If you’re considering bariatric surgery, two of the most common options are gastric sleeve (sleeve gastrectomy) and gastric bypass (Roux-en-Y gastric bypass). While both are effective tools for long-term weight loss, they work differently — and the right choice depends on your health goals and medical history.

In this article, we’ll break down the differences, pros, cons, and how to decide which one may be right for you.

What Is Gastric Sleeve Surgery?

Gastric sleeve surgery removes about 75–80% of your stomach, leaving behind a narrow, sleeve-shaped pouch.

Key Features:

• Reduces the size of the stomach (restrictive)
• No rerouting of intestines
• Fewer complications than bypass in some cases

Benefits:

• Shorter surgery time
• Lower risk of vitamin/mineral deficiencies
• Appetite is naturally reduced due to lower ghrelin (hunger hormone) levels

What Is Gastric Bypass Surgery?

Gastric bypass creates a small pouch from the stomach and reroutes part of the small intestine to that pouch. This limits food intake and changes how your body absorbs calories.

Key Features:

• Both restrictive and malabsorptive
• More dramatic early weight loss
• May resolve acid reflux more effectively than sleeve

Benefits:

• Long history of proven success
• Stronger impact on blood sugar control for type 2 diabetes
• Often recommended for patients with GERD or severe obesity

How Do the Weight Loss Results Compare?

Both surgeries lead to significant long-term weight loss. On average:

• Gastric sleeve patients lose 50–70% of excess weight
• Gastric bypass patients lose 60–80% of excess weight

Bypass may lead to slightly more weight loss, especially in the first 12–18 months.

How to Know Which One Is Right for You

Choose gastric sleeve if you:

• Want a simpler procedure with fewer nutritional risks
• Don’t have severe acid reflux
• Prefer not to have intestines rerouted

Choose gastric bypass if you:

• Have type 2 diabetes, GERD, or more severe obesity
• Need greater appetite control or metabolic impact
• Are okay with a more complex procedure and stricter vitamin regimen

Talk to a Bariatric Surgeon

Every patient is different. At BASS Bariatric Surgery Center, our experienced surgical team will evaluate your health history, lifestyle, and weight loss goals to help you choose the safest and most effective option.

Ready to Take the Next Step?

Request a consultation with our bariatric team today and learn which procedure is right for you.