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Which Type of Weight Loss Surgery Is Right for Me?

September 20, 2024

If you’re struggling with obesity, weight loss surgery can be an effective solution.

But with so many to choose from, how do you know which type of weight loss surgery is right for you?

We asked Danielle Friedman, MD, a general and bariatric surgeon with the Hartford HealthCare Digestive Health Institute, to share more details.

Are you a candidate for weight loss surgery?

Before considering weight loss surgery, talk with your doctor to make sure it’s right for you.

“Weight loss surgery can usually help people lose about 25-30% of their total body weight,” says Dr. Friedman. “In comparison, the most effective weight loss medications typically result in about 15% total body weight loss.”

To determine if weight loss surgery is right for you, your doctor will evaluate several factors, including:

• Body mass index (BMI)
• Other existing medical conditions
• Prior surgeries
• Pre-existing gastrointestinal conditions
• Plans for future pregnancy
• Current medications
• Various lifestyle factors

“Weight loss surgery is an individualized decision,” says Dr. Friedman. “The first step in determining the best option is a thorough discussion with your healthcare provider.”

> Related: What to Expect Ahead of Weight Loss Surgery

4 different types of weight loss surgery

1. Gastric bypass

For patients who have more weight to lose and more moderate obesity-related conditions like diabetes, sleep apnea or heart disease, gastric bypass may be an effective option.

This procedure divides the stomach into a small pouch and a larger, unused “remnant stomach.” The small pouch is then connected to a lower part of the small intestine, creating a detour around some of the digestive tract.

“Gastric bypass typically results in about 70-80% loss of excess weight, which is the difference between a person’s current weight and their ideal body weight based on height,” says Dr. Friedman. “While that ideal weight may not be the actual goal, this formula helps us standardize discussions about outcomes.”

2. Sleeve gastrectomy

Sleeve gastrectomy is the most popular weight loss surgery today. It’s often a safer choice for patients with a high BMI (over 65) or conditions like severe heart disease, as it requires less time under anesthesia and has a lower risk of certain complications.

In this procedure, about two-thirds of the stomach is removed, leaving a narrow, tube-shaped stomach connected to the esophagus and small intestine. While it typically results in 60-70% excess weight loss, there are some potential considerations.

“Between 20-30% of patients may experience new or worsening acid reflux after the surgery, so it might not be the best option for those with severe GERD or heartburn,” notes Dr. Friedman.

3. Adjustable gastric banding

In this procedure, a plastic ring with a small port is placed around the upper stomach. The port, located under the skin of the upper abdomen, allows fluid to be injected into the ring, tightening it to restrict the amount of food the stomach can hold.

“Adjustable gastric banding has a high rate of complications and is less effective,” says Dr. Friedman. “We don’t typically recommend it anymore.”

4. Other weight loss surgeries

Gastric bypass and sleeve gastrectomy are the most performed weight loss surgeries. But there are other options out there.

“There are also some endoscopic weight loss options, like the endoscopic sleeve or gastric balloon,” explains Dr. Friedman. “However, these are not effective long-term options and are not considered the ‘standard of care’ in most institutions.”

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Talk to your doctor about weight loss surgery.

High-quality research shows that bariatric surgery is safe and the most effective option for long-term weight loss, especially if you have a plan for after surgery.

“Patients need to be ready for long-term changes, like quitting smoking, following a healthy eating plan, making some lifelong dietary adjustments, taking vitamins and getting more active,” says Dr. Friedman.

Meeting with a bariatric surgeon is a great place to start if you have questions about weight loss surgery or other methods.

“This doesn’t mean you have to have surgery,” adds Dr. Friedman. “We’re here to help you find what works best for you.”