Gastric Bypass vs Gastric sleeve: What are the Similarities and Differences?

Although most people immediately think of gastric bypass when they hear bariatric weight loss surgery, there are in fact many options for those considering bariatric surgery: gastric bypass, gastric sleeve, gastric band, etc. Each one of these surgeries has its own properties, its own way to induce weight loss, and its own advantages and disadvantages. 

Two surgeries that often get compared are gastric bypass and gastric sleeve, with many patients not being clear on their differences, relative performance, potential complications, etc. Here, we’ll explain both operations and then compare and contrast them, so you, as a patient, can make a more informed decision.

What’s Gastric Bypass and How Does It Work?

Gastric bypass surgery is a surgical procedure performed to aid severely obese individuals in their weight loss journey by modifying the way their stomach and small intestine process food. This intervention is typically recommended when other weight loss methods have proven ineffective.

During gastric bypass surgery, which is conducted under general anesthesia, two main steps are undertaken:

• Restructuring the Stomach: The surgeon divides the stomach into two sections – a small upper section called the pouch and a larger bottom section. The pouch, approximately the size of a walnut, has a limited capacity of holding around an ounce of food. This restriction helps patients consume smaller portions, leading to a reduction in calorie intake and subsequent weight loss.
• Reconnecting the Small Intestine: In the second step, the top portion of the divided small intestine is connected to a lower portion further down. This allows the stomach acids and digestive enzymes from the bypassed stomach and initial part of the small intestine to mix with the food.

Gastric bypass surgery is a significant medical procedure that requires careful consideration and evaluation. It is crucial to note that this intervention is typically recommended after other weight loss methods have been exhausted. By altering the way the stomach and small intestine process food, gastric bypass surgery aims to provide a long-term solution for individuals struggling with severe obesity.

Remember, this surgical procedure should be approached with a comprehensive understanding of its implications and a commitment to making necessary lifestyle changes to ensure successful weight loss and overall well-being.

Benefits and Health Risks of a Gastric Bypass Procedure

Gastric bypass surgery presents numerous benefits for individuals who are severely obese, including: 

• Reduction of Weight-Related Health Problems: A gastric bypass procedure effectively diminishes the risk of life-threatening conditions linked to obesity, including gastroesophageal reflux disease, heart disease, high blood pressure, high cholesterol, and obstructive sleep apnea.
• Short and Long-Term Weight Loss Success: Gastric bypass surgery consistently delivers substantial short-term weight loss, with individuals achieving a remarkable 60 to 80 percent reduction in excess weight. Moreover, it ensures enduring success in maintaining weight loss over the long term.
• Lifelong Commitment: It is important to acknowledge that gastric bypass surgery requires a significant and enduring commitment. Patients must embrace and sustain healthy lifestyle adjustments, such as dietary alterations and consistent physical activity, to uphold their weight loss and overall well-being. Additionally, it is advisable to refrain from excessive consumption of alcohol and soda in one’s daily routine.
• Short-Term Complications: Just like any surgical procedure, gastric bypass surgery carries the risk of short-term complications. It is crucial for patients to be aware of potential issues that may arise from the procedure. Therefore, it is highly recommended to engage in a comprehensive discussion with a doctor or surgeon prior to undergoing gastric bypass surgery.

Gastric bypass is not an operation for everyone who is overweight: to qualify, you have to either be severely obese (a body mass index (BMI) of over 40) or obese (BMI>35) with major obesity-related health problems. Gastric bypass helps with heart disease, type-2 diabetes, high cholesterol, high blood pressure, etc.

What’s Gastric Sleeve and How Does It Work?

Gastric sleeve surgery, also known as sleeve gastrectomy or vertical sleeve gastrectomy, is a common weight loss surgery that involves vertically slicing the stomach and removing around 75% to 80% of it so it is much smaller.

Gastric sleeve surgery, also known as bariatric surgery, is a highly effective procedure designed to facilitate weight loss by restricting food intake. This surgical intervention involves the removal of a significant portion of the left side of the stomach, resulting in the formation of a slender tube referred to as a sleeve. As a result, patients experience substantial weight loss and improved overall health.

How is a Gastric Sleeve Procedure Done 

The gastric sleeve surgery is performed laparoscopically, utilizing small incisions in the upper abdomen. This minimally invasive approach ensures a quicker recovery time and reduced scarring.

