Types of Bariatric Surgery: Key Differences

Written by Bari Life Team and medically reviewed by Dr. Stephen Boyce, MD

Bariatric surgery is a type of weight loss surgery that involves modifying the digestive system to restrict food intake and reduce calorie absorption. There are several types of bariatric surgery, including the best bariatric surgery options available,and each with its own unique approach to achieving weight loss.

Main Types of Bariatric Surgery

There are three main types of bariatric surgery, each with distinct methods for achieving weight loss. Each surgery offers unique benefits and risks, and choosing the right one depends on a patient’s health and weight loss goals. Understanding these surgeries can help individuals make an informed decision about their weight loss journey.

Roux-en-Y Gastric Bypass (RYGB)

Roux-en-Y gastric bypass is a surgical procedure designed to treat severe obesity by altering the digestive system in two significant ways: creating a small stomach pouch and bypassing a portion of the small intestine. 

In this surgery, the surgeon divides the stomach to form a smaller, pouch-like section, significantly reducing its capacity. As a result, patients can consume only a limited amount of food at a time, leading to weight loss through reduced caloric intake. 

Additionally, by rerouting the small intestine, the procedure also limits the body’s ability to absorb nutrients and calories from the food that passes through, further promoting weight loss.

After surgery, patients often rely on bariatric vitamins and bariatric multivitamins to prevent nutrient deficiencies due to the limited absorption. Some opt for bariatric vitamins chewable to make supplementation easier.

The Roux-en-Y bariatric surgery is widely regarded as one of the most effective and commonly performed bariatric surgeries for long-term weight management. Studies have shown that patients typically lose 60-80% of their excess body weight within the first year after surgery.

According to the American Society for Metabolic and Bariatric Surgery (ASMBS), RYGB can lead to significant long-term weight loss, improved blood sugar control, and reduced risk of heart disease.

Sleeve Gastrectomy

This significant reduction in stomach size not only limits the amount of food a person can consume but also leads to hormonal changes, particularly a decrease in the production of ghrelin, the hormone responsible for stimulating hunger.

Sleeve gastrectomy is a surgical weight-loss procedure that involves removing approximately 80% of the stomach, which is an alternative to laparoscopic bariatric surgery. This technique does not require rerouting the intestines like roux en y bariatric surgery and offers a less invasive option for weight loss,and leaving behind a narrow, tube-like structure, also known as a gastric sleeve. 

Patients who undergo sleeve gastrectomy may benefit from including bariatric protein shakes and bariatric protein bars in their diet to ensure they are receiving adequate protein. Bariatric snacks can also help maintain energy levels while adhering to portion control.

These combined effects promote substantial weight loss by reducing both appetite and caloric intake.Unlike Roux-en-Y gastric bypass (RYGB), another popular bariatric surgery, sleeve gastrectomy is considered a less complex procedure,making it easier for some patients to manage their nutritional intake with bariatric multivitamin with iron and liquid bariatric vitamin supplements.

It does not involve rerouting the intestines or creating new connections between the stomach and the intestines, which reduces the risk of certain complications such as nutrient malabsorption and dumping syndrome.

Additionally, because sleeve gastrectomy preserves the normal pathway of digestion, it tends to have fewer long-term nutritional deficiencies compared to RYGB. 

According to the Cleveland Clinic, sleeve gastrectomy is effective for moderate to significant weight loss and has fewer complications compared to gastric bypass.

Adjustable Gastric Banding

Adjustable gastric banding is a form of bariatric surgery that involves placing a silicone band around the upper part of the stomach, effectively creating a smaller stomach pouch. 

This smaller pouch limits the amount of food the stomach can hold at any given time, which helps to promote feelings of fullness more quickly, reducing overall food intake. 

The procedure works by constricting the passage of food from the upper to the lower part of the stomach, slowing the rate at which food moves through the digestive system. 

However, unlike other weight-loss surgeries such as gastric bypass, adjustable gastric banding does not interfere with the body’s natural digestive processes. 

The food is still digested and absorbed normally in the intestines, and there is no alteration in the way nutrients are absorbed. One advantage of adjustable gastric banding is that the band can be tightened or loosened over time, allowing for personalized adjustments to the degree of restriction based on the patient’s weight loss progress and needs.

bariatric surgery types

Adjustable gastric banding is less invasive, but weight loss can be slower and requires frequent adjustments. According to WebMD, adjustable gastric banding is a reversible procedure that can be adjusted as needed.

Mechanisms of Weight Loss with Bariatric Surgery

Bariatric surgery is a complex procedure. It affects the body’s weight control in several ways. Knowing how bariatric surgery promotes weight loss can help. It can make people appreciate the science of this life-changing procedure.

Restriction of Food Intake

By reducing the size of the stomach, bariatric surgery restricts the amount of food that can be consumed at one time, leading to a decrease in overall caloric intake. This results in weight loss as the body is forced to adapt to the reduced food intake.

Malabsorption of Nutrients

Some bariatric procedures, such as gastric bypass surgery, involve bypassing a portion of the small intestine, which reduces the absorption of nutrients, including calories, carbohydrates, and fats. This leads to weight loss as the body is unable to absorb the same amount of nutrients as it did prior to surgery.

Hormonal Changes

Bariatric surgery can also lead to changes in hormone levels, including a decrease in ghrelin, the “hunger hormone,” and an increase in peptide YY, the “fullness hormone.” These hormonal changes help to reduce hunger and increase feelings of fullness, making it easier to stick to a healthy diet and achieve weight loss.

Changes in Gut Bacteria

Research has shown that bariatric surgery can alter the composition of gut bacteria, leading to changes in the way the body processes and stores energy. This can contribute to weight loss and improved overall health.

Increased Motility

Some bariatric procedures, such as gastric bypass surgery, can also increase the motility of the small intestine, allowing food to move more quickly through the digestive system and reducing the time available for nutrient absorption. This can lead to weight loss as the body is unable to absorb as many calories.

Advantages of Each Surgery Type

Each type of bariatric surgery has its own unique benefits and advantages. Understanding these advantages can help individuals make an informed decision about which type of surgery is best for their weight loss journey.

Roux-en-Y Gastric Bypass

  • Provides significant long-term weight loss (60-80% of excess weight)
  • Helps with obesity-related conditions like diabetes and hypertension
  • Alters gut hormones to sustain weight loss

Sleeve Gastrectomy

  • Effective for moderate to significant weight loss
  • Fewer complications compared to gastric bypass
  • Does not require foreign objects or rerouting of the intestines

Adjustable Gastric Banding

  • Reversible and adjustable over time
  • Minimal risk of nutrient deficiencies
  • Shorter recovery time and lower initial complication rate

Disadvantages and Risks

Bariatric surgery can help with weight loss. But, each type has risks. So, weigh the downsides before deciding. Understanding these risks can help people make informed choices. It can also prepare them for potential challenges.

Roux-en-Y Gastric Bypass

  • Higher risk of nutrient deficiencies (e.g., iron, calcium, vitamin B12)
  • More complex surgery with higher risk of complications like leaks or infections
  • Potential for dumping syndrome (rapid gastric emptying causing nausea, vomiting, diarrhea)

Sleeve Gastrectomy

  • Permanent removal of part of the stomach; not reversible
  • Risk of long-term vitamin and mineral deficiencies
  • Potential for acid reflux and stomach leakage

Adjustable Gastric Banding

  • Slower weight loss compared to other methods
  • Requires ongoing adjustments and possible re-operations
  • Risk of band slipping, erosion, or infection

Factors to Consider When Choosing Surgery

Choosing the right bariatric surgery is a personal decision. It depends on several individual factors. To choose wisely, consider these key factors. They can affect your weight loss success.

Patient’s Health and Medical Conditions

  • Existing conditions like heart disease or diabetes may influence the choice of surgery
  • Some surgeries are better suited for patients with severe obesity-related comorbidities

Long-Term Weight Loss Goals

  • Different surgeries offer varying levels of weight loss success; patients need to match their goals with the procedure’s efficacy
  • More invasive procedures (RYGB) generally result in more dramatic long-term weight loss

Potential Risks and Lifestyle Adjustments

  • Patients should consider their willingness to adopt lifelong dietary changes and take supplements (especially with malabsorptive procedures like RYGB)
  • The invasiveness, risk of complications, and recovery time differ between procedures

Conclusion

No one-size-fits-all approach exists when it comes to bariatric surgery. The best surgery depends on the person’s health, weight goals, and medical issues. RYGB offers high weight loss but has higher risks. Less invasive options, like gastric banding, are safer but slower. All procedures require long-term changes to diet, exercise, and medical follow-up. These are vital for success and to manage risks. Individuals can make an informed choice about bariatric surgery. They must know the types of surgery, how they cause weight loss, and their pros and cons. They also need to know the risks.

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