What is the difference between bariatric (weight loss) surgery and sleeve gastrectomy (surgical removal of a portion of the stomach)?

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Last updated: May 13, 2025View editorial policy

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From the Guidelines

Bariatric surgery and sleeve surgery are not separate procedures, but rather, sleeve gastrectomy is a type of bariatric surgery that involves removing approximately 80% of the stomach to restrict food intake and reduce hunger hormones. Bariatric surgery is a broad term that encompasses several weight loss procedures designed for people with severe obesity, including sleeve gastrectomy, gastric bypass, adjustable gastric banding, and biliopancreatic diversion with duodenal switch 1. The main difference between these procedures lies in their mechanisms for weight loss, complexity, risk profiles, and potential long-term outcomes.

Some key points to consider when evaluating the difference between bariatric and sleeve surgery include:

  • The indications for metabolic and bariatric surgery (MBS) include a BMI ≥ 35 kg/m2, or BMI 30–34.9 kg/m2 with type 2 diabetes, or patients with suboptimal treatment response, recurrent weight gain, or without comorbidity improvement using non-surgical methods 1.
  • MBS can lead to improvements in or resolution of obesity complications, such as type 2 diabetes, hypertension, hyperlipidemia, sleep apnea, and MAFLD, and reduces the risk of some malignant tumors, acute cerebrovascular events, and all-cause mortality 1.
  • The choice between different bariatric procedures depends on individual factors, including BMI, medical conditions, previous abdominal surgeries, and personal preferences, which should be discussed thoroughly with a bariatric surgeon 1.
  • Bariatric surgery needs to be performed by specialized surgeons in hospitals with dedicated multidisciplinary teams that can provide lifelong medical follow-up and support 1.

Overall, the decision to undergo sleeve surgery or another type of bariatric surgery should be made on a case-by-case basis, taking into account the individual's unique needs and circumstances, and under the guidance of a qualified bariatric surgeon.

From the Research

Difference between Bariatric and Sleeve Surgery

  • Bariatric surgery is a broad term that encompasses various surgical procedures aimed at weight loss, including sleeve gastrectomy, Roux-en-Y gastric bypass, and adjustable gastric banding 2, 3, 4.
  • Sleeve gastrectomy, a type of bariatric surgery, involves the removal of a major part of the stomach, resulting in a restrictive procedure that also impacts hormone levels such as Ghrelin and Glucagon-like Peptide 1 2.
  • The primary difference between bariatric surgery and sleeve surgery lies in the specific procedure and its effects on the body. Sleeve gastrectomy is mainly a restrictive procedure, whereas other bariatric surgeries like Roux-en-Y gastric bypass may involve both restriction and malabsorption 3, 4.

Key Characteristics of Sleeve Gastrectomy

  • Sleeve gastrectomy is an effective procedure for weight loss with a relatively low risk of malnutrition 2.
  • It can be performed as a single-stage procedure for certain cohorts of patients, including super-super-obese or high-risk patients, and those with conditions that preclude intestinal bypass 3.
  • However, the lack of long-term data on sustained weight loss and resolution of obesity-related comorbidities is a limitation of sleeve gastrectomy 3.

Comparison with Other Bariatric Surgeries

  • Studies have compared the outcomes of sleeve gastrectomy with other bariatric surgeries like Roux-en-Y gastric bypass and adjustable gastric banding 4, 5.
  • Roux-en-Y gastric bypass has been found to be more effective than sleeve gastrectomy in terms of weight loss and quality of life, although sleeve gastrectomy may have a lower risk of complications 4, 5.
  • Adjustable gastric banding has been shown to be less effective than both sleeve gastrectomy and Roux-en-Y gastric bypass in terms of weight loss and quality of life 4.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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