During the procedure, the remaining stomach maintains its natural function of emptying into the small intestine. No alterations are made to the small intestine itself.

The primary mechanism of gastric sleeve surgery involves the reduction of stomach size, effectively limiting the amount of food that can be consumed. By doing so, this surgical intervention aids in weight loss.

Furthermore, this procedure induces hormonal changes that contribute to weight reduction and alleviate obesity-related conditions, such as high blood pressure and heart disease.

It is important to note that gastric sleeve surgery is typically considered as a last resort, only recommended after other weight loss methods have been attempted without long-term success.

This surgical intervention is specifically designed to address severe obesity and is exclusively offered to individuals who have experienced persistent difficulties in achieving sustainable weight loss through alternative means. These individuals often suffer from significant medical conditions associated with their obesity or are at a high risk of developing them.

The benefits of gastric sleeve surgery extend beyond weight loss. This procedure has been shown to improve, and in some cases, eliminate various diseases, including insulin resistance, Type 2 diabetes, hypertension, hypertensive heart disease, hyperlipidemia (high cholesterol), and arterial disease.

By restricting the volume of food intake and reducing appetite, gastric sleeve surgery effectively aids in weight management. The use of minimally invasive laparoscopic techniques and small incisions ensures a safe and efficient procedure.

The results of gastric sleeve surgery are remarkable, with the majority of patients experiencing a loss of more than half their excess weight and successfully maintaining this weight loss for years to come.

How Does Gastric Bypass Surgery Compare to Gastric Sleeve Surgery?

Now that we’ve laid down how each operation is carried out, we have covered the necessary ground to start comparing them and delve into their many similarities and many differences.

Similarity Between Gastric Bypass and Gastric Sleeve

Both bariatric surgeries are similar:

• Target demographic

Both surgeries are broadly suitable for the same kind of patients: obese people with a BMI over 35 that suffer from weight-related health complications. Although gastric bypass is generally prescribed to people with a BMI of over 45 (due to its better weight loss effects) if you’re suitable for one of the operations, it is likely you’re suitable for the other.

• Results of the operation

Although there are some key differences, the results of the operation and the recovery broadly follow the same pattern for both procedures: you’ll start losing weight progressively for a 12-18 month period after both procedures, you’ll have to follow a strict diet for months after surgery, and you’ll be facing fairly similar risk profiles during either surgery.

Difference Between Gastric Bypass and Gastric Sleeve

• How each procedure is carried out

How a gastric bypass procedure is carried out, how you need to prepare, and how much you need to spend in the operation room are all different from a gastric sleeve procedure.

• How your body handles food

Although the end effect of both procedures are broadly similar, the way your body handles food after each procedure and how weight loss is induced are starkly different.

In the case of gastric bypass surgery, the operation helps you lose weight through two primary mechanisms: firstly, the smaller poach makes you feel full quicker, which forces you to eat less food, and secondly, due to the fact the food ‘bypasses’ most of your stomach and some of your intestine, your body is mechanically unable to extract as much nutrition from the food as it did before: this means you consume fewer calories for the same amount of food you eat.

In the case of gastric sleeve surgery, the primary weight loss mechanism is the far smaller stomach the patient has after the surgery. Similar to gastric bypass, this makes the patient eat less food and progressively lose excess weight. Unlike gastric bypass, however, a gastric sleeve doesn’t substantially influence how many calories the patient’s body consumes from food.

Gastric Bypass vs Gastric Sleeve: What are the Advantages of Each Operation?

The Advantages of Gastric Bypass over Gastric Sleeve

• The gastric bypass procedure is a more established bariatric surgery than the gastric sleeve. This doesn’t mean gastric sleeve is unsafe or experimental. It just means that there are more studies into the effects of gastric bypass, and there are more surgeons with experience carrying it out.
• As we’ve mentioned before, gastric bypass surgery impacts how your body extracts nutrition from food. This not only makes gastric bypass surgeries more potent weight loss procedures, but it means they can alleviate metabolic syndrome conditions.
• If you suffer from gastroesophageal reflux disease (GERD), gastric bypass surgery is the better option, since gastric sleeve risks exasperating the disease’s symptoms.

