Gastric Bypass vs Gastric Sleeve

Gastric bypass and gastric sleeve are two surgeries used for weight loss, which are highly helpful in regulating metabolic diseases such as diabetes mellitus and even cancer. Both surgeries are performed laparoscopically. Small abdominal incisions are made, and the laparoscope (a long, narrow lens attached to a camera and light), along with other required instruments, are introduced into the abdomen.

Advantages of Gastric Bypass and Gastric Sleeve

Gastric bypass is very popular due to its effectiveness and rapidly visible results. Studies show that after a gastric bypass, people lose around 70 to 80 percent of their excess body weight. Due to the malabsorption caused by this procedure, people start having bowel movements more frequently, on average three to four times a day. This malabsorption means that only 60 to 70% of what you eat is absorbed. In addition, the gastric reservoir created during the procedure is much smaller than a normal stomach, so the patient consumes less food.

For these reasons, gastric bypass is a highly effective surgery for long-term weight loss. Another advantage is that it achieves better blood glucose control in diabetic patients. Although gastric bypass is considered a permanent surgery, in rare cases, it can be reversed. However, restoring the original integrity of the gastrointestinal tract requires a highly complicated procedure.

The gastric sleeve is the most performed obesity surgery worldwide. It offers two simultaneous results: it reduces the amount of food that fits in the stomach and decreases the feeling of hunger by removing the part of the stomach responsible for producing ghrelin, which is one of the main hormones responsible for appetite.

The gastric sleeve helps a person lose between 50 and 60% of their excess body weight. It also achieves blood glucose control for diabetic patients, slightly lower than the bypass, which means that the latter remains the choice for patients with diabetes mellitus. Even so, there are patients who do not want to subject themselves to the lifestyle after the bypass, and for these patients, the sleeve is an excellent option. After the gastric sleeve, the intestinal tract is not changed, so food follows its normal path; even so, it will be necessary to consume nutritional supplements, although more flexibly than with the gastric bypass.

Both surgeries are highly effective in reducing the risk of diseases such as cancer and the decrease in life expectancy that obesity brings. After a bariatric surgery of this type, you will live longer and better.

Disadvantages of gastric bypass and gastric sleeve

Experienced surgeons perform these surgeries quickly and effectively on a daily basis; however, as in any surgery, there is a possibility of complications such as bleeding, infections, or thrombosis, which can cause pulmonary thromboembolism. For this, many preventive measures are always taken, which have successfully reduced the risk of thromboembolism to 0-3%. The specific possible complication of gastric bypass is dumping syndrome (rapid emptying), which can cause diarrhea, vomiting, and abdominal pain, which can appear immediately or minutes after eating certain types of food, for example, very sweet or fatty ones. This can lead the patient to be afraid of consuming certain types of food in public places; for this, patient education is very important, which is achieved with an interdisciplinary team composed of psychologists and nutritionists. On the other hand, after the bypass, there is a malabsorption of nutrients. This helps with extra weight loss, but it also interferes with the absorption of substances (calcium, vitamins, iron, zinc) that are essential for the body, so nutritional supplements must be used for life. The main disadvantage of the gastric sleeve is that it is a much newer procedure, so less research and study have been done on it, and it is irreversible. Furthermore, there is the possibility of regaining the lost weight if the patient does not make a permanent change in their lifestyle and if they do not continue with the support of an interdisciplinary team like the one mentioned.

Life After Surgery

After gastric surgery, the person must modify their lifestyle, especially during the first 6 months. Certain limitations must be followed. For example, patients will have to reduce high-fat foods and sweet foods. Also, cereal, dry bulk products, nuts, and hard vegetable skins must be avoided due to digestion difficulties. They must chew slowly and avoid sugary drinks like non-diet sodas. These measures are necessary after both procedures. The main difference between the lifestyle led with the gastric sleeve and the bypass is that gastric sleeve patients have to take fewer nutritional supplements than those with gastric bypass. During the first 6 months after gastric bypass, approximately 60% of excess weight is lost. In the following years, the weight decreases slowly and finally the weight becomes constant. After the gastric sleeve, weight loss is slower but constant until it finally stabilizes at a certain weight.

We can see that both surgeries have their advantages and are performed according to the specific requirements and needs of each patient. The important thing to highlight is that invariably, the participation of the patient and their adaptation to new and better habits is necessary in both cases. Bariatric surgeries are very efficient in obtaining results, but their permanence always depends on the patient's willingness to maintain a healthy diet and an active and healthy life.

For more information on any of these or other surgical procedures, do not hesitate to contact us.