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Gastric sleeve vs gastric balloon

Before and After BMI

October 10, 2018

Gastric sleeve vs gastric balloon

Gastric sleeve vs gastric balloon: Your guide to the pros and cons

While bariatric procedures should still be accompanied by a change in lifestyle, they can make it much easier to avoid overeating and to lose weight with a successful long-term outlook.

Two of the most popular weight loss procedures are gastric sleeve surgery and the gastric weight loss balloon. The following guide will provide you with specifics about these procedures as well as the pros and cons of each to help you find the best fit for you.

Doctor pointing towards a virtual stomach she is holding in her other hand.

What happens during gastric sleeve and gastric weight loss balloon procedures?

Gastric sleeve

Gastric sleeve surgery is performed laparoscopically by making several quarter- to half-inch incisions in the abdomen, which makes it a simpler type of surgery than gastric bypass. Gastric sleeve is a permanent surgery that can’t be reversed.

About 75 percent to 80 percent of the stomach is removed in a gastric sleeve operation, and the remaining parts of the stomach are joined together to make a banana-shaped sleeve. Since this sleeve will only be about 10 percent of the size of the original stomach, it will hold much less food, and recipients of the procedure won’t be able to eat as much as they did prior to their surgery.

A smaller stomach means less storage for food, but this isn’t the only reason for the procedure’s success—in gastric sleeve surgery, the part of the stomach that produces ghrelin (a hormone that stimulates appetite and promotes fat storage) is removed. With less of this hormone in your body, you won’t want to eat as much food, and your body will store less fat.

Gastric weight loss balloon

Gastric weight loss balloons—also called intragastric or stomach balloons—are often considered to be a middle ground between medication and surgery. The capsule is made of gelatin that comes from pigs or a vegetable-based capsule. The balloon itself is made of plastic and when folded into the capsule it is slightly larger than a typical vitamin pill. You will simply swallow each capsule to deliver them to your stomach.

Once the balloon reaches your stomach, it will be filled and inflated with a nitrogen hexafluoride gas mixture, using a bendable tube attached to an inflation system. The balloon will be inflated to 250cc in volume which is the size of a small orange. Once the balloon is inflated, the bendable tube will be detached and gently pulled out from the mouth. Since the balloon is free-floating it will move around the stomach.

This first balloon can be left in your stomach for up to six months, during which time your appetite will decrease. The inflated balloon will decrease the amount of space available for food and therefore cause you to feel fuller after eating less food. After about a month, you will usually swallow a second balloon capsule and about two months later the third balloon capsule. All balloons will be removed about 6 months after the first capsule was swallowed.

What type of patient may be a good candidate for each procedure?

Gastric sleeve

You might be a good candidate for gastric sleeve surgery if you’ve been unable to lose weight through diet and exercise. You should be between the ages of 18 and 65 and have a BMI (body mass index) of 40 or higher. If you meet or exceed this BMI, you’re considered to be medically obese. For a point of reference, that means that if you’re 5 feet 9 inches tall, you’ll have a body weight of about 270 pounds or more.

You may also be able to qualify if you have a BMI of 35, which would put your weight at about 235 pounds or more if you’re 5 feet 9 inches tall. If you have this lower BMI, you’ll usually need to have at least one health problem that’s related to obesity, such as type 2 diabetes, hypertension, fatty liver disease or sleep apnea.

Since a gastric sleeve procedure is a surgical operation, you’ll need to be in good enough physical condition to handle the surgery and not have any medical issues that could make it especially risky. You should also be prepared to make changes in the way you eat and exercise and be able to handle any psychological changes related to the surgery and weight loss.

Gastric weight loss balloon

You may be a good candidate for a gastric weight loss balloon procedure if you’ve tried and failed to lose weight through diet and exercise. You should also have a BMI of between 30 and 40 (or sometimes as low as 27), meaning this procedure can be appropriate for people who have a lower BMI than what’s required for gastric sleeve surgery.

Having one or more obesity-related health issues—such as type 2 diabetes, hypertension, fatty liver disease or sleep apnea—is another recommended qualifier if you’re considering this type of procedure.

