The most important things to consider if are trying to decide between getting vBloc therapy or gastric sleeve surgery to aid with your weight loss include:
- How they work: Both make you feel less hungry and full sooner while eating, so you’ll eat less and lose weight. Only the gastric sleeve does so by removing 80% of your stomach. Only vBloc (i) does so using an implanted device that controls hunger signals sent to the brain, (ii) is reversible, and (iii) is adjustable.
- Minimum requirements to qualify: The gastric sleeve requires 30+ body mass index (BMI) with accompanying obesity-related health problems or 40+ BMI without healthy problems. vBloc requires 35+ BMI with accompanying obesity-related health problems or 40 to 45 without.
- Hospital stay & recovery time: vBloc is a less complicated procedure with a shorter operating time, shorter hospital stay, and quicker/easier recovery when compared to gastric sleeve surgery.
- Weight loss & health improvement: Gastric sleeve results in about two times more weight loss and is much more likely to improve or cure your obesity-related health conditions
- Insurance: The gastric sleeve is covered if your medical insurance policy covers bariatric surgery. vBloc is only covered by Department of Veterans Affairs (VA facilities).
- Cost without insurance: Gastric sleeve surgery is $500 to $1,000 more expensive than vBloc if you are paying without insurance coverage.
- Diet & life after: vBloc has no diet restrictions. The gastric sleeve has several dietary restrictions. The exercise regimen is same for both. (see below)
- Complications & side effects: Both have close to 100% survival rate. Gastric sleeve surgery has a higher risk of complications and side effects.
Read and click the sections below for everything you need to know to decide which procedure is best for you.
TABLE OF CONTENTS
Click on any of the topics below to jump directly to that section
- vBloc Therapy and the Gastric Sleeve make you feel less hungry & feel full sooner while eating, so you'll eat less and lose weight
- vBloc does this using an implanted device to control hunger signals sent to the brain
- Gastric sleeve surgery does this by reducing the size of your stomach
Understanding gastric sleeve surgery vs vBloc Therapy starts with the fundamental differences in how each procedure impacts your brain and digestive system:
Why Gastric Sleeve Works
- Reduced stomach size makes the patient feel full sooner after eating
- Removed portion of the stomach means fewer hunger-causing hormones are secreted, causing patient to feel less hungry generally
How Gastric Sleeve Is Performed
Gastric sleeve surgery, also called the Vertical Sleeve Gastrectomy (VSG), is performed by removing a large portion of the stomach to create a long pouch that connects the esophagus to the small intestine. The pouch is stapled and the rest of the stomach is removed. Some surgeons take an additional step to reinforce the staple line, although whether that is effective is up for debate.
Why vBloc Therapy Works
- Implanted device periodically blocks the vagal nerve and prevents it from delivering hunger signals to the brain, making you feel full between meals and full sooner after smaller meals.
How vBloc Device Implantation Is Performed
Your surgeon will implant the vBloc Therapy device below your rib cage just under the skin. She will then attach the device to your vagal nerve, just above the stomach, via two leads (wires). The whole procedure usually takes between 60 and 90 minutes.
If necessary, during follow up office visits your surgeon can increase or decrease the device’s hunger-reducing settings remotely.
Recharging the Device
The vBloc device is battery-powered so it is important you charge it at least every other day.
- Gastric sleeve surgery results in 2 times more weight loss
Patients lose weight quickly after both the gastric sleeve and vBloc procedures. However, gastric sleeve patients:
- Lose over 2 times more weight over the short- and long-term
- Tend to gain back at least some weight over the long-term (although total long-term weight loss is still about 2 times more than with vBloc)
For for a person who is 5 feet, 7 inches tall and 250 lbs, following is the amount of average expected weight loss for each procedure:
|Timeframe||Gastric Sleeve: Total Expected Weight Loss for 5’7”, 250 lb patient||vBloc Therapy: Total Expected Weight Loss for 5’7”, 250 lb patient|
|3 months||28 lbs||9 lbs|
|6 months||46 lbs||18 lbs|
|1 Year||64 lbs||23 lbs|
|2 Years||60 lbs||23 lbs|
|3 Years||55 lbs||23 lbs|
|5 Years||5 lbs||23 lbs|
- Gastric sleeve surgery is much more likely to improve or cure your health conditions than vBloc
Gastric sleeve surgery is much more likely than vBloc Therapy to improve or cure (as long as you don’t regain the weight) at least 15 obesity-related health conditions like diabetes, hypertension, and sleep apnea.