The Advantages of Gastric Sleeve over Gastric Bypass

• Gastric sleeve surgery is associated with less hunger, contrary to what people commonly believe. Hunger isn’t just about the mechanical elements of having your stomach feel full or empty, it is also about hormones (released primarily by your stomach) that send signals to your brain that you’re indeed hungry. So, despite gastric bypass patients having a smaller poach for food, since most of their stomach is still intact, the patients’ ability to release hunger hormones remain. While in the gastric sleeve’s case, because around 80% of the stomach is removed, less of the hormone is released. Feeling less hunger is not always an advantage, but for people who want to consistently lose excess weight, it definitely is.
• The weight loss after a gastric sleeve procedure happens more gradually than gastric bypass, and although this might sound like a disadvantage at first, studies are reporting some psychological and physiological benefits of a slower weight loss process (from less soggy skin to higher muscle retention).

Contrasting Recovery Processes Between Gastric Sleeve Surgery and Gastric Bypass Procedure

When comparing the recovery process of gastric surgery and gastric sleeve surgery, it’s important to note their significant differences despite their shared goal of weight loss. Let us delve into the specific aspects of recovery for each surgery:

Gastric Sleeve Surgery:

One advantage of gastric sleeve surgery is that the duration of anesthesia is shorter. This can be particularly beneficial for patients who are at a higher risk of experiencing surgical complications.

Compared to gastric bypass surgery, the recovery period for gastric sleeve surgery is generally faster. This means that patients can expect to resume their normal activities sooner.

Gastric sleeve surgery is considered to be less invasive when compared to gastric bypass surgery. This is due to the fact that it involves the removal of a portion of the stomach, rather than rerouting the digestive system.

Typically, the recovery time for gastric sleeve surgery ranges from 2 to 3 weeks. However, it is important to note that individual recovery times may vary depending on factors such as the extent of the surgery and the overall health of the patient.

Gastric Bypass Surgery:

The recovery time for gastric bypass surgery is slightly longer when compared to gastric sleeve surgery. Patients can expect a recovery period of around 4 to 6 weeks before they can resume their normal activities.

It is worth mentioning that gastric bypass surgery has consistently demonstrated positive results over decades of research. This further supports its effectiveness as a weight loss procedure.

It is crucial to note that individual recovery times may vary depending on factors such as the extent of the surgery and the overall health of the patient. Therefore, it is highly recommended to consult with a doctor and carefully consider personal preferences when making a decision between the two surgeries.

Key Differences Between Gastric Bypass and Gastric Sleeve Procedures 

Gastric sleeve and gastric bypass are two types of bariatric surgery that can effectively aid individuals in weight loss and improve obesity-related conditions. Although both procedures can lead to significant weight reduction within 1-2 years post-surgery, it is important to understand the distinctions between the two.

Gastric Sleeve Procedure 

This procedure involves the removal of a portion of the stomach, resulting in the formation of a tubular-shaped sleeve. It is solely restrictive in nature, meaning it reduces the size of the stomach and restricts the amount of food that can be consumed. Compared to gastric bypass, the gastric sleeve is less invasive and boasts a slightly faster recovery period.

Gastric Bypass Surgery 

In contrast, gastric bypass entails the creation of a small gastric pouch and the rerouting of the small bowel. This procedure is both restrictive and malabsorptive, as it not only reduces the size of the stomach and limits food intake but also diminishes the absorption of calories and nutrients. Due to the rerouting of the small bowel, gastric bypass is considered more invasive than the gastric sleeve.

Extensive research conducted over several decades has consistently demonstrated the efficacy of gastric bypass, showcasing rapid weight loss within the first six months and an ultimate reduction of 60-80% of excess weight.

Ultimately, the choice between gastric sleeve and gastric bypass hinges on various factors, including an individual’s overall health, body mass index, and personal preferences. While the gastric sleeve is less invasive and solely restrictive, gastric bypass offers the combined benefits of restriction and malabsorption, with a proven track record of long-term success.

• Please note that the cost ranges provided are approximate and may vary depending on factors such as the specific clinic, location, and individual circumstances. It’s always recommended to consult with a healthcare professional or directly inquire with healthcare providers for accurate and up-to-date cost information.