing google searches, heard about it on the news, and it helps people like me lose weight… thank God…


14Find a Top Gastric Bypass Surgeon
  • Ask for a free insurance check or cost quote
  • Attend a free seminar or webinar
  • Schedule a phone or in-person consultation (both often free)

Search the gastric bypass surgeon directory below to find a top surgeon by country and region:

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United States, Canada & Mexico

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