The chart below compares study results by condition for each procedure:
|Co-morbidity||vBloc % Improved /Resolved||Gastric Sleeve % Improved /Resolved|
|Hyperlipidemia (high levels of fat in the blood, high cholesterol)||–||35%|
|High Blood Pressure (hypertension)||–||68%|
|Joint/Bone Disease (osteoarthropathy)||–||46%|
|Venous Stasis Disease||–||95%|
|Gastroesophageal Reflux Disease (GERD)||–||50%|
|Non-Alcoholic Fatty Liver Disease||–||n/a|
|Mortality Reduction/ Life Expectancy (5 year mortality)||–||89%|
|Quality of Life Improvements||–||93%|
|Polycystic Ovarian Syndrome||–||Most|
|Obstructive Sleep Apnea||–||62%|
|Stress Urinary Incontinence||–||90%|
- vBloc Therapy requires that you have a 35+ BMI with accompanying obesity-related health problems or 40 - 45 without health issues.
- Gastric sleeve surgery requires that you have a 30+ BMI with accompanying obesity-related health problems or 40+ without health issues.
In order to have vBloc Therapy, your body mass index (BMI) must fall within one of the following ranges:
35 to 39.9 with an obesity-related health problem such as, but not limited to:
- High blood pressure
- High cholesterol
- Type 2 diabetes
- Sleep apnea
In addition, vBloc requires that you:
- Are at least 18 years old
- Have been unable to keep off weight with diet or exercise during a medically supervised diet program in the last 5 years
In order to have gastric sleeve surgery, your BMI must fall within one of the following ranges:
- Body mass index 40 or above or
- Body mass index from 35 to 40 as long as you have a serious obesity-related health problem (“comorbidity”) such as diabetes, asthma, hypertension, joint problems, sleep apnea, or one of many others.
- Body mass index from 30 to 35 may be accepted if certain health issues are present
Use the BMI Calculator above to determine your body mass index.
- Gastric sleeve surgery is covered if your policy covers bariatric surgery (check below)
- vBloc is only covered at VA facilities for now (otherwise it's not covered by your medical insurance)
vBloc Therapy is currently only covered by the Department of Veteran Affairs (VA facilities). If you do not have VA coverage, you’ll need to pay for the procedure out of pocket.
Gastric sleeve surgery will be covered by your insurance as long as your specific insurance policy includes weight loss surgery. Use the tool below to find out if your plan covers it and, if it does, what your out of pocket costs are likely to be:Click Here to Check Your Insurance
The gastric sleeve surgery insurance approval process can take anywhere from 1 to 12 months, depending on your insurance company and your situation.
Following are the typical steps:
Confirm with your doctor that your body mass index and health conditions fall within one of the two qualification requirements:
- BMI over 40 –OR–
BMI over 35 with one or more of the following (insurance companies will usually not cover BMI’s below 35):
- Clinically significant obstructive sleep apnea
- Coronary heart disease
- Medically refractory hypertension
- Type 2 diabetes mellitus
- Other obesity-related health issues
- Complete 3 to 7 consecutive months of a medically supervised diet program, depending on your insurance company (can be coordinated by your bariatric surgeon).
- Schedule a consultation with your bariatric surgeon.
- Schedule a consultation with your primary care physician to obtain a medical clearance letter.
- Schedule a psychiatric evaluation to obtain a mental health clearance letter (usually coordinated by your bariatric surgeon).
- Schedule a nutritional evaluation from a Registered Dietitian (usually coordinated by your bariatric surgeon).
- 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).
Insurance company sends approval or denial letter:
- If approved, your surgeon’s bariatric coordinator will contact you for scheduling.
- If denied, you can choose to appeal the denial.
Take the Easy Route – Your surgeon’s office will do most of this legwork for you. They are highly experienced in managing the process and may even have all of the required personnel on staff (e.g., registered dietitian, psychiatrist, bariatric coordinator, etc.).
Click here to find a gastric sleeve or vBloc surgeon near you to get started. Most offices will check your insurance for free to confirm coverage.
For more information about weight loss surgery insurance, see our Bariatric Surgery Insurance Guide.
