When trying to select the best bariatric surgery for you, it can feel like a very overwhelming idea. A lot of people will lean towards procedures that another family member or friend may have selected because those individuals experienced great weight loss success.

While this is a great place to start, it is important to realize that surgery is not a one size fits all approach to weight loss. What might work incredibly well for one person, may not be the best fit for another.

It is important to speak to your medical professionals to get information on all the surgical options to decide what is the best option for your unique self. This involves taking into account your own medical history and medical conditions as well as challenges you currently face with your own diet and lifestyle. 

In this article, we will focus on surgery choice related to the struggles you may currently face with your diet, to help give you more information on what option could possibly be a good fit for you.

Sleeve Gastrectomy

Who would be a good candidate? 

Best for people needing to lose less than 100 pounds, however men have a higher chance of seeing greater than 100 pound weight loss because they typically have more muscle and a faster metabolism than women. If you do not struggle with emotional eating or food addiction, but does skip meals or eats 1 large meal a day due to being busy. Additionally, we find that people who struggle with feeling hungry often and have a hard time with portion control in general can benefit greatly from this surgery.

Who might not be a good candidate? 

As a dietitian, there are a few habits or qualities that may make this surgery not the ideal option for some people. If you struggle with eating “slider foods” like chips, crackers, popcorn, and cereals, this surgery will not help you eat a smaller portion of these items. And if they stay in the diet, will only prevent weight loss.\

In a similar way, the Sleeve will not help people avoid high sugar foods like sweets and desserts. If you have a “sweet tooth,” and have always struggled with avoiding sugar in your diet, this is likely not the right choice.

Additionally, we have noticed that women with PCOS (Polycystic Ovarian Syndrome) or other hormonal imbalances that struggle with weight loss, typically do not see the results they would expect. 

The Sleeve Gastrectomy is the ideal option for people who truly struggle with portion control and hunger levels, but not the best option for individuals that struggle with high sugar foods, “slider” foods, emotional eating, and minimal weight loss through calorie restriction in the past.

Gastric Bypass

Who would be a good candidate? 

The gastric bypass is an excellent option for people seeking 100-150 pound weight loss and struggling with consuming sweets and desserts throughout the week. This could look like someone who has a “sweet tooth” that has foiled their past weight loss attempts and they can’t quite seem to break the habit.

People with GERD (Gastroesophageal reflux disease, aka severe heartburn), Type 2 Diabetes, Pre-diabetes, and women with PCOS may find this to be a very helpful surgery. The gastric bypass almost immediately helps to relieve heartburn symptoms, and significantly improve diabetes management! 

Who might not be a good candidate? 

Let’s discuss a few lifestyle factors and behaviors that might not make this the best option for everyone. For those who do not want to quit smoking or reduce their alcohol consumption, this may not be the best option.

There is a higher risk for developing liver cirrhosis and alcoholism after this surgery for those who continue to consume alcohol on a regular basis.

For those with past experiences of binge eating and emotional eating, the gastric bypass may cause some emotional challenges after surgery, as that coping mechanism is completely removed.

For those who have struggled with binge or emotional eating in the past, we typically suggest exploring the LOOP Duodenal Switch surgery as a potential option. 

Loop or Standard Duodenal Switch 

Who would be a good candidate? 

This is an excellent option for individuals seeking to lose 100-150 pounds or more from their surgery. This is a great option for individuals that have struggled with emotional or binge eating in the past. 

For those currently struggling with binge eating and emotional eating, we strongly encourage working with a therapist or psychologist to help you navigate your relationship with food. If this is not resolved or managed before any bariatric surgery, there is a very great chance that you will experience weight regain and minimal weight loss after surgery. Even with the Duodenal Switch. 

Additionally, people that would call themselves “grazers,” eat out often, or struggle with consuming high fat/greasy foods, can benefit the most from this surgery.

The Duodenal Switch surgery causes fat malabsorption, so when higher fat foods are consumed this will trigger gut upset and diarrhea. This physical reminder helps many stay on track with their weight loss and can help many see the long term weight loss success they have been hoping to achieve.

Who might not be a good candidate? 

One big consideration for this surgery includes the financial commitment to your health. This surgery requires the person to take specialty, bariatric vitamins for a lifetime and continue to take protein supplements longer term. This may not fit well within someone’s budget, and should be a point of discussion with your medical provider.

Also, for people that do not have easy bathroom access with their job, this may not be the ideal option as the Duodenal Switch does cause more frequent bathroom visits. 

Making the Decision

Selecting a surgery is not an easy decision. This article is here to help you begin to evaluate what you might personally struggle with in your own life to help point you in the right direction. Take what you learn from this article to help you have a really productive conversation with a surgeon at our office.

Take a look at the table below. Whatever column you feel resonates with you the most is a great place to begin when thinking through your surgical options.