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How Do I Know Which Weight Loss Surgery Is Best for Me?


By Dr. Dieter Pohl

At Roger Williams Medical Center, our Bariatric Weight Loss Surgery Program offers four different bariatric procedures or surgeries:

  1. Sleeve Gastrectomy
  2. Gastric Bypass
  3. SADI
  4. Duodenal Switch

At your first appointment, when you meet with your surgeon, he will review all of the surgeries with you. The surgeon will recommend which surgery may be best for you based on your current weight, your health and any other health conditions that you have. For example, if you have a history of heartburn (often called gastric reflux or Gastroesophageal Reflux Disease), the best surgery for you may be the gastric bypass. If you have a lot of weight to lose, the duodenal switch may be the best option for you to achieve your goals. Everyone is different. Even if you have the same amount of weight to lose as a friend, your medical history may be different and therefore, the surgery that is best for you may be different from your friend’s.


Here is a brief overview of the Weight Loss Surgeries at Roger Williams Medical Center. Be sure to ask your surgeon if you have any questions. For more information, see the Weight Loss Surgery Information booklet, pages 4-8. 

Sleeve Gastrectomy

The sleeve gastrectomy or gastric sleeve is a procedure in which the majority of your stomach is stapled off and removed. The stomach is still connected to the esophagus on one end and your intestines on the other end. This new stomach looks like a banana in shape and holds about 3 ounces. This surgery works by reducing the portions of food that can be eaten. There is no change to your intestines. With the gastric sleeve, there is also