Dividing fact from fiction in bariatric surgery: a comparison between Gastric Band and Gastric Bypass

We are frequently asked about the difference between Gastric Band and Gastric Bypass surgery, so in this section you will find a definitive comparison.

Roux-en Y is the most common gastric bypass. During this procedure a small upper section of the stomach is separated by staples to create a small pouch. A Y-shaped section of the small intestines is attached to the stomach. This allows food to bypass the upper portion of the intestines. This limits the amount of food that can be consumed.

The Gastric Bypass procedure will soon become outdated, as other methods are safer and yield better long term results, with less invasive surgery, less scarring, less chance for complications, less nutritional deficiencies and a permanent ability to prevent volume eating.

Special considerations

Gastric Bypass surgery creates dramatic changes in the size and shape of the stomach. It usually takes some time to get used to these changes. Patients report a wide variety of complications after surgery. Some of these disappear after a time, while others can be lessened with adjustment of the diet.

  • Nausea and vomiting are the most common complications.
  • Dehydration is also a concern, especially if vomiting and diarrhoea is frequent.
  • Food intolerance – especially to red meat, milk and high fibre foods.
  • Dumping Syndrome. This occurs when food passes quickly from the stomach into the small intestine. Symptoms can include nausea, discomfort, cramping and diarrhoea, weakness, sweating, feeling dizzy and fast heart rate.
  • Stomach pain, ulcers, gastritis and kidney stones are complications which may require medical attention.
  • Portion of digestive tract is bypassed, reducing absorption of essential nutrients resulting in Iron, Vitamin B12, Folic Acid and Calcium deficiencies.

Weight loss

Surgery deals with the physical aspects but does not address the underlying emotional issues or behaviour around weight gain. It is a common misconception that support and follow up are not necessary after Gastric Bypass. Although the initial weight loss is rapid, this will eventually slow down. Without a programme of support and behaviour modification, patients will start to eat as they did prior to surgery.

This will start slowly until eventually they will stretch their ‘pouch’. As they eat larger volumes, their food choices will inevitably be those that caused their excess weight in the first place. It is common for Gastric Bypass patients to regain their weight after a period of 3 to 5 years.

Gastric BandGastric Bypass
Least invasive surgical approachCutting and stapling of stomach and bowel
No change in anatomyPermanent change in anatomy
1 hour procedure2-3 hour procedure
Surgical complications in less than 1% of patientsSurgical complications in 19% of patients
Keyhole surgery42% keyhole surgery
Fully reversibleNon-reversible
Adjustable for lifeNon-adjustable (55% regain weight after 5 years)
1 night hospital stay2-3 nights’ hospital stay
1 week off work2-3 weeks off work
Low malnutrition riskLifelong vitamin supplementation
Slow initial weight lossRapid initial weight loss