While all surgeries have some amount of risk, there are many noninvasive options available for weight loss surgery.

Weight loss surgery, also called bariatric surgery, is a type of surgery that helps people with obesity lower and manage their weight. In 2018, more than 250,000 people in the United States underwent weight loss surgery, according to statistics from the National Institute of Diabetes and Digestive and Kidney Diseases.

While most weight loss surgeries are generally considered safe, there are risks and benefits for each type of surgery. For example, research has shown that gastric band surgery has a lower risk of side effects than other bariatric surgeries. But it’s also not as effective for weight loss as gastric bypass surgery or gastric sleeve surgery.

Below, we’ll explore more about the safety and effectiveness of the most common types of weight loss surgery — including which weight loss surgery is the safest and most effective.

What are the most common types of weight loss surgery?

In the United States, the three most common types of weight loss surgery include:

  • Gastric bypass: Also called Roux-en-Y gastric bypass, this is a procedure in which a doctor connects a smaller pouch of your upper stomach to a different part of your small intestine. The “bypassed” part of your stomach and segment of your small intestine no longer store food but still contribute stomach acids and enzymes to digested food.
  • Gastric sleeve: Also known as vertical sleeve gastrectomy, this is a procedure in which a doctor removes a significant portion of your stomach and sews the remainder of your stomach into a small pouch or sleeve.
  • Gastric band: Also called adjustable gastric band, this is a procedure in which a doctor places a band around the top portion of your stomach that can be adjusted to modify the volume of your stomach.

Even though each surgical procedure is different, all three of these surgeries help with weight loss by directly changing the way that you eat and absorb your food.

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One major study from 2018 compared the effectiveness and safety of various bariatric surgeries in more than 65,000 people. Results of the study found that of the three common surgical weight loss procedures, gastric sleeve surgery was the safest procedure with the lowest risk of side effects.

According to the results, rates of side effects within 30 days after the surgery were 5% for gastric bypass surgery, 2.9% for gastric band surgery, and 2.6% for gastric sleeve surgery.

Gastric bypass surgery was associated with the highest percentage of side effects after the procedure, while both gastric band and gastric sleeve were much lower.

Most modern weight loss surgeries are performed laparoscopically. Laparoscopic surgery refers to a type of surgery using specialized tools with a camera that are inserted into small incisions, or openings, in your body.

Research suggests that laparoscopic surgery is less invasive, safer, and more effective than open surgery. It’s associated with shorter recovery times, less pain, fewer complications, and a lower risk of death.

Some weight loss procedures may also be performed endoscopically. Endoscopic surgery uses instruments that are inserted into your mouth to access various areas of your digestive tract.

Endoscopic bariatric surgery isn’t as common as laparoscopic bariatric surgery, so there isn’t as much research available on the safety and effectiveness of this type of weight loss surgery. But one study from 2022 found that endoscopic bariatric surgery had lower side effect rates, surgery length, and length of stay than laparoscopic bariatric surgery.

In the same large study mentioned above from 2018, gastric bypass surgery was associated with the highest average total weight loss percentage after 1 year. Results of the study found that gastric bypass resulted in more than 31% total weight loss after a year, with gastric sleeve and gastric band at 25.2% and 13.7% respective weight loss after a year.

Gastric sleeve and gastric bypass are also effective for non-weight loss outcomes, too. In one large analysis, researchers found that both surgeries had comparable benefits for type 2 diabetes resolution. Gastric bypass resulted in improvements in dyslipidemia, high blood pressure, and gastroesophageal reflux disease (GERD).

Which weight loss surgery has the highest failure rate?

Research studies suggest that gastric banding tends to have the lowest impact on weight loss. In one early study from 2014, researchers found that gastric band surgery was associated with a high percentage of failure, with roughly 31% of people not experiencing clinical weight loss and another 13% undergoing band removal.

All surgeries have risk

Whether you’re undergoing a major surgical procedure like bariatric surgery or a simple procedure like a tooth extraction, all surgeries come with the risk of complications. These complications can happen both during the surgery and during recovery.

If you’ve decided to undergo weight loss surgery, it’s because you and a doctor have decided that the benefits outweigh the risks. If you have any questions or concerns about the risks associated with your weight loss surgery, consider reaching out to a doctor to discuss them.

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In one major study from 2021, researchers explored the safety of both gastric sleeve and gastric bypass in more than 95,000 people with obesity up to 5 years after surgery. According to the study results, gastric sleeve had a lower risk of complications, mortality, and surgical revisions.

But the authors also noted that gastric sleeve surgery was associated with a higher risk of surgical revision. Surgical revision was defined as any changes to the original procedure, such as changing from gastric sleeve to gastric bypass.

All surgeries have the potential for complications, but here are some of the frequently noted complications of bariatric surgery:

Weight loss surgery can be an effective way for people living with obesity to lower and manage their weight. Most weight loss surgeries are generally regarded as safe. But of all three major surgeries, gastric sleeve surgery has a lower risk of complications and a higher effectiveness for weight loss.

If you or a loved one has been considering weight loss surgery, reach out to a doctor to discuss the options available to you. Together, you can find an option that’s both safe and effective for your own personal health journey.