- Gastric sleeve costs about $19,000 total (or ~445 a month if you take out a medical loan to pay for the surgery)
- vBloc Therapy costs about ~$18,500 total (or ~445 a month if you take out a medical loan to pay for the procedure)
The cost of surgery should not dictate which procedure you have. You should move forward with the procedure that is most likely to work for you after thorough research and a consultation with your surgeon.
If you do not have insurance that covers the procedure, there will be very little difference in vBloc Therapy vs gastric sleeve cost:
- Gastric sleeve: Average cost is about $19,000
- vBloc Therapy: Average cost is about $18,500
However, surgeons in your area may charge as low as $10,000 for either procedure, depending on current discounts and specials.
Financing may also be available, depending on your credit. Payments are likely to be around $445 for either procedure if you finance it over 5 years
- Gastric sleeve: $445/mo
- LAP-BAND®: $334/mo
Visit our Financing Weight Loss Surgery page for all the possible ways to finance your surgery.
Cost of Not Having Surgery vs Cost of Weight Loss Surgery
Even if you’re paying out of pocket, the cost of gastric sleeve and vBloc Therapy is likely to be far less than the long-term costs of obesity-related health problems for morbidly obese people who don’t have a procedure.
Gastric Sleeve Health Cost Savings
On average, gastric sleeve surgery patients pay off their entire surgery and start getting ahead financially after only 2 years (11).
To illustrate: One study found that bariatric surgery patients pay as much as $900 less per month as soon as 13 months after surgery than similar people who didn’t have surgery (12). Starting in month 13, that’s almost $11,000 saved per year in total medical costs.
Fewer prescription drugs alone have been found to save patients $3,000 or more per year (13).
vBloc Therapy Health Cost Savings
While there are no cost savings studies specific to vBloc Therapy, we know that the procedure results in about half of the weight loss of gastric sleeve. Assuming cost savings are proportionate to weight loss, that means vBloc will save about $5,500 per year in total medical costs for each patient.
That puts vBloc Therapy’s breakeven timeframe at less than 3.5 years compared to gastric sleeve’s 2 year breakeven point.
- vBloc Therapy has quicker and easier recovery than Gastric Sleeve
- Unlike Gastric Sleeve, vBloc Therapy has no specific diet restrictions during recovery
vBloc Therapy is a much simpler, faster, and less invasive procedure than gastric sleeve.
vBloc also has no diet restrictions because it does not change your digestive system. About 80% of the stomach is removed during the gastric sleeve procedure, so patients must slowly transition back to solid foods.
The following chart compares recovery for vBloc Therapy and gastric sleeve surgery:
|vBloc Therapy||Gastric Sleeve|
|Operating time||1 hour or less||2 hours|
|Hospital Stay||Outpatient (same day)||2 to 3 days|
|Time Off Work||3 to 4 days||1 to 3 weeks|
|Time to Full Recovery||4 to 6 weeks until incisions fully heal||4 to 6 weeks until incisions and stomach fully heal|
|Pain||Less because digestive system not altered; Pain is managed with medication||More because part of stomach is removed and must heal; Pain managed with medication|
|Activity||Slow transition back to normal while incisions heal||Slower transition back to normal while incisions and stomach heal|
|Diet (More information in the next section)||No specific diet restrictions because anatomy is not altered (but dietitian will work with you to improve diet as part of overall plan)||Gradual transition from clear liquids to solid foods – may take up to 4 weeks (timeframe varies by surgeon)|
See the following pages for more information about vBloc Therapy vs gastric sleeve recovery:
- Gastric sleeve surgery requires specific diet restrictions & requirements (read below)
- vBloc Therapy does not have specific diet restrictions, but you must recharge your device every other day
Diet: Gastric Sleeve Vs vBloc Therapy
Gastric sleeve has much more stringent dietary requirements than vBloc Therapy.
However, your vBloc device is designed to work in tandem with lifestyle changes. If you don’t adhere to the recommended changes, you will not lose as much weight.
