Which bariatric surgery is best for you?


Graphic depiction of weight loss surgeries (from left to right:  gastric banding, sleeve gastrectomy, roux-en-y gastric bypass and bibliopancreatic diversion with duodenal switch.  Source:  International Journal of Obesity

On many weight loss surgery forums I look at from time to time, some people have asked, “Which is the best surgery to have?  Which one will help me lose the most weight?”  That’s a little difficult to answer, because all of us are different.

The short answer is to speak with your doctor about which surgery is best for you and your unique circumstances.  I highly recommend doing your own research to see all of what’s out there to make the final determination.

There are several types of weight loss surgeries out there; the most common ones are the ones shown in the graphic above.  In my opinion – and keep in mind that I’m not a doctor – I don’t think that one is necessarily better than the other or is going to help you lose the most weight.  It will be your long-term dietary and exercise habits that will make any weight loss procedure to be effective.  I happened to choose the gastric sleeve because it seemed the most appropriate and medically safe approach for me and my long-term health goals.  I’m not comfortable with someone rerouting my insides via the bypass or duodenal switch.  I don’t want a foreign object inserted into my body either, so I chose not to have the lap band.  And I know I need help longer than 6 months, so the gastric balloon would not be a good fit for me. vBloc Therapy sounds scary to me, and the weight loss stomach pump just seems unbelievably gross.

If you are unsure, below is a brief summary about each of these procedures in layman’s terms:

  • Laparoscopic adjustable gastric banding (aka “the band” or “lap band”):  A small silicone band is placed around the stomach and tightened to restrict how much food the stomach can hold at one time.
  • Vertical gastric sleeve (aka “the sleeve”):  Half of the stomach is physically removed, leaving it banana-shaped, and unable to allow more than a few ounces of food at a time to be consumed.
  • Roux-en-Y gastric bypass (aka “the bypass”):  A small pouch at the top of the stomach is detached from the rest of the stomach and reconnected to the bottom of the small intestine (the top portion of the small intestine is considered “bypassed”), leaving you a stomach pouch about the size of an egg. This severely limits how much food you are able to consume at one time.
  • Bibliopancreatic diversion with duodenal switch (aka “duodenal switch” or “the switch”):  This procedure is a mix of the sleeve and the bypass; half of the stomach is physically removed, leaving it banana-shaped.  Then the new stomach is reconnected to the bottom portion of the small intestine.
  • Gastric balloon:  An implant is placed into the stomach, taking up most of the space in your stomach so that only a few ounces of food is able to fit inside with it.  The gastric balloon is removed after a maximum of six months.
  • Vagal Blocking Therapy (aka “vBloc Therapy”):  A device, similar to a pacemaker, is implanted in the abdomen that interrupts the hunger signals received by the brain, making you feel fuller longer.
  • Weight loss stomach pump/Aspire Assist:  A tube is attached from the stomach to a port on the outside of the skin’s surface, allowing you to manually drain undigested food out of your body before it can pass through for digestion and absorption of fat, calories and carbs.

(Sources:  Bariatric Surgery Source, American Society for Metabolic and Bariatric Surgery, Bariatric Times, The US Food and Drug Administration, and the National Institute of Diabetes and Digestive and Kidney Diseases.)

Because of all of the options out there, it’s important to talk to your doctor about what’s best for you.  Not all of these options are going to be appropriate for you, and it could be that your doctor decides that the procedure you choose might not be in your best interest for several reasons.  For example,

Again, do your own research and talk about it with your doctor.  And get a second opinion or third opinion if necessary.  This is a huge decision, and you need to be comfortable with your choice as well as the decision your doctor deems is best for your unique situation.


How did you approach the decision about which surgery you will have?  What considerations were the most important to you?  I’d love to hear from you!

Disclaimer:  I want to again stress that I am NOT a medical doctor and am unable to provide medical advice.  Please do your research and speak with your doctor for advice about your unique circumstances.


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