Gastric Sleeve vs. Gastric Bypass: What's the Difference?

Gastric sleeve is the most common weight loss surgery used,¹ but gastric bypass surgery has been around longer.² While the two share similarities — like helping you lose weight by limiting how much food your stomach can hold — there are some key differences. We're comparing gastric sleeve to gastric bypass, including how much weight you can lose, potential risks and costs.

Gastric Sleeve Surgery and Gastric Bypass Surgery: What Are They?

Though they sound similar, there are distinct differences between the two — one removes part of the stomach, whereas the other simply reduces the size of the stomach without removing any part of it.

Gastric sleeve surgery

Gastric sleeve surgery, also called vertical sleeve gastrectomy or VSG for short, is a medical procedure that removes around 80% of the stomach.⁸ You're left with a tubular “sleeve" that's around the size of a banana. It's usually performed as laparoscopic or robotic surgery, which means that instead of accessing your stomach through a large incision, the surgeon performs the surgery via tiny incisions using a long tube with a camera and other long, thin tools.¹

Gastric bypass surgery

Gastric bypass — also called Roux-en-Y surgery — is a type of weight loss surgery that reduces the amount of food you can eat. The procedure can often be performed laparoscopically, or as open surgery through a large incision in the abdomen. This two-part procedure involves stapling the upper stomach into a small pouch about the size of an egg, and then attaching the pouch directly to a part of the small intestine called the Roux limb, forming a “Y" shape.²

How Gastric Sleeve and Gastric Bypass Surgery Help You Lose Weight

Both gastric sleeve and gastric bypass assist in your weight loss by limiting the amount of food and drink your stomach can hold.

Gastric sleeve surgery

Gastric sleeve helps you lose weight in a couple of ways. First, the much smaller stomach holds less food and liquid, so you're likely to consume considerably less food (and calories). Also, the procedure removes the part of the stomach where most of the “hunger hormone" is produced, which decreases appetite and cravings.¹

Gastric bypass surgery

Gastric bypass reduces your stomach to roughly the size of an egg or walnut, so it's only able to hold around 1 ounce (or 28 grams) of food.² This makes you feel full on considerably less food.³ The food you eat then bypasses the rest of your stomach and upper small intestine, reducing the amount of fat and calories you absorb.³

Conditions Gastric Sleeve and Gastric Bypass Surgery Can Treat

Both gastric sleeve and gastric bypass can treat obesity and other metabolic issues, as well as issues affecting the joints and bones.

Gastric sleeve surgery

Gastric sleeve can help improve conditions related to obesity, such as:¹

• Insulin resistance and type 2 diabetes
• High blood pressure
• High cholesterol
• Heart disease
• Joint pain
• Osteoarthritis
• Obstructive sleep apnea
• Nonalcoholic fatty liver disease

Gastric bypass surgery

Like gastric sleeve and other bariatric surgery procedures, gastric bypass can improve:²

• High blood sugar
• Diabetes
• High blood pressure
• High cholesterol
• Heart disease
• Sleep apnea
• GERD (gastroesophageal reflux disease)
• Osteoarthritis
• Nonalcoholic fatty liver disease

Gastric Sleeve and Gastric Bypass Surgery Results

Results from both gastric sleeve surgery and gastric bypass surgery can be impressive, but require maintenance for ultimate success.

Gastric sleeve surgery

Gastric sleeve surgery starts working immediately by only allowing small amounts of food into the stomach, leading to weight loss.⁴ People lose an average of 60% of excess body weight,⁴ but some lose as much as 80%.⁵

Maintaining results depends on how well a person follows their healthcare provider's nutrition and exercise recommendations. Most people maintain a weight loss of 51% to 54% more than 10 years after their surgery.⁶

Gastric bypass surgery

Gastric bypass surgery results can be dramatic, with most patients losing around 66% to 80% of their excess weight in the first 18 to 24 months after surgery.⁷ While gastric bypass surgery will help you lose weight fast, it's not a quick fix. You'll need to follow your healthcare provider's diet recommendations to maintain your results long term because overeating can stretch out your smaller stomach and cause weight gain.²

Gastric Sleeve and Gastric Bypass Surgery Recovery

Gastric sleeve surgery and gastric bypass surgery both need recovery time, and in some cases there is some residual pain. There are limitations you'll have to abide by, too.

Gastric sleeve surgery

Recovery time after gastric sleeve surgery varies from person to person and depends on how quickly you adapt to eating fewer calories. Most people can return to normal activities within four weeks.¹

Gastric bypass surgery

During gastric bypass surgery recovery, moderate pain is typical in the first few days and you'll be given prescription pain medication to help you manage your pain at home. Most people are able to stop taking the prescription pain meds within a week.²

You'll need to avoid strenuous exercise for up to six weeks and will be given instructions on what you can eat after surgery. You will be required to follow a liquid diet at first and will eventually start adding protein and soft foods to your diet.²

Side Effects of Gastric Sleeve and Gastric Bypass Surgery

Both procedures involve possible side effects, from physical fatigue to emotional changes and more.

Gastric sleeve surgery

You may feel tired and fatigued for a few days or weeks after surgery as your body adjusts to eating fewer calories.¹ Some pain at the incision sites is also to be expected.

Gastric sleeve surgery is typically considered safe, with a less than 1% risk of surgical complications, including:¹

• Infection
• Bleeding
• Reactions to anesthesia
• Leaking from the staple line

After recovery, some people develop long-term issues. Fortunately, these are usually easy to treat. These can include:¹

• Scar tissue, which can cause nausea and vomiting
• GERD
• Nutritional deficiencies
• Gallstones

Gastric bypass surgery

The rapid weight loss and limited nutrition during recovery and the first few months after gastric bypass surgery can cause a few side effects, including:²

• Fatigue
• Stool changes
• Mood changes
• Feeling cold
• Hair loss
• Body aches

Compared to gastric sleeve surgery, gastric bypass surgery carries the potential for more surgical risks and complications, which include:²

• Infection
• Excessive bleeding
• Reactions to anesthesia
• Hernias
• Small bowel obstruction
• Anastomotic leaks

Gastric bypass also carries the risk for long-term complications, including:²

• Gastrointestinal symptoms, such as diarrhea
• Malabsorption and malnutrition
• Hypoglycemia
• Bile reflux
• Ulcers
• Gallstones

Cost of Gastric Sleeve and Gastric Bypass Surgery

The average cost of gastric sleeve surgery is $7,631, but it can cost as much as $25,000 without insurance.⁸ The average cost of gastric bypass surgery is $10,790 but it, too, can cost as much as $25,000 without insurance.⁹

Gastric sleeve surgery

The factors that can impact how much gastric sleeve surgery costs include:⁸

• Your bariatric surgeon's experience and credentials
• Geographical location, with surgeons in major cities often charging more due to the higher cost of living
• Whether surgery is performed in a hospital operating room or an outpatient facility
• Length of your hospital stay

Some insurance plans cover some or all of the costs of gastric sleeve surgery,⁸ so it's worth checking with your provider. Even if they don't cover the cost of the gastric sleeve procedure, related expenses — like blood work and other pre-op exams — may be covered.⁸

Gastric bypass surgery

The range of costs, which can seem dramatic, are influenced by factors such as:⁹

• The surgeon's experience and credentials
• Geographic location, with surgeons in major cities often charging more due to the higher cost of living
• Length of your hospital stay
• Postoperative care, such as follow-ups, blood work and consultations with nutritionists and therapists

Some health insurance plans cover some or all of the costs of gastric bypass surgery,⁹ so it's a good idea to check with your provider. Even if they don't cover the cost of the surgery, related expenses may be covered, such as blood work and other pre-op exams.⁹

Whether you're looking at gastric sleeve surgery or gastric bypass surgery, if you're uninsured, find out what financing options your healthcare provider will accept. For instance, many surgeons accept the CareCredit credit card. You can use our handy provider locator to find a weight loss surgeon near you that accepts CareCredit.

Who Qualifies for Gastric Sleeve or Gastric Bypass Surgery?

Here's what you need to know about possibly becoming a candidate for gastric sleeve surgery or gastric bypass surgery.

Gastric sleeve surgery

To be a candidate for gastric sleeve surgery:¹

• You have severe obesity, which is a BMI (body mass index) of 40 or higher or a BMI of at least 35 with one or more related diseases.
• You have tried to lose weight unsuccessfully before surgery, which may require spending three to six months on a medically supervised weight loss plan.
• You are physically and mentally prepared for surgery, which must usually be determined by a team of medical specialists that may include dietitians and psychologists.

Gastric bypass surgery

To be a candidate for gastric bypass or any other bariatric surgery requires meeting pretty much the same criteria. This includes:²

• A BMI of 40 or higher or a BMI of at least 35 with one or more related diseases
• Having tried to lose weight unsuccessfully using other means
• Being physically and mentally prepared for surgery, which will be determined by a team of medical specialists that may include dietitians and psychologists

Which Is Better, Gastric Sleeve or Gastric Bypass Surgery?

So, is gastric bypass surgery better than gastric sleeve surgery? That's the million dollar question for anyone considering weight loss surgery, but the answer isn't that simple. One isn't inherently better than the other because everyone is different, and what's best for one person may not be right for another.

Both gastric sleeve¹ and gastric bypass surgery² are effective and provide long-term weight loss. Typically, people lose more weight faster with gastric bypass.² But gastric sleeve is less invasive and has a lower risk for complications because it doesn't rearrange the digestive tract.¹ Your surgeon can guide you on whether gastric sleeve or gastric bypass is better for you, based on your medical history.¹⁰

Below is a chart that summarizes the differences and similarities between gastric sleeve surgery and gastric bypass surgery, as well as cost information.

Managing Health & Wellness Costs With the CareCredit Credit Card

If you are looking for an option to help manage your health & wellness costs, consider financing with the CareCredit credit card. The CareCredit credit card can help you pay for the care you want and need and make payments easy to manage.* Apply today and use our Acceptance Locator to find a provider near you that accepts CareCredit. Continue your wellness journey by downloading the CareCredit Mobile App to manage your account, find a provider on the go and easily access the Well U hub for more great articles, podcasts and videos.

Author Bio

Adrienne Santos-Longhurst is a writer who has been covering health and lifestyle for almost two decades. Her work has appeared in Healthline, Insider, Medical News Today and more.