Operations to lose weight: sleeve, bypass or gastric band?

May 20, 2020: Posted by Mohamed Kahna

Note: The goal of the article is to spread awareness, so does not constitute medical advice and medical opinion should be sought for further information because the diagnosis may differ for each patient.

When you are severely overweight and want to lose several dozen kilos, it is possible to resort to obesity surgery, which consists of reducing the size of the stomach. There are 3 interventions, which require medical follow-up: the sleeve, the bypass and the gastric band.

When surgery helps you lose weight

Losing weight can be done in many different ways: through sport, dieting, rebalancing your diet, etc. But when these means have not worked, surgery can be used to reduce weight permanently and help prevent weight regain. These surgical operations, of which there are 3, can allow you to lose up to 50 kilos progressively and are generally aimed at adults with sufficient bone mass. The patient must not have any contraindications to the surgery, and have a high BMI, that means be obese, which justifies the intervention. The choice of the operation is made according to each patient, in agreement with the medical profession.

The sleeve or gastrectomy, when part of the stomach is removed…

A gastrectomy, also called a sleeve, is a restrictive technique that consists of removing part of the stomach, specifically two-thirds, to form a tube. Food will then be sent to the small intestine more quickly. This surgery is intended for patients who are morbidly obese, i.e. overweight, which affects their physical health and quality of life on a daily basis. In fact, it is an operation recommended by the medical profession. This operation reduces the patient’s appetite and therefore helps them to eat less every day. The results are visible after several months. It is the most common and most drastic operation, which reduces the stomach to a volume of about 20ml, and also reduces the feeling of hunger. Side effects can be transit problems (constipation) or gastric reflux.

Bypass, the procedure that reduces the size of the stomach…

Gastric bypass is a restrictive and malabsorptive operation, which consists of reducing the size of the stomach (about 100 ml) by changing the usual food circuit and disrupting the absorption of food. This is the second weight loss surgery after the sleeve. After the operation, the food no longer passes through the digestive tract but goes directly into the small intestine, which in fact reduces the size of the stomach. Very sweet foods are less easily digested and cause a feeling of nausea when ingested, so consumption drops drastically. Fats are also less easily digested, allowing the patient to assimilate less of them and therefore lose weight, especially when this procedure is associated with sports. Finally, the bypass reduces the appetite by lowering the level of ghrelin, which is the hunger hormone.

Gastric banding, to change the shape of the stomach

Gastric banding, which is a restrictive surgical technique just like the sleeve, makes it possible to modify the physiology of the stomach: it will “compress” it in its centre to transform it into an hourglass. After fitting, the band, which is inflatable, remains adjustable, allowing the medical profession to control weight loss throughout the post-operative follow-up. Although the operation is reversible, the ring is not meant to be removed: this would result in weight regain. Once the band is in place, the patient will feel fuller faster than before, due to the contraction of the stomach, which can only hold a limited amount of food at a time. Meals should be taken slowly, bit by bit, with bites spaced out.

Obesity surgery: what are the results of weight loss?

As we have seen, these three operations are intended for obese patients and are therefore not suitable for people who only have a few kilos to lose. On the other hand, they do show good results in the long term and can help lose up to 50 kilos. On a daily basis, these surgeries can cause discomfort (nausea, indigestion, difficulty eating in normal quantities, etc.), due to the reduction in the size of the stomach, which can no longer accommodate an overflow of food. Appetite is also altered, and even the general attraction for food. Be careful all the same, above 20kg, weight loss must be closely monitored in order to compensate for possible deficiencies in minerals, vitamins and trace elements.


1.Weight loss surgery – NHS
2.Choosing a Type of Weight Loss Surgery – WebMD

Mohamed Kahna About Mohamed Kahna – Tunisia | @MohamedKahna1
a medical student in the University of Tunis El Manar, Music therapist and Surgical Entrepreneur in Digital Health, a global health enthusiast and global surgery advocate and passionate about medical innovation and E-health
By joining One.Surgery, He aspires to achieve global surgery goals

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