Obesity surgery: What are the options?

If you’re obese and haven’t been able to achieve and maintain a healthy weight through lifestyle changes, your doctor may recommend surgery. There are a number of options available, each with pros and cons. The ideal option depends on a number of factors, including overall health, risks and weight loss goals.

The term bariatric means relating to or specializing in the treatment of obesity. Bariatric surgery is an umbrella term for weight loss surgeries such as gastric bypass surgery. Bariatric surgery involves making changes to a person’s digestive system to help with weight loss. These kinds of surgery are best for people who are obese and have not been able to lose weight through diet and exercise changes. People pursuing bariatric surgery to lose weight may also have serious health issues they are looking to manage or improve.

There are a few options when it comes to weight loss procedures. You may be a suitable candidate for bariatric surgery if you are considered severely obese, which is defined as having a body mass index (BMI) over 40, or if you have a BMI between 35 and 40 and at least one serious obesity-related health issue. BMI is an estimate of body fat based on an adult’s weight in relation to their height.

Gastric bypass surgery

The most common bariatric surgery for severe obesity is gastric bypass surgery, which involves making the stomach smaller by closing off some of the stomach and creating a small pouch. This smaller stomach pouch is connected directly to a person’s middle intestines. This is a way to bypass most of the stomach and induce weight loss. The surgery changes hormones and bacteria in the body, which impacts appetite. The creation of the pouch from the stomach leads to lower calorie absorption in the body and promotes weight loss. This procedure is highly effective as patients lose an average of 70% of their excess body fat. The surgery is difficult to reverse, but can be reversed if necessary.

Gastric sleeve procedure

Sometimes called sleeve gastrectomy, gastric sleeve procedures are another type of weight loss surgery. The surgery involves removing a large portion of the stomach, leaving a narrow tube, which leads to limited food consumption and hormonal changes that help with weight loss. This procedure is considered less invasive than gastric bypass because there is less disruption to the intestines. However, the success rate is more variable, and this procedure cannot be reversed.

Gastric balloon procedure

Another option for weight loss surgery is a gastric balloon procedure, which involves a doctor placing a balloon inside a person’s stomach through the mouth and throat. This balloon takes up space in the stomach, leading to limited food consumption and weight loss. This procedure is growing in popularity because it is safe, nonsurgical and easy to perform. However, the balloon must be removed and replaced every six months, and weight loss results are usually more limited.

While bariatric surgery is generally safe, there can be complications. Some gastric bypass side effects after surgery may include infection, blood clots, excessive bleeding and breathing problems. Long-term complications from bariatric surgery can include bowel blockages, gallstones, hernias and sometimes the need for a second procedure or surgery.

There are many potential benefits of bariatric surgery. People pursuing this surgery are often facing health issues such as type 2 diabetes, heart disease, high blood pressure and sleep apnea. Bariatric surgery can improve these issues and allow for more physical movement in daily life. For severely obese people, the surgery can even extend lifespan by years.

There are multiple options when it comes to bariatric surgery. When diet and exercise modifications don’t lead to weight loss, these procedures can improve health conditions and quality of life. However, not everyone who is overweight or obese is the right candidate for bariatric surgery. Speak with your healthcare provider if you would like to learn more about weight loss surgery options.

Clinically reviewed and updated October 2023.