You’ve decided to go forward with exploring bariatric surgery. Congratulations! You’ve started a journey toward better health and a fuller life. And we’re happy you’ve included MIIS Weight Loss Institute as part of your research.
There are several different types of weight loss surgeries, and the one that’s right for you depends on multiple factors, including:
- Your body mass index (BMI): This indicates the degree of obesity and is one of the primary tools used to determine surgical eligibility. While it is not the only measure of health, it provides important context when evaluating procedure suitability.
- Any underlying health conditions: These can include type 2 diabetes, hypertension, sleep apnea, gastroesophageal reflux disease (GERD), metabolic-associated steatohepatitis (MASH), and others. Different surgeries can help address these conditions in various ways, oftentimes improving or resolving them.
- Your weight loss history: You’ve likely tried multiple approaches (diet programs, medications, or supervised weight-loss plans) without achieving long-term success. Understanding what has and hasn’t worked in the past can help guide surgical recommendations.
- Lifestyle readiness: Bariatric surgery is a major decision that requires long-term commitment to modifying daily habits. The most successful patients are prepared to make lasting changes in how they eat, move, and care for their health and engage with ongoing medical follow-up and nutritional support.
- Your anatomy and overall health: Prior or anticipated surgeries and general surgical risk may also influence which procedure is recommended.
MIIS Surgical Options
Our team focuses on identifying the procedure that best aligns with your medical needs, health history, and long-term goals. We specialize in two of the most widely studied and commonly performed bariatric procedures today: Sleeve Gastrectomy (gastric sleeve) and Roux-en-Y Gastric Bypass (gastric bypass).
Both procedures are designed to support significant, sustained weight loss and to improve obesity-related health conditions. How they do that is where they differ.
Sleeve gastrectomy works by permanently reducing the size of the stomach; approximately 70% of the stomach is removed, leaving behind a narrow, banana-shaped gastric pouch. A stomach this size holds significantly less food, which makes you feel full sooner and eat smaller portions. Also, the part of the stomach that produces most of the hormone ghrelin (the “hunger hormone”) is removed, which can lead to reduced appetite and fewer hunger-driven cravings.
Research suggests that weight loss following sleeve gastrectomy is comparable to that seen after gastric bypass, particularly in the first one to three years after surgery, with a lower risk of certain perioperative complications.1 Sleeve gastrectomy has also been shown to improve many obesity-related health conditions, with sleep apnea topping that list.1 Type 2 diabetes remission can also happen, though outcomes vary based on disease duration, severity, and individual metabolic response.
It is important to understand that sleeve gastrectomy is irreversible and may not be the best option for everyone. One of its most notable limitations is an increased risk of gastroesophageal reflux disease (GERD), which can worsen or newly develop after surgery in some patients.
Gastric bypass works by changing both the size of the stomach and the way food moves through the digestive system. During the procedure, the surgeon creates a small stomach pouch and connects it directly to a portion of the small intestine. The food you eat bypasses most of the stomach and the first segment of the small intestine, limiting how much you can consume and reducing the absorption of calories and nutrients.
Gastric bypass alters the gastrointestinal tract more extensively than sleeve gastrectomy. Some studies suggest that gastric bypass may lead to slightly greater weight loss and higher rates of diabetes improvement compared to sleeve gastrectomy, but individual outcomes do not always mirror clinical trial data, and real-world, long-term results can be comparable.1
The intricacy of gastric bypass reflects the intensity with which it improves a wide range of obesity-related conditions, including type 2 diabetes, high blood pressure, high cholesterol, obstructive sleep apnea, GERD, joint pain, and MASH. On the flip side, because of the greater physiological change from gastric bypass, it carries a slightly higher risk of complications and nutrient deficiencies compared to sleeve gastrectomy. When determining risks and benefits, it’s important to consider them in the broader context of the health risks associated with untreated obesity, as well as your unique medical history and existing conditions.
Making the Choice
Both procedures are intended for individuals with severe obesity (generally defined as a BMI of 40 or higher, or a BMI of at least 35 with one or more obesity-related health conditions) who have not achieved lasting weight loss through non-surgical approaches. Prep for either procedure involves a comprehensive evaluation process, including medical testing, nutritional counseling, and sometimes behavioral health assessments to ensure patients are physically and mentally prepared for the changes ahead.
Most patients spend one to two nights in the hospital and return home to begin recovery. In the beginning, you’ll be restricted to a liquid diet. Over several weeks post-surgery, you’ll progress from soft foods to solid meals, giving the digestive system time to adapt. Walking is encouraged as soon as you’re cleared by the surgical team, and physical activity follows a similar trajectory: start low, go slow. Light activities can be resumed within a few weeks, and your care team will recommend a gradual return to normal daily routines as you go.
Both surgeries require lifelong lifestyle changes – no ifs, ands, or buts. Your success depends on adopting a high-protein, nutrient-dense diet, staying well hydrated, avoiding excess sugar, and engaging in regular physical activity. And because both procedures alter digestion, ongoing vitamin and mineral supplementation is essential. Most patients take a daily multivitamin, calcium with vitamin D, and B vitamins. You are also strongly encouraged to attend regular follow-ups and blood draws so that deficiencies are identified and addressed early.
Patients who engage with support groups, peers, family members, therapists, and other healthcare professionals often report better adherence and long-term success. Bariatric surgery is a sustained commitment that benefits from encouragement, accountability, and shared experience.
You also want the right bariatric team by your side. At MIIS Weight Loss Institute, experience, training, and a patient-centered philosophy matter. With more than 2,000 procedures performed, patients at MIIS achieve substantial excess weight loss and high rates of comorbidity improvement.
Bariatric surgery is the beginning of lasting change. If you still have questions, we offer informational seminars led by board-certified surgeons to help you better understand your options and determine whether surgery may be right for you. From there, we can schedule a consultation. We look forward to being a part of this new phase of your life!
- Alaidaroos, O., Al Jaber, A. A., Al Jaber, A. A., Alshehri, A. H., Alkehaimi, M. B., & Alsannat, O. A. (2024). Long-Term Outcomes of Sleeve Gastrectomy Versus Gastric Bypass. Cureus, 16(11), e72961. https://doi.org/10.7759/cureus.72961.