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The fascinating pros and cons of different weight loss surgeries

Before and After BMI

September 14, 2015

The fascinating pros and cons of different weight loss surgeries

Stomach with belt fastened around it

If you have struggled to lose weight for years, you may be at your wits’ end comparing different weight loss options. Have you considered surgery? As long as you meet the requirements for weight loss surgery – including being 18 years of age or older and having a high body mass index and obesity-related health problems – you could be a candidate.

Over the past 50 years, several weight loss surgery options have become available. Learn the pros and cons of each to help decide which is right for you.

Sleeve Gastrectomy

With this first procedure, three-quarters of your stomach is removed. The portion left behind resembles a sleeve through which food passes on its way to the small intestine.


  • Perfect for patients with a higher risk of complications from weight loss surgery, including those with morbid obesity. Losing weight with a sleeve gastrectomy opens the door to other procedures, such as gastric bypass, later down the road.
  • Fast weight loss: 30 to 50 percent of weight loss occurs in the first 6 to 12 months.
  • No implants involved, which decreases the chance of infection or other complications.
  • Results can be lifelong with dietary and lifestyle changes


  • The procedure is irreversible.
  • Staples can leak and cause infection.
  • You could still gain weight following a sleeve gastrectomy if you make poor dietary decisions.
  • Supplements are also required for the sleeve post op.

Gastric bypass

This procedure divides the stomach in half and shortens the small intestine. One half of the stomach collects food and sends it on as usual, while the second half simply creates digestive fluids. With a smaller stomach, you feel full faster, and with shorter intestines, fewer calories are absorbed.


  • Fast, dramatic results. As much as 50 percent of the total weight loss occurs in six months.
  • Rapid weight loss means rapid recovery from obesity-related health problems, such as high blood pressure, sleep apnea and diabetes.
  • With dietary and lifestyle changes, results can last a lifetime.


  • Supplements are needed to counter lower nutrient uptake, one of the most common weight loss surgery side effects.
  • Higher risk of complications such as infection, gallstones and blood clots.

Adjustable gastric band

A gastric or lap band is an inflatable device surgically placed around the stomach. When expanded, it shrinks the upper stomach, which fills up fast so you feel full after eating just a small amount of food.

  • The surgery is temporary. If you decide you want to have the gastric band removed, you can undergo low-risk surgery to do so.
  • Short recovery time.
  • Customizable, as you can ask the doctor to inject or remove saline from the band to make it tighter or looser.


  • Weight loss is slower.
  • The implant may slip or leak, resulting in pain that can only be fixed with additional surgery.
  • Requires regular fills (see below).

Lap-band fills

As explained above, gastric bands can be altered by adding or removing saline. A lap-band fill is the process of injecting more saline into the band to maximize weight loss efficiency.

  • Injections aided by fluoroscopy ensure the doctor knows where to stick the needle on the first try.
  • An image of the lap band appears right on the fluoroscopy screen. This helps you visualize how much your stomach is being constricted so you have a good idea of how much you should eat at each meal.
  • BMI of Texas can offer lap-band fills regardless of where you had your adjustable gastric band surgery.


  • Not every medical office uses fluoroscopy, which could result in second, third or fourth tries sticking the needle.
  • Requires frequent needle sticks, and radiation exposure of using fluoroscopy.

Revision surgery

It’s possible to regain weight or experience complications from weight loss surgery, requiring a revisit. When you want to reverse a past surgery or enhance your weight loss results, revision surgery may be required.


  • You can improve your results by altering your primary surgery.
  • The procedure is most often performed in a minimally invasive way.
  • BMI of Texas staff advocates on your behalf to increase the chance of your insurance covering the revision surgery.
  • You and your doctor will make the decision together on whether to operate again.


  • Riskier than the original surgery.
  • All patients are required to begin a medical weight loss program prior to having revision surgery. This ensures they learn what they need to lower the risks and prevent the potential of weight regain.
  • Extensive testing is needed to plan an operation with the lowest risks possible.

Incisionless revision surgery

Some revision surgeries may be candidates for an incisionless procedure, made possible by the Overstitch device. This device is attached to a scope and placed down the patient’s throat and into the stomach. There, the surgeon can place sutures, tighten connections and make other changes.


  • Surgeons can perform revision surgery without making any incisions from the outside.
  • Improved satiety and restriction without additional scars.
  • Very short recovery time.
  • Lower risk than traditional revision surgeries.


  • Long-term outcomes are still unknown because incisionless procedures have only been around for a few years.

Duodenal switch

Morbidly obese patients with diabetes tend to meet the weight loss surgery requirements for the duodenal switch procedure, which combines elements from the sleeve gastrectomy and gastric bypass. The switch involves removing about 80 percent of the stomach and bypassing part of the small intestines to decrease the amount of calories absorbed.


  • Drastic weight loss (the highest of any weight loss surgery option) during the first six months.
  • Most patients recover from obesity-related health problems, including diabetes, high blood pressure and high cholesterol.
  • Low risk of complications and high long-term success rate.


  • Mineral deficiencies require patients to take supplements every day for the rest of their lives.
  • Dumping syndrome (characterized by diarrhea, nausea, rapid heartbeat, fainting and flushing) may occur. Decrease the likelihood of this by following your doctor’s dietary suggestions.
  • Leakage, gallstones, hernias and strictures are all potential complications.

You can get more help choosing the right weight loss surgery option for you by speaking with a medical professional. Contact BMI of Texas to start your weight loss journey today.