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Choosing A Bariatric Procedure

Bariatric surgery is just the first step in a lifelong commitment toward better health. When deciding if weight loss surgery is right for you, keep in mind that surgery is only tool. Your ultimate success depends on strict adherence to the recommended dietary, exercise and lifestyle changes. The goal is to live better, healthier and longer. After reviewing all the information and attending one of the free educational seminars with the New Jersey Bariatric Center team, you’ll need to decide if you are ready to make that commitment.

The New Jersey Bariatric Center performs three surgeries that have resulted in successful weight loss and improved health for our patients: gastric bypass, gastric sleeve (also called a sleeve gastrectomy) and gastric band (LAP-BAND® or REALIZE® Band). Not all bariatric surgery procedures are the same. If you qualify for weight loss surgery (visit Do I Qualify?), the New Jersey Bariatric Center team will guide you in deciding which procedure will give you the best chance for success based on factors such as your current weight and your ability to follow the post-surgical guidelines. Here is a side-by-side look at each procedure:

How the procedure is done
Gastric bypass	Gastric sleeve	LAP-BAND® or REALIZE® gastric band
In a gastric bypass, a portion of the stomach is stapled off to create a small pouch that is then connected to the lower portion of the intestine, allowing food to bypass a portion of the digestive tract. The newly formed pouch can hold about 4 oz. of food.	During the sleeve gastrectomy, a thin vertical sleeve about the size of a banana is created from the stomach using a stapling device. The rest of the stomach is removed. The newly shaped stomach can hold about a cup of food.	An adjustable band is placed around the upper part of the stomach, creating a small pouch that holds about a half-cup of food.
How it helps you lose weight
Gastric bypass	Gastric sleeve	LAP-BAND® or REALIZE®
Bypass is the only one of the three procedures that affects both the amount of food you can eat and the way your body absorbs it. The surgery limits the amount of food that can be eaten at one time and also decreases hunger hormones, so you feel full sooner and stay that way longer. Bypass patients absorb fewer calories as well. Your body will stop storing excess calories and start using its fat supply for energy.	The smaller stomach pouch limits the amount of food you can eat at one time leaving you feeling fuller sooner and longer. The procedure also decreases your levels of hunger hormones so you feel less hungry. As you eat less food, your body will stop storing excess calories and start using its fat supply for energy.	The smaller stomach pouch limits the amount of food that can be eaten at one time. You’ll feel full sooner and stay full longer. As you eat less food, your body will stop storing excess calories and start using its fat energy supply.
How your digestion changes
Gastric bypass	Gastric sleeve	LAP-BAND® or REALIZE®
With gastric bypass, food travels to a small stomach pouch so you feel satisfied after eating only a small amount of food. The ingested food then bypasses an entire section of the digestive tract, which reduces the number of calories that are absorbed as well. You’ll absorb fewer calories but you’ll also absorb fewer vital nutrients, so bypass patients will need to take protein and vitamin supplements (calcium, vitamin B12, MTV and iron) for life.	Food passes through the digestive tract in the usual order. Since the sleeve doesn’t change the way you absorb your food, all the nutrients you eat will be absorbed, but so will all the calories. Because of this, sleeve patients must be extra vigilant to avoid high-calorie, high-fat foods. Since you’ll be eating a lot less, you’ll need to take vitamin supplements to ensure you are getting the right amount of vitamins.	Food passes through the digestive tract in the usual order. The tightness of the band is what affects how much food you can eat and how long it takes for the food to travel through the small upper pouch. Adjustments to the band will need to be made post-surgery to optimize weight loss. The band doesn’t change the way you absorb your food, so all the nutrients and calories you eat will be absorbed. Because of this, band patients must be extra vigilant to avoid high-calorie, high-fat foods. Band patients should take a daily multivitamin.
Reversible
Gastric bypass	Gastric sleeve	LAP-BAND® or REALIZE®
No	No	Yes, but keep in mind that patients who have the band removed typically gain the weight back.
Length of hospital stay and recovery time
Gastric bypass	Gastric sleeve	LAP-BAND® or REALIZE®
NJBC's bypass patients typically spend two nights in the hospital and return to normal activity - walking, climbing stairs, etc. - a few days after surgery. Patients are advised to take two weeks off before returning to work to adjust to the new lifestyle that is required with all weight loss surgeries. Those who are unable to take that much time off can return to work earlier, as long as their work does not require heavy lifting (anything over 15 lbs.), but this is not the norm.	NJBC's sleeve patients can expect to spend one to two nights in the hospital and return to normal activity - walking, climbing stairs, etc. - a few days after surgery. Patients are advised to take two weeks off before returning to work to adjust to the new lifestyle that is required with all weight loss surgeries. Those who are unable to take that much time off can return to work earlier, as long as their work does not require heavy lifting (anything over 15 lbs.), but this is not the norm.	NJBC's band patients typically go home the same day of surgery and return to normal activity - walking, climbing stairs, etc. - a few days after surgery. Patients are advised to take two weeks off before returning to work to adjust to the new lifestyle that is required with all weight loss surgeries. Those who are unable to take that much time off can return to work earlier, as long as their work does not require heavy lifting (anything over 15 lbs.), but this is not the norm.
Laparoscopic vs. open surgery
Gastric bypass	Gastric sleeve	LAP-BAND® or REALIZE®
All weight loss procedures at NJBC are performed through minimally invasive laparoscopic surgery, in which surgical instruments are inserted through four to five small incisions. This replaces the need for one long incision to open the abdomen. The result is less pain and easier breathing and lung functioning after surgery. Laparoscopy also results in a shorter hospital stay and fewer wound complications such as infection, scarring or hernia. New Jersey Bariatric Center surgeons were the first in New Jersey to perform single incision laparoscopic band surgery, in which surgery is performed though one incision around the belly button. The surgeons will determine whether you are a candidate for single incision surgery. If not, traditional laparoscopic surgery is performed.
Weight loss
Gastric bypass	Gastric sleeve	LAP-BAND® or REALIZE®
Initial weight loss with the gastric bypass is approximately 3 lbs. to 5 lbs. per week for the first 3 to 6 months. Over 18 months, a gastric bypass can result in the loss of about 65 percent to 70 percent of excess weight. That means that a patient who is 100 pounds overweight typically loses 65 lbs. to 70 lbs.	Patients typically lose 2 lbs. to 4 lbs. a week after sleeve gastrectomy, with a total excess weight loss of up to 55 percent to 65 percent over an 18-month period. That means a patient who is 100 pounds overweight typically loses 55 lbs. to 65 lbs.	Patients who've had the LAP-BAND® or REALIZE® band procedure usually lose about 1 lb. to 2 lbs. a week. Over an 18-month period, patients can see a loss of about 50 percent to 55 percent of excess weight. For a person who is 100 pounds overweight, that means an overall weight loss of 50 lbs. to 60 lbs.
Dietary and lifestyle changes
Gastric bypass	Gastric sleeve	LAP-BAND® or REALIZE®
All weight loss surgery patients have to learn completely new eating habits. Your meal sizes will be drastically reduced. Most people cannot tolerate dry, solid foods like steak and certain foods, like rice, will be off limits. Sugary foods – such as soda, juice and fruits - should be avoided, as should high-fat sweets such as ice cream. When you eat properly, you’ll feel full longer so the desire to snack between meals will be eliminated, even with your much smaller meal size. Patients are told to eat three small meals a day and one snack. Not only will old eating habits change but sedentary lifestyles will have to change as well. NJBC patients who routinely engage in physical activities have the best long-term results. After their initial weight loss, many find enjoyment in exercise for the first time in their lives and dive into it in a way they never believed was possible.
Risks of Bariatric Surgery
Gastric bypass	Gastric sleeve	LAP-BAND® or REALIZE®
As with all surgeries, weight loss surgery should not be taken lightly. Our surgeons review all the risks involved in detail at our patient education seminar and also at office visits. The New Jersey Bariatric Center has a zero mortality rate and below average complications for all bariatric surgeries. In addition, as a Bariatric Surgery Center of Excellence, the surgeons and staff here have demonstrated their unparalleled ability to consistently deliver safe, effective evidence-based care. Read more about the Risks of Bariatric Surgery.

New Jersey Bariatric Center is a Center of Excellence for Bariatric Surgery