Compare the 3 Weight Loss Operations

	Restriction and Malabsorption		Restriction (Stomach only)
	Roux en Y Gastric Bypass		Sleeve Gastrectomy		Adjustable Gastric Band
Anatomy	Small gastric pouch (30ml) connected to the small intestine and bypassing 1m of intestine (many other variants of Bypass are in common use)		Long narrow gastric pouch (150ml)		Adjustable silicone band (ring) around the top of the stomach, small gastric pouch (30ml)
Effects of Procedure	Significantly reduces meal sizes Not Adjustable Malabsorption (mild) Dumping syndrome when sugar or fats are eaten		Significantly reduces meal sizes Not Adjustable No malabsorption or dumping		Moderately reduces meal sizes if eating pattern adapted Adjustable No malabsorption or dumping
Directly impacts on	Hunger Speed of Eating Volume of food that can be eaten Absorption of calories and nutrition		Hunger Speed of Eating Volume of food that can be eaten		Hunger Speed of Eating
Weight Loss (average at 10 years)	75% of excess weight		70% of excess weight		60% of excess weight • Requires the most effort
Long Term Daily Dietary Modification ALL PROCEDURES WILL FAIL WITH EXCESSIVE HIGH CALORIE	Less than 1000 calories Avoid sugar and fats to prevent “dumping”		Less than 1000 calories		Less than 1000 calories 3 solid, textured meals, well chewed No drinking with meals
Long Term Nutritional Supplements	Multivitamins required Deficiencies infrequent		Multivitamins required Deficiencies very rare		Multivitamins required Deficiencies very rare
Potential Problems	Leak Dumping Syndrome Ulcers Bowel Obstruction	Vitamin Deficiencies (B12, folate), anaemia	Leak “Eating Squeezing”, nausea and vomiting initially	Heartburn Inadequate weight loss	Slow weight loss Inadequate weight loss Slippage Erosion	Port problems “Blockage” Reoperation 10% (?)
Reversibility	Not reversible, partly modifiable		Not reversible, highly modifiable		Reversible, partly modifiable
Hospital Stay	3 to 4 days		1 to 3 days		1 day
Time off Work	1 to 2 weeks		1 to 2 weeks		1 to 2 weeks
Operating Time	120 minutes		90 minutes		30 minutes
Major Complications	5%		2%		1%
General Recommendation	Most eating patterns BMI >45		Most eating patterns BMI 35 to 55		Self disciplined eating style BMI 35 to 45
Typical patient Summaries	“I need the operation with the greatest weight loss.”		“I am worried I will not have the self discipline required to get a band to work”		“I just need a constant reminder to help me: I can lose the weight, I just can’t keep it off”
You need to discuss this with your surgeon, family and friends to try and make the best choice for you.					All figures given are a rough guide only.

Dr Draper does not perform Gastric Bypass surgery and this information is provided for educational purposes.

Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.