However, the procedure may not be advisable if you have had bariatric or gastrointestinal surgery in the past or have an inflammatory disease of the gastrointestinal tract. Other conditions such as a gastric mass, hiatal hernia, or liver failure may also disqualify you for a gastric balloon procedure.

Gastric balloon vs gastric sleeve: What results can you expect?

Gastric sleeve

Patients who have gastric sleeve surgery lose an average of about 60 percent to 70 percent of their excess weight. This degree of weight loss is usually reached by about 12 to 24 months after surgery.

In the beginning, most patients lose about a pound a day for the first two weeks, and weight loss continues from there. Since the amount of lost excess weight is significant, many patients see a reversal or significant improvement in obesity-related conditions.

Gastric weight loss balloon

Gastric weight loss balloon patients typically lose about 10 percent to 15 percent of their total body weight during the first six months. One study found that patients lost about 29 percent of their excess weight when they also received behavioral therapy in addition to the procedure. Obesity-related illnesses also show improvement, but usually not as much as with gastric sleeve surgery because the weight loss isn’t typically as great. As the balloon is removed after six months, the long-term results for this procedure are very much dependent on lifestyle changes.

What risks are involved?

Gastric sleeve

Gastric sleeve surgery has a low rate of complication—but as with any surgery, complications are a possibility, with most occurring within 30 days after surgery. Patients may have a reaction to the anesthesia or have bleeding or a gastric leak from the staple line. Intra-abdominal bleeding, blood clots, infection and heartburn can also occur. In addition, malnutrition is possible—as you’ll be taking in fewer calories, you may become deficient in vitamin B-12, folate, zinc and vitamin D if you do not take proper supplements.

Gastric weight loss balloon

The gastric weight loss balloon procedure is associated with minimal complications, most of which occur if the balloon is left in your stomach for more than six months. Complications such as nausea, vomiting, diarrhea and abdominal pain may result as your body becomes accustomed to the balloon’s presence, and the balloon may also deflate, although this is rare.

Close-up of female doctor gesturing with hands to the patient on the other side of the desk.

Gastric balloon vs sleeve: Which is better gastric sleeve or balloon?

Gastric sleeve


  • Has a higher expected weight loss
  • Has a greater ability to reduce or eliminate obesity-related health conditions
  • Faster results
  • Long-term tool


  • Has a higher risk of complications
  • Can’t be reversed

Gastric weight loss balloon


  • Less invasive, as it’s performed endoscopically (through the mouth) and doesn’t require a change in anatomy
  • General anesthesia required only removal
  • Device is temporary; procedure can be reversed if desired
  • Can be performed on patents with a lower BMI
  • Usually has a lower cost when looking at cash pay prices
  • Quicker procedure (takes less than 30 minutes vs. about 100 minutes for the gastric sleeve)
  • Quicker recovery
  • Lower risk of complications


  • Lower percentage of average weight loss
  • Less effect on obesity-related conditions since less weight is lost
  • Not covered by insurance

How do you decide which weight loss procedure is right for you?

Essentially, some of the differences in these procedures come down to the fact that the gastric weight loss balloon procedure is less invasive, has a lower risk of complications and has a quicker recovery time when compared to gastric sleeve surgery. The trade-off, however, is that this procedure usually results in a lower percentage of weight being lost—and as a result, it has a reduced impact on obesity-related diseases when compared to gastric sleeve surgery.

Talk to your doctor about the pros and cons of each weight loss option in terms of your unique situation. In helping you make the right choice, your doctor will consider the amount of weight you have to lose, as well as the percentage of your overall body weight that needs to be lost. The efforts you’ve taken to try to lose weight should be discussed, and your medical history as well as your current overall health must also be taken into account.

Armed with this specific information, your doctor can then advise you on which, if any, weight loss procedure would be appropriate for you, as well as ensuring you understand what will be expected of you after the procedure. More specifically, you’ll need to make a commitment to living a healthier lifestyle, which includes making changes to your diet and making time for regular physical activity to help you lose the weight and improve your chances of keeping it off over time.

Contact our specialists at BMI of Texas today to begin discussing the best weight loss plan and procedure for you.