9 Differences between Gastric Bypass and Gastric Sleeve Surgery

For individuals choosing between gastric bypass and gastric sleeve surgery, the decision should be made in consultation with a medical professional. Both procedures can assist individuals in losing excess weight, despite differing in how the procedure is performed. Each treatment has its benefits, risks and effects on related conditions. How does gastric bypass vary compared to gastric sleeve surgery?

1. Rate of weight loss

Gastric bypass is considered to result in a quicker rate of weight loss compared to gastric sleeve surgery. While both gastric sleeve surgery and gastric bypass restrict the volume of food an individual can consume, gastric bypass also uses malabsorption and metabolic changes to further promote weight loss. Gastric bypass:  

  • Limits the amount of nutrients (including calories) the body can absorb due to altering the digestive system and its function
  • Reduces the level of hunger-inducing hormones found in the digestive system due to changes in the digestive tract

This can be especially beneficial for individuals with a higher BMI (Body Mass Index). 

2. Better Resolution of Comorbidities

Individuals who undergo gastric bypass surgery often experience a high rate of improvement or resolution of obesity-related health conditions. Conditions such as hypertension and sleep apnea show signs of improvement and for some patients, result in a full remission of symptoms.  

Most notable are improvements in type 2 diabetes. The results were significant enough for Diabetes Australia to issue the following statements:

  1. “Research shows is it possible for some people to achieve type 2 diabetes remission”* and 
  2. “After bariatric surgery, blood glucose may return to normal levels without medication in up to three out of four people with type 2 diabetes”

Dr Kuzinkovas explores the effects of gastric bypass on type 2 diabetes in more detail here

3. Malabsorption 

Gastric sleeve relies on restrictive methods to reduce the volume of food an individual can consume. This results in a lower overall calorie consumption. Gastric bypass combines the restrictive method with a malabsorptive method. This encourages weight loss by altering how the body digests food. By changing the digestive path to bypass the upper intestines, fewer calories are absorbed from the food consumed. 

4. Rapid Initial Weight Loss

Due to changes in the digestive system being more significant, individuals who undergo gastric bypass often achieve a faster rate of initial weight loss compared to gastric sleeve surgery. While rapid weight loss is not the sole measure of success, patients can experience higher levels of motivation which promotes a healthier lifestyle following surgery. 

5. Reduced Hunger and Appetite

Ghrelin is a hormone that is found in the digestive system. It is partially responsible for the feeling of hunger. Often referred to as the hunger hormone, ghrelin activates the appetite which can lead to increases in food intake. 

Unlike the gastric sleeve, gastric bypass has been shown to reduce the production of ghrelin in the stomach. This improves the individual’s ability to control their appetite and reduces the sensation of hunger between meals.

6. Enhanced Diabetes Control

Both gastric sleeve and gastric bypass procedures show promising results when it comes to positively affecting insulin resistance patients. According to Diabetes Australia, insulin resistance describes a “process where the body no longer responds to insulin in the way it should. It often precedes a diagnosis of type 2 diabetes”. 

While further research is required, it is understood that gastric bypass surgery is likely to provide greater improvements over and above gastric sleeve surgery. This is due to the changes in the digestive tract and how nutrients such as glucose are absorbed.

7. Lower Risk of Acid Reflux 

Although rare, gastric sleeve surgery does carry a risk of gastric acid reflux. Gastric bypass surgery typically results in lower cases of GERD (gastroesophageal reflux disease). Gastric bypass is also considered to be one of the most effective surgical treatments for GERD symptoms in patients who have previously undergone weight loss surgery.

8. Lower Risk of Weight Regain

When comparing the gastric sleeve and gastric bypass for weight regain, the gastric bypass procedure makes it easier for patients to keep the weight off following surgery. This is due to the complementary effects of restriction and malabsorption. 

9. Reversible 

Gastric sleeve surgery results in the removal of approximately 75% of the stomach to achieve the desired weight loss. Gastric bypass however doesn’t remove the stomach. A small section of the stomach is used to create a gastric pouch. Once food is ingested, it is redirected to ‘bypass’ a portion of the upper digestive tract. This approach results in gastric bypass surgery being reversible. 

Choosing the best weight loss procedure

An individual’s current health and medical history are the most important elements when it comes to determining the most appropriate type of weight loss surgery. Risk factors, related conditions and BMI are all considered during the initial process to ensure each weight loss journey is as successful as possible. 

If you’d like to arrange an appointment with Dr Kuzinkovas, get in touch with our team today by contacting our clinic on 1300 551 533.

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