Gastric Sleeve vs Gastric Bypass – Which is Better?

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Thank you for choosing my blog to help resolve the battle of gastric sleeve vs gastric bypass in your quest to decide which procedure you will undergo or even just to learn more about these two procedures.

Here’s my story!

When I started the journey toward weight loss surgery, the medical plan I was on only allowed two options, gastric bypass (medically known as Roux-En-Y) or gastric sleeve (Sleeve Gastrectomy). Yes, other weight loss procedures existed, but my surgeon’s plan would address only the two most effective procedures. The patients under that plan get to choose which of these two surgeries they will undergo. Hopefully, your surgeon allows this, too.

For now, we’ll focus on these two, the top two surgeries so we can address most people with this article.

I try not to get too much into medical terminology with my writing; mostly because laymen’s words are much easier to spell. So please bear with me as I try to explain these two procedures in some sort of hybrid between medical terms and laymen’s terms.

As always you can comment below if you have something to add to this article or if you have a question

Bariatric Surgery – A Short History Lesson

Of the top two weight loss surgeries, which procedure do you think has been around the longest?

Trying to force the human body to lose weight has been going on for a very long time. Have you ever heard of people having their stomachs stapled?

Stomach stapling for weight loss has been around since only 1980 and, believe it or not (Interesting fact alert), was developed by the same guy that created the original gastric bypass surgery in 1966.

The reason I’m mentioning stomach stapling in this article is because I believe that both of today’s top two weight loss procedures were created using stomach stapling as a base. It certainly took gastric bypass surgeries to an improved level.

Gastric Bypass – It Got a Bad Rap!

While gastric bypass has been around since 1966, it went through a long, mysterious period. Causes and effects of symptoms were not consistent and a significant number of patients were afflicted with lifelong complications.

The procedure that is being performed today has been around since 1993. There are several technical variations of this procedure, but we’ll leave that stuff for your surgeon to think about.

So Why Is it Any Safer Now?Laparoscopic Surgery

Surgical tools! Now that surgeries can be performed without opening us up, there are shorter recovery times, less risk of infection, less time under anesthesia…all of those things, and more! The anesthesia is very hard on our bodies. The shorter surgical times mean that you are under anesthesia for a lot less time.

That’s a big deal!

The Sleeve – A New Kid in Town

The sleeve gastrectomy has been performed in the United States since about 2010. It was performed as a modification to one of the other weight loss surgeries and was also performed as a way to perform the first part of a bypass surgery so a risky patient wouldn’t have to be under anesthesia for so long. Of course, this patient would end up having to undergo a second surgery to complete the procedure.

At some point the doctors were learning that, in many cases, the first part of this two-part surgery was working very well. Well enough, in fact, to make it a stand-alone procedure.

New Kid In TownA new surgery was born!

Being so much newer means that there is a lot less study material to sort through. The statistics aren’t backed by 25 years of results, only 8 years. That’s something to consider.

For me, a big consideration was that a sleeve gastrectomy doesn’t take as long to perform as the gastric bypass does.

As I mentioned before, less time under the knife is a big deal.

What is the Procedure?

Okay, I’m not going to get into the pre-surgical appointments, your visit to the hospital, going into surgery, recovery or even the weight loss aspect of the procedure. I’m simply writing here what your surgeon will be working on while they are under the hood, so to speak.

  • Gastric Bypass (Roux-En-Y)

With this procedure, your surgeon will cut your stomach into two pieces. The smaller of the two pieces will now be known as your pouch. It will remain attached to your esophagus. The larger part of your stomach remains attached to your small intestine and plays a vital role in your digestion and absorption of nutrients.

Once your stomach is parted then closed, the surgeon will take your small intestine and cut it in two. The end with all the rest of your intestines attached is brought up and attached to your pouch. The end of the small intestine that comes from the lower part of your stomach will then be attached further down your small intestine. That creates the “Y” and is why it is called a bypass (Roux-En-Y).

Drawings of both procedures

  • Gastric Sleeve

With sleeve gastrectomy, the surgeon cuts off about 85% of your stomach. Your esophagus, stomach and intestines remain intact and attached throughout the procedure. The remaining stomach is closed and the part that was cut off is removed from your body.

Which Surgery Is Most Effective? – It’s All In The Numbers

Statistically speaking both surgeries work just about as well, meaning that you can expect about the same results without regard to which surgery you choose. As I mentioned above, there are a lot more statistics for the bypass than there are for the sleeve. That means that the statistics may be more reliable.

Talking about statistics, there’s always a margin of error. The trend in almost all statistics shows that the bypass is more effective, but there’s that pesky littleStatistic Say margin of error there trying to say they are, essentially, the same.

So these are the layman’s statistics: If you only care about which is most effective, it’s the bypass. If you are concerned about how long you will be in surgery, it’s the sleeve (I’ve had the sleeve, have lost 120 pounds and am still losing).

That makes a great place to put the next section.

PROS and CONS – The Good, The Bad and The Ugly

Here are some pros and cons that caught my attention:

Gastric Bypass


  • Probably slightly better results in both the short (faster) and long (more weight) term.
  • Comes with its own penalty system to let you know when you’ve made a dietary mistake (Dumping Syndrome).


  • Dumping Syndrome.
  • Your body is rearranged.
  • Mal-absorption of required nutrients is very common.
  • Longer times in surgery.

Weighing it out


  • Shorter surgery times.
  • Your body remains the way it was designed.
  • Less risk of mal-absorption.
  • Far less likely to have a dumping reaction.Cons:
  • Probably slightly less success in both the short (faster) and long (more weight) term.
  • Has no built-in punishment system (almost no dumping).


  • Probably slightly less success in both the short (faster) and long (more weight) term.
  • Has no built-in punishment system (almost no dumping).

So… Which Is Best? – An Opinion Piece

It’s hard to believe that, prior to my surgery, I did my due diligence only to end up with the same result that you’re coming up with today.

That’s right. I did all this writing to provide a little bit of insight from someone who’s had a surgery (My wife has, too) and has come to the conclusion that this really is a decision that you and your doctor have to make together.

Once you decide what you want, tell that to your doctor and see if you can make that happen.

Opinion PieceThis is where my opinion comes in:

I recommend gastric sleeve surgery because there are a lot fewer cuts being made, which means to me that there are fewer opportunities for something to go wrong. I also find it appealing that my body still works the way it was designed to work.

Laparoscopic gastric bypass remains to be one of the most difficult laparoscopic surgeries to perform. That is one reason that the patient’s time under anesthesia is increased.

Let’s face it; we’re big people. Anesthesia is harder on big people. Why take the added risk?

You might want the gastric bypass, but maybe you have other conditions that keep you from being under the knife for as long (like a heart or a lung condition).

Those are very real examples.

That’s All There Is

Which ever surgery you choose, you are going to lose weight. You will sometimes feel sick, you will sometimes miss your favorite food and you will sometimes put WAY more on your plate (and in your mouth) than you should have. So you’ll sometimes struggle.

These surgeries change our bodies, they don’t change our minds.

That’s why I started this blog. It sometimes feels like punishment. Most of the time, though, it feels GREAT!

I went to a family reunion today (October 5, 2018). Many family members were present that I hadn’t seen in years. None since my surgery. Days like today are the payoff! I’ve lost 120 pounds and not a single family member didn’t talk incredulously about how great I look.

Here are a couple of pictures that are not “traditional” before and after pics:

My Before

I really don’t know how I felt comfortable in life
before surgery!

So come back and share the highs and lows with me here. I’ll be writing more definitive information here…support type articles about nutrient absorption, supplemental requirements, dietary requirements and other things that people like you inspire me to write about.

I kind of want this site to find balance in being a food, diet and support blog for those who are considering or have had weight loss surgeries.

My Before

This is from a vacation I took 1 week before my surgery

Me After 52nd

This is me on my 52nd Birthday in 2018

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