Your nurse or dietitian will work with you to find ways to improve your diet and exercise habits, including:
- One-on-One Coaching
- Personal Tracking Technology (such as an electronic scale that sends data to your dietitian)
- Online Tools and Resources (e.g., Meal and exercise tracking, educational materials, videos, and guides
Your gastric sleeve diet transition is likely to be as follows (varies by surgeon):
- 2+ Weeks Before – Practice your post-surgery diet
- 2 Weeks Before – High protein, low sugar, low carbs
- 1 Week Before – Stop or change some medications
- 2 Days Before – Clear liquids only
- Midnight Before Surgery – Nothing to eat or drink
- In Hospital to 7 Days After Surgery (Varies by Surgeon) – Sugar-free clear liquids only
- Day 1 to Week 2 After Surgery (Varies by Surgeon) – Add thicker drinks & smooth foods
- Day 2 to Week 3 After Surgery (Varies by Surgeon) – Slowly test pureed foods & soft solid foods
- Day 3 to Weeks 4+ After Surgery (Varies by Surgeon) – Slowly test solid foods
Following are the long-term dietary guidelines for gastric sleeve:
- Test one food at a time to make sure you can tolerate it
- Eat proteins first, in solid form (e.g., not protein shakes)
- Eat healthy “whole” foods
- Avoid processed foods
- Avoid sugary foods or drinks
- Eat slowly and chew thoroughly
- No starchy foods like rice, bread, and pasta
Avoid any food that is difficult to digest (may be able to tolerate over time), such as:
- Fibrous vegetables like broccoli, celery, and corn
- Skin of any meat
- Tough meats
- Avoid whole milk products
- Drink 64+ oz (2+ liters) of fluids spread throughout the day
- No drinking 30 minutes before or after meals (other than gastric balloon)
- Alcohol only in moderation
See the following pages for more information:
Vitamins: Gastric Sleeve Vs vBloc Therapy
Gastric sleeve patients require lifelong vitamins to make up for fewer nutrients being eaten and processed by the smaller stomach. vBloc patients are much less likely to require supplementation.
Following is the typical vitamin regimen for gastric sleeve patients:
- 1 to 2 per day, forever
- Chewable or liquid versions are best (instead of tablets)
- Take with food (except dairy) to maximize absorption
- At least 200% of the Recommended Dietary Allowance (RDA) of iron, folic acid, thiamine, copper, selenium and zinc
Daily calcium supplement, in the form of calcium citrate
- Must be calcium citrate (NOT other forms of calcium)
- 1000-1500 mg. daily, forever
- Chewable and liquid versions are best (instead of tablets)
- Try to find one that includes Vitamin D
- Take 2 hours apart from Iron supplements (or Multivitamin that contains Iron) to maximize absorption
Sleeve patients may also be required to take one or more of the following depending on vitamin levels:
- Folate (folic acid)
- Thiamin (Vitamin B1)
- Vitamin D
Exercise: Gastric Sleeve Vs vBloc Therapy
After you’ve full recovered from surgery (4 to 6 weeks), recommended exercise is the same for both vBloc and gastric sleeve patients: 2.5 hours per week, spread out over 2 to 4 days.
Following this regimen will cause you to:
- Lose more weight
- Be more physically and mentally healthy
Learn more on our Exercise After Weight Loss Surgery page.
Hunger: vBloc Therapy Vs Gastric Sleeve
You will feel less hungry after both gastric sleeve and vBloc Therapy, but for very different reasons.
After gastric sleeve, you are likely to feel less hungry as a result of 80% of your stomach being removed.
When your new gastric sleeve stomach is empty, it secretes a hormone called ghrelin into your bloodstream which causes your brain to generate hunger impulses. After you eat, the amount of secreted ghrelin drops then slowly rises until your next meal. Since your stomach will be significantly smaller after gastric sleeve surgery, the amount of ghrelin the stomach secretes – and your resulting feelings of hunger – may also go down.
In contrast, vBloc Therapy uses an implanted pacemaker-like device to regulate hunger impulses sent from your stomach to your brain.
If needed, your surgeon can adjust the settings of your device remotely (during an office visit) to increase or decrease hunger impulses.
Food Addiction: vBloc Therapy Vs Gastric Sleeve
Regardless of which procedure you have, food addiction could be a problem.
Our bodies secrete certain hormones, like ghrelin mentioned above, that tell us when we’re hungry and full, but hyperpalatable food (like junk food) may be overriding those hormone signals by overstimulating our reward centers, much like our bodies and brains react to an addictive drug.
You may have a bona fide food addiction if your desire for food takes priority over other parts of your life that you acknowledge to be more important, such as personal health, family, friends, work, your appearance, or avoiding obesity related health issues like hypertension, sleep apnea, or diabetes.
If left unchecked, food addiction can lead to obesity. For weight loss surgery patients, if not addressed prior to surgery, it can also lead to weight regain.
To find out if you may be suffering from food addiction, take our Food Addiction Quiz.
Relationships After Weight Loss
Significant weight loss after any type of bariatric surgery can lead to big changes with everyone around you.
While many of those changes are positive, some can also be extremely challenging and unexpected.
See our Relationships After Weight Loss Surgery page for important changes to prepare for.
- Gastric sleeve surgery has higher risk of complications/side effects than vBloc (but complications and side effects are rare for both)
vBloc Therapy has a lower risk of complications and side effects than gastric sleeve because it does not alter your digestive system.
vBloc Therapy complications are very rare and almost never life-threatening. vBloc side effects, which are mild to moderate and not permanent, may include:
- Abdominal Pain or Cramping
- Digestive issues such as belching, difficulty swallowing (dysphagia), heartburn, indigestion (dyspepsia), and nausea
- Gallbladder disease
- Surgical pain or pain at the neuroregulator site
See our vBloc Therapy Downsides section for more details
Gastric sleeve complications, which are also relatively rare and almost never life-threatening, include staple line leaks, bleeding, and stenosis/strictures.
Gastric sleeve side effects include:
- Gastroesophageal reflux disease (GERD) experienced by 20% of patients during the first year. Drops to 3% after 3 years.
- Intolerance to certain foods may cause nausea, vomiting or indigestion. Fixed by changing diet or eating habits
- Vitamin and mineral deficiency possible if don’t take prescribed supplements
- Gallstone formation occurs in about half of all patients as a result of rapid weight loss
See our Gastric Sleeve Complications page for more details
Full vBloc Therapy vs Gastric Sleeve Downsides Comparison
|Band Problems (band erosion, band infection, band intolerance, band leak, band slippage)||–||–|
|Body Feeling Changes||Yes||Yes|
|Bowel Function Changes (diarrhea, constipation, foul-smelling bowel movements and flatulence, difficulty swallowing, gurgling noises)||Yes||–|
|Deep Vein Thrombosis||Yes||–|
|Evisceration & Incisional Hernia||–||–|
|Gallstones||Up to 1/3 of bariatric patients||–|
|Gastroesophageal Reflux Disease (GERD)||About 20% after 1 year; About 3% after three years||–|
|Gastrointestinal Leaks||About 2% of patients||–|
|General Anesthesia Complications||Yes||Yes|
|Hemorrhage (Bleeding)||About 1% of patients||Yes|
|Intolerance to Certain Foods||Yes||–|
|Nausea, Vomiting and/or Stomach Cramps||Yes||–|
|Organ Injury During Surgery||Yes||Yes|
|Port Problems (port flip/ inversion or dislodgement, port leak, port infection, port dislocation)||Yes||Yes|
|Skin Changes (e.g. acne, dry skin, sagging skin, etc.)||Yes||–|
|Stenosis/Stricture||About 1% of patients||–|
|Thrush (Yeast Infection)||Yes||Yes|
|Vitamin & Mineral Deficiency / Malnutrition / Malabsorption||Yes||–|
For definitions of any issue in the chart, see our Bariatric Surgery Complications page.
- Read the "Winner" & "Loser" by category below
- The overall winner truly depends on your unique situation
Your individual situation will determine whether vBloc Therapy or gastric sleeve surgery is best for you. Following is a review of which procedure is “better” in each category discussed on this page.
- Most Popular Procedure: Gastric Sleeve
- Most Short-Term Weight Loss: Gastric Sleeve
- Most Long-Term Weight Loss: Gastric Sleeve
- Best Health Improvement Gastric Sleeve
- Easiest to Qualify: Tie
- Low-Cost Procedure (With Insurance): Gastric Sleeve (other than VA patients)
- Low-Cost Procedure (Without Insurance): Gastric Sleeve
- Easiest Recovery: vBloc Therapy
- Best Post-Op Diet: vBloc Therapy
- Fewest Risks & Side Effects: vBloc Therapy
Discuss each of the pros and cons with your surgeon before making a final decision. Click here to find a weight loss surgeon.
- You can ask a local bariatric practice for a free insurance check or cost quote
- You should schedule a phone or in-person consultation (both often free), if you are interested in learning more about weight loss surgery