Bands, Bypasses, and Balloons: Weight Loss Surgery Explained

Healthy diet and lifestyle should always be your first weapon against obesity. But extreme obesity can get so dangerous as to require a surgery. Read our guide to find out how effective it is.

Image Credit: Anastasia Kazakova /

The risks of being overweight

Being obese doesn’t just make it difficult to run or play with your kids. Once the body mass index (BMI, calculated as your weight in kg divided by the square of your height in meters) gets above 30, a person’s risk of dying from heart disease or stroke grow rapidly. Obesity is often accompanied by Type 2 diabetes, inflammation, high cholesterol, and sleep apnea (more on obesity health risks). This means that many extremely heavy people absolutely need to lose weight, but diets simply don’t work for them anymore, and they cannot engage in sports. In such cases, bariatric (weight loss) surgery is prescribed.

Types of weight loss surgery

You can often hear people talk of gastric bands (or lap bands), though in fact it is not the most popular type of surgery anymore. Here is some basic info (more on the topic here ):

  1. Band – a band is placed around the stomach and divides it in two unequal parts. Once food fills the top part – a small pouch – the person stops feeling hungry. The band can be inflated or deflated, allowing to regulate the size of the pouch (and thus, the size of an average meal). Patients end up eating much less. The procedure is fully reversible.
  2. Bypass – currently the most popular procedure. A small pouch (circa 30 cubic cm) at the top of the stomach is separated from the rest and connected directly to the intestine. The patient eats less, and much less of the hunger hormone – ghrelin – is produced.
  3. Sleeve gastrectomy – most of the stomach is removed, and the remaining part resembles a sleeve.
  4. Balloon – not a surgery per se, but an effective alternative for some people. A deflated balloon is placed in the stomach and filled with 0.5 l of water through a tube, and occupies most of the space in the stomach. After 4 months, the balloon bursts and is safely exreted.

Which is better?

Gastric bands used to be the main option and are still popular due to lower price, but now over 40% of all bariatric surgeries are bypasses. The figures say it all: on average people receiving a bypass lose over 30% of their weight, while those getting a band lose only 16%. Weight loss is not the only benefit, however. Type 2 diabetes goes into remission in a large proportion of cases, though scientists are still not sure why (the chances are different, though: 30% of patients with a lap band experience a remission, and over 70% of those with a bypass). Cholesterol levels improve dramatically, too, as does the general feeling of well-being (read more on the effects). To some people, the surgery provides life-long improvements, while for others the effects last only a few years.

It’s not for everyone

The key thing to understand is that a band or a bypass are still a surgery and can result in complications. Repeat surgeries are quite common, and quite a few patients eventually ask for their band to be removed.

Just as importantly, bariatric surgery is not an alternative to healthy lifestyle. It is a radical solution fit for people whose life is in danger due to extreme obesity. Those who do receive a surgery have to alter their diet radically, switching to whole grains, vegetables, fruit, and healthy oils, and exercise actively.

If you’d like to shed some weight, therefore, don’t run to a surgeon for a miracle cure – there isn’t one. Even with a band, you will have to eat well and engage in sports – so why not start right now?

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