Which is better for weight loss, a gastric band or sleeve?

Would a gastric band or sleeve be better for someone looking to lose 75 lbs? I’ve been obese my entire life, and I finally want to take control of my health and body. I want to get one or the other and I would really like to understand the pros and cons of both options.


F, 41, New York

Tags:woman age 35-44 weight loss pros and cons overweight

Both a gastric band and a gastric sleeve are safe and effective options for obese patients who are looking to achieve significant weight loss with surgery.

Adjustable laparoscopic gastric band surgery (otherwise known as lap band surgery) is the less invasive of the two weight loss procedures. It involves placing an inflatable device around part of your stomach, which controls your appetite and allows you to feel fuller for longer.

The key benefits of a lap band are that it is reversible, the procedure is usually performed on an outpatient basis (meaning you can go home within a day of surgery), and it doesn’t permanently change the shape of the stomach. The disadvantages of gastric banding are that the weight loss is usually slower, and it typically requires more follow-ups with your doctor in the months and years following surgery.

A sleeve gastrectomy is more invasive, though it is still widely considered to be a very safe procedure. During gastric sleeve surgery, part of the stomach is removed from the body and the remaining section is formed into a sleeve-like shape.

The new stomach is much smaller, which restricts food intake. The primary benefits of gastric sleeve surgery revolve around the fact that it delivers faster results than a lap band, and does not involve the placement in your body of any foreign devices. The main disadvantage is that the procedure cannot be reversed.

I strongly recommend booking a consultation with an experienced bariatric surgeon to discuss your options in more detail.

Congratulations on making those crucial first steps toward taking control of your health. Bariatric surgery (weight loss surgery) is a very effective way to lose weight and can reduce the risk of many health problems associated with obesity, including heart disease, type 2 diabetes, high blood pressure, and more.

Typically indicated for morbidly obese adults with a body mass index (BMI) of 40 or above, a sleeve gastrectomy procedure involves removing part of the stomach, and shaping the remaining part into a tube or sleeve. The remaining, smaller stomach cannot hold as much food and produces less ghrelin, a hormone that is known to stimulate appetite and increase food intake.

This facilitates better portion control and can reduce hunger. A gastric sleeve tends to provide superior weight loss for the first year or two after surgery.

The downside of a sleeve gastrectomy is that it is a permanent procedure and cannot be reversed. In addition, gastric sleeve surgery is more invasive than lap band surgery and may require a longer recovery time — most people remain in hospital for a few days and require two weeks off of work. Nevertheless, this type of bariatric procedure does offer fantastic, long-term results that really can be life changing for many patients.

Adjustable laparoscopic gastric band (gastric banding) surgery is generally indicated for obese patients with a BMI of 30-40. It involves placing an adjustable band around the upper part of the stomach.

This band effectively creates a new stomach that has a significantly lower capacity than the regular stomach. The band can be inflated or deflated to change how much food your stomach can hold.

This type of surgical procedure is reversible, does not involve cutting stomach muscles, and requires less downtime than a sleeve gastrectomy. However, lap bands do require frequent visits to the doctor to adjust the band. In addition, losing weight is usually slower with lap band surgery — it typically takes three or four years to achieve weight loss that can be achieved in just two years with a sleeve gastrectomy.