Gastric Sleeve Surgery vs. Gastric Bypass Surgery

Choosing between gastric sleeve or RNY gastric bypass procedure can be a difficult decision to make. Both procedures reduce body weight markedly and can resolve obesity-related comorbidities, such as type 2 diabetes and heart disease. While the gastric sleeve operation is less complex and invasive, the bypass procedure could have higher excess weight loss results.

Sleeve gastrectomy and RNY bypass limit the amount of food you eat, but ghrelin (appetite) levels is much more reduced in the sleeve than in the bypass, making gastric sleeve more appetite suppressing.

This guide will show you the pros and cons, similarities and differences, and long-term results you can expect for both Vertical Sleeve Gastrectomy (VSG) and Roux-en-Y Gastric Bypass (RYGB).

gastric bypass vs gastric sleeve - Mexico Bariatric Center

How Gastric Sleeve Surgery Works

Gastric sleeve surgery is a permanent weight loss surgery that downsizes the stomach by as much as 80%.

  • Less Invasive Surgery
  • Low Complication Rate
  • Low Risks and Side Effects
  • Low Surgery Costs
  • Most Popular Surgery

Losing weight after gastric sleeve is produced in two ways. First, the smaller stomach capacity makes patients feel full faster, reducing caloric intake. Secondly, the number of hunger hormones (Ghrelin) is lowered, resulting in decreased hunger.

Learn more about Gastric Sleeve

Gastric Sleeve Surgery Schematic

How Gastric Bypass Surgery Works

Gastric bypass surgery is a powerful bariatric procedure that uses two surgical methods to achieve significant weight loss. RNY gastric bypass uses restriction and malabsorption to reduce caloric intake considerably.

  • Highest Amount of Excess Weight Loss (%EWL)
  • Better Remission of Type 2 Diabetes Mellitus
  • Highest Reduction in Comorbidities & Health-Related Problems

The new stomach is a small pouch and is connected to the small intestine where food and digestive juices are separated for the first 3 to 5 feet. This procedure is intended for patients who are suffering from co-morbidities, along with very debilitating obesity.

Learn more about Gastric Bypass

Gastric Sleeve Surgery Schematic

The Pros and Cons of Gastric Sleeve versus Gastric Bypass

After gastric sleeve and RNY bypass procedures, there is a sharp rise in several gut peptides, including Glucagonlike Peptide-1 (GLP-1) and Peptide-YY (PYY), leading to weight loss and improvements in glucose metabolism. However, sleeve gastrectomy suppresses fasting and postprandial ghrelin levels much more than RNY bypass.

Statistics since 2005 show that sleeve gastrectomy and Roux-en-Y gastric bypass have been the most widely requested and effective treatments for morbid obesity and type 2 diabetes. Gastric Bypass Surgery, once known as the “gold standard,” accounted for 80% of all bariatric procedures performed in the United States. Today, Gastric Sleeve Surgery represents over 90% of all weight loss surgeries performed across the country.

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Gastric SleeveGastric Bypass
MethodRestrictiveRestrictive & Malabsorptive
StomachRemove 80-85%
(2-3 oz.)
New Pouch Created
(1 oz.)
AnatomyNo ChangeReroutes Intestines
Duration1.5 hours2.5 hours
Hospital1 to 2 days2 to 3 days
Time Off1 to 2 weeks2 to 3 weeks
Recovery3 weeks4 to 6 weeks
Low Risk
Higher %EWL
More Effective on Comorbidities
Less %EWL
Vitamins Required
Dumping Syndrome (Common)
Hard to Revise
Weight Loss60-75% (%EWL)64-80% (%EWL)
Post-Op3 to 5 Meals/Day
800-1200 Cal
3 to 5 Meals/Day
Avoid Sugar and Fats
Vitamin and Protein Supplements
HealthT2DM: 75%
HTN: 56%
GERD: 56%
OSA (CPAP): 62%
T2DM: 93%
HTN: 45%
GERD: 56%
OSA (CPAP): 77%
CandidacyBMI of 30+
“1st” Procedure
BMI of 35+
“Sweet Tooth”
Severe Acid Reflux
  • (%EWL) = % Excess Weight Loss

  • T2DM = Type 2 Diabetes Mellitus
  • HTN = Hypertension

  • OSA = Obstructive Sleep Apnea

Differential Effects of Gastric Sleeve vs. Gastric Bypass?

The notable difference between these two operations is that the gastric bypass provides slightly more expected excess weight loss (%EWL) and is better suited for the resolution of obesity-related health problems than the gastric sleeve.

The RNY gastric bypass has a higher risk of complications than the sleeve gastrectomy. As a result of the malabsorption after gastric bypass, essential nutrients, vitamins, and minerals are not absorbed by the body. Therefore, it is crucial to maintain a lifelong intake of vitamins and dietary supplements following gastric bypass surgery. The gastric sleeve procedure is also less invasive because there is no rerouting, or bypassing, of the intestines.

Moreover, there is a lower chance of stretching the new stomach (stoma) after the gastric sleeve as the pyloric valve stays intact. There are also more effective revision surgery options for sleeve patients.

Gastric Sleeve vs Gastric Bypass Infographic

Complications After Gastric Sleeve
Gastric sleeve surgery has the lowest potential complications compared to other weight loss procedures. Mainly because it only removes a portion of the stomach.

Complications After Gastric Bypass
The Roux-en-Y Gastric Bypass is an established bariatric procedure. Even with extensive surgical experience, there are more complications with bypass versus sleeve.

Which Procedure is Best for Me?

The gastric sleeve is a good option for patients with extensive adhesions from a previous surgery in the abdominal area. Sleeve gastrectomy is also suitable for patients with a history of ulcers, those taking aspirin, or individuals who smoke.

Gastric bypass is better for patients with severe acid reflux/GERD and slow metabolism. If patients have previously had Nissen fundoplication anti-reflux surgery, meaning the stomach is wrapped around the esophagus valve, gastric bypass is the most appropriate. People requiring high amounts of insulin are better off with RNY bypass.

Do I Qualify for Gastric Sleeve?

  • BMI 30+
  • Existing Abdominal Scarring
  • Previous Ulcer
  • Sleeve is Easily Revised
  • Smoker

Do I Qualify for Gastric Bypass?

  • BMI 35-55
  • Severe Acid Reflux or GERD
  • Slower Metabolism
  • “Sweet Tooth”
  • Barrett’s Esophagus

Consult with MBC’s top-rated weight loss surgeons in finding out the best option for you!

Comparing Costs and Insurance Coverage

Having insurance to cover for weight loss surgery in the United States is a difficult task and lengthy process. You should first make sure your doctor agrees with your decision to get bariatric surgery. Then, speak with your insurer to see if you have coverage for gastric sleeve surgery or gastric bypass surgery. If you have insurance coverage, it generally takes about one year to be approved – after a long pre-op diet, check-ups, classes, psychologist, and nutritionist meeting.

Depending on location, gastric sleeve costs range from about $4,395 up to $24,000+. On the other hand, gastric bypass costs start at $5,595 and can go up to $27,000. Mexico Bariatric Center can help you decide which surgery is best for you quick and hassle-free. Just take a few minutes to do the health application.

Sleeve vs Bypass Cost Comparison