If you are considering bariatric surgery, you might be wondering which type may be right for you. Gastric bypass surgery has been around since 1966 and is the oldest bariatric procedure performed today. It is considered the “gold standard” of bariatric surgeries because of its extensive, decades-long track record of safety and success. You may wonder, “Are there alternatives to gastric bypass?”
Yes. Some alternatives to gastric bypass include gastric sleeve, duodenal switch, gastric banding, a temporary gastric balloon, weight-loss medicine, and gastric plication.
These choices do not all work the same way. Some make permanent changes to your stomach, while some also reroute your intestines. Others do not require abdominal incisions. The right gastric bypass alternative depends on your health, goals, medical history, and aftercare needs.
Why Consider an Alternative to Gastric Bypass?
Gastric bypass surgery makes a small stomach pouch and changes the path food takes through the small intestine. It can treat obesity, but it also changes your digestion process. Because of this you will need to pay close attention to ensure you get the nutrition you need for the rest of your life.
You may prefer an option that does not reroute the intestines or you may want a short-term treatment because you may not feel ready for surgery. And issues like reflux, diabetes, past surgery, current medicines, and your current weight-loss needs may also influence the best choice.
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) explains that one procedure does not fit or work the best for every person. A bariatric surgeon can review the benefits and risks with you.
A Quick Comparison of Gastric Bypass Alternatives
| Option | Does It Require Surgery? | Does It Reroute the Intestines? | Is It Temporary or Removable? |
|---|---|---|---|
| Gastric sleeve | Yes | No | No. A portion of your stomach is permanently removed. |
| Duodenal switch | Yes | Yes | No |
| Adjustable gastric band | Yes | No | The band can be removed at anytime. |
| Gastric balloon | No abdominal surgery. The balloon is placed by endoscopy. | No | Yes. The balloon is removed after 6 or 9 months. |
| Prescription medication | No | No | Treatment can be changed or stopped with medical guidance. |
| Gastric plication | Yes | No | It may be reversible, but it is a less common option. |
6 Alternatives To Gastric Bypass Surgery
When comparing alternatives to gastric bypass, it is important to focus on the option that works best for your needs and circumstances and not on which is the fastest and easiest.
1. Vertical Sleeve Gastrectomy
A vertical sleeve gastrectomy (gastric sleeve) makes the stomach smaller without changing the path food takes through your intestines. The surgeon removes much of your stomach and leaves a narrow section shaped like a sleeve that will become your new stomach pouch.
The gastric sleeve is the most often performed bariatric surgery today and is usually the choice patients pick when they do not want their intestines rerouted.
The American Society for Metabolic and Bariatric Surgery explains the benefits and limits of gastric sleeve surgery.
Some of the benefits include:
- The surgery is not too complex, so it takes a shorter time to complete than gastric bypass.
- Can sometimes be used for certain patients with high-risk medical conditions.
Some disadvantages include:
- The portion of your stomach that is removed cannot be put back.
- The surgery can make acid reflux worse for some people.
2. Biliopancreatic Diversion With Duodenal Switch
A biliopancreatic diversion with duodenal switch combines a sleeve-shaped stomach with a major change to the routing of the small intestine. You eat less, and your body takes in fewer calories and nutrients.
The NIDDK reports that the duodenal switch may lead to more weight loss than other forms of bariatric surgeries. It also has a higher risk of nutritional problems and experiencing low levels of protein, vitamins, and minerals.
You will need to have regular checkups and make sure to take your prescribed supplements so your body gets what it needs to function properly.
3. Adjustable Gastric Banding
With an adjustable gastric band, the surgeon places a band around the upper part of your stomach. The band creates a small pouch, and the size of its opening can be changed through a port that is placed under your skin. It does not remove stomach tissue or reroute your intestines. A surgeon can also remove the band if needed.
Gastric banding is less common in the United States than it once was. The reason it is not used as often is because it often leads to less weight loss than a gastric sleeve or bypass. Some people need to have the band removed because of side effects or other problems. The band also requires ongoing follow-up visits for changes.
4. Orbera Gastric Balloon
The Orbera gastric balloon is placed into your stomach through your mouth and down your throat with an endoscope and does not require abdominal incisions. The balloon takes up space in your stomach to help you feel full quickly while eating less food. It works best when used with a doctor-supervised diet and behavior plan. The balloon is only temporary and must be removed after it has been in place for 6 months using a similar endoscopic procedure.
5. Prescription Weight-Management Medication
Prescription medicine may be an alternative to gastric bypass for some people. It should be used with dietary changes, increased exercise, an adequate amount of sleep, and other healthy lifestyle habits. Some medications reduce hunger, and others help you feel full sooner or for a longer time.
The Cleveland Clinic reports that weight loss medications are not right for everyone and should be used as part of a doctor-supervised weight loss plan. Sometimes, these medications are used with bariatric surgery or a non-surgical weight loss procedure.
6. Laparoscopic Greater Curvature Plication
Laparoscopic greater curvature plication is a procedure that makes your stomach smaller by folding it inward and holding the fold in place with stitches. It does not remove any stomach tissue or reroute your intestines.
Plication is a less common form of bariatric surgery than a gastric sleeve or gastric bypass and is still considered an investigational surgery, so it is not often covered by medical insurance.
How Do You Choose the Right Option?
Having a list that explains all your choices can be great, but it is not able to definitively choose the right option for you. The best way to determine the procedure that will work best for you would be through a personal bariatric consultation with the experts at the Laparoscopic & Endoscopic Surgical Institute (LESI).
A bariatric evaluation normally looks at:
- Your health and any chronic weight-related health problems you have,
- Reflux or other digestive problems.
- Past weight-loss attempts, medicines, or surgeries.
- Your feelings about having lasting changes made to your stomach or intestines.
- Your ability to follow a special diet, take your supplements, and attend all your checkups
- Your insurance details and the cost of the procedure.
LESI offers several bariatric surgery and endoscopic weight-loss options in Alpharetta, Georgia. The team can review your health and explain which treatments may fit your needs and lifestyle along with the preparation, recovery, nutrition, and cost of each.
Set up your consultation to learn more today.
FAQs
What Are the Top Alternatives to Gastric Bypass?
There are many alternatives to gastric bypass surgery, and the right choice for you depends on your current health, medical history, and the goals you are trying to achieve. Some options include gastric sleeve, duodenal switch, adjustable gastric banding, a temporary gastric balloon, prescription weight-loss medicine, and gastric plication.
What Is the Least Invasive Alternative to Gastric Bypass?
A gastric balloon is one of the least invasive options because it is placed into your stomach through your mouth with an endoscope and does not require any incisions in your belly. Prescription weight-loss medicine is another option that does not require surgery that has been proven effective for many people. These can be used alone or together, and no one treatment is right for everyone, but whatever you choose should be done as part of a medically supervised weight-management plan.
Is Gastric Sleeve Surgery a Good Alternative to Gastric Bypass?
Gastric sleeve surgery may be a good alternative for someone who wants a smaller stomach without having any other digestive system changes made. The stomach tissue that is removed cannot be restored, making these changes permanent. Gastric sleeve surgery can make acid reflux worse for some people, so you should work closely with your bariatric surgeon to ensure you pick the right procedure for you.
Can Weight-Loss Medicine Replace Gastric Bypass Surgery?
Weight-loss medicine may help some people manage obesity without surgery, but it may not replace gastric bypass or another weight loss treatment for everyone. The results, side effects, cost, and need for long-term treatment can vary by medication and by person. Weight regain may also occur after treatment stops, so ongoing medical guidance and long-term lifestyle changes will be necessary.
