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Gastric bypass or gastric band – what’s the difference?

Celeste Hebets, P.T.

There are several different options when considering weight loss (bariatric) surgery for improving health and reducing weight. Primarily there are two kinds of surgeries for weight loss – restrictive-only and restrictive /malabsorptive. Adjustable gastric band surgery is restrictive only; gastric bypass is restrictive/malabsorptive.

Adjustable Gastric Band   
During gastric band surgery, a small band is placed around the upper portion of the stomach, creating a small pouch above the band that can hold only a few ounces of food and liquid. This allows a person to feel full sooner and restricts the amount of food ingested. It also allows all the nutrients from the food to be absorbed by the body.

The band is like a small inner tube that is filled with fluid to allow the restrictive opening to be adjusted to allow more or less food to pass through to the intestines. The band is placed through laparoscopic surgery around the upper portion of the stomach. Often, there are two to three band adjustments in the first year – either to make the band tighter or looser to meet individual weight loss goals. Other adjustments can take place over the next few years as needed.

Since this minimally invasive surgery only requires the placement of the band, patients often go home the same day as surgery or the day after. Individuals experience a steady and significant weight loss with this surgery. The average weight loss is 4 to 10 pounds a month or about 40-percent excessive weight loss in the first year.

Gastric Bypass

The Roux-en-Y Gastric Bypass Surgery is considered the “gold standard” for weight loss surgery and is the most common weight loss surgery performed. During gastric bypass surgery, the stomach is cut to create a small pouch – taking the stomach from the size of a football to the size of a golf ball. Additionally, a portion of the intestines are “bypassed” so that the contents of the stomach are entering the intestinal tract much lower. Because the size of the stomach is significantly smaller and a portion of the intestines are bypassed, there is less opportunity for food nutrients to be absorbed, making gastric bypass surgery both restrictive and malabsorptive.

Because gastric bypass surgery requires cutting the stomach and rerouting the intestines, patients usually have to remain in the hospital for two to three days to ensure there is no leakage around the stomach and no complications. Because this surgery does not allow food nutrients to be readily absorbed, gastric bypass patients are required to take multivitamins and follow a rather strict diet for the rest their lives.

Individuals experience a rapid and significant weight loss with gastric bypass. The average weight loss is 10 to 20 pounds a month or about 60- to 80-percent excessive weight loss in the first year.
Is weight loss surgery right for you?

Weight loss surgery is major surgery. It is not a “magic bullet” but is considered a tool to be coupled with dietary and lifestyle modifications. The success of each patient’s surgery always depends on the commitment of the patient to a lifetime change in eating and exercise behaviors.

If you are considering weight loss surgery, you are invited to attend a free information session from 6 – 7 p.m. on the second Tuesday of each month at the Northern Arizona Healthcare Education Center, 1000 N. Humphreys (Fort Valley Shopping Center, just south of Flagstaff Medical Center, off Beaver Street). These sessions include a presentation by surgical staff about the causes and complications of morbid obesity and the types of surgeries available, with time for questions and answers following the presentation. No registration is required for this session. For more information call 928 214-3737 or visit 

Celeste Hebets, P.T., is a physical therapist and coordinator of FMC’s Bariatric Surgical Weight Loss Center.