By Dr Mohgah Elsheikh: Bariatric surgery is a highly effective treatment for severe obesity and can lead to long-term weight loss, improved health conditions and a better quality of life. But when it comes to gastric bypass (RYGB) vs. sleeve gastrectomy (SG), which procedure delivers the best results over time?
A recently published 10-year clinical study compared the two weight loss surgeries to determine which offers the greatest long-term benefits. If you are considering bariatric surgery, here’s what you need to know.
What Are the Differences Between Gastric Bypass and Sleeve Gastrectomy?
Sleeve Gastrectomy (SG)
- Removes about 80% of the stomach, leaving a tube-shaped “sleeve.”
- Reduces hunger by lowering ghrelin (hunger hormone) levels.
- A simpler procedure with a lower initial risk of complications.
- Can lead to acid reflux (GERD) over time.
Gastric Bypass (RYGB)
- Creates a smaller stomach pouch and bypasses part of the small intestine.
- Results in greater hormonal changes that help regulate appetite and blood sugar.
- More effective for type 2 diabetes remission.
- Less risk of developing acid reflux compared to SG.
What Did the Study Find?
- Weight Loss: Both surgeries helped people lose a significant amount of weight but those who had a gastric bypass lost slightly more weight in the long run.
- Health Improvements: Both groups saw major improvements in conditions related to obesity such as type 2 diabetes, high blood pressure and sleep apnoea with no major differences between the surgeries.
- Heartburn & Acid Reflux: One big drawback of the sleeve gastrectomy was that more patients developed new acid reflux symptoms over time, while gastric bypass helped prevent reflux.
- Need for Additional Surgery: Patients who had sleeve gastrectomy were more likely to need another operation later, often because of weight regain or severe acid reflux.
- Quality of Life: Both surgeries significantly improved quality of life over the 10 years, with no major differences between the two.
Which Bariatric Surgery Is Right for You?
Both gastric bypass and sleeve gastrectomy are effective for long-term weight loss and health improvements, but choosing the right surgery depends on your unique health needs.
Gastric Bypass (RYGB) may be better if:
- You have acid reflux or GERD and want to avoid worsening symptoms.
- You have type 2 diabetes and need stronger metabolic effects.
- You want a lower risk of needing revision surgery.
Sleeve Gastrectomy (SG) may be better if:
- You want a simpler procedure with a shorter operating time.
- You don’t have acid reflux or a hiatal hernia.
- You’re looking for effective weight loss but prefer a less complex surgery.
Final Thoughts: Gastric Bypass vs. Sleeve Gastrectomy
If you are considering bariatric surgery, both sleeve gastrectomy and gastric bypass offer life-changing benefits. However, the 10-year study suggests that gastric bypass may have an edge in weight loss, type 2 diabetes control and avoiding acid reflux.
For the best results, speak with an experienced bariatric surgeon to discuss your personal health goals and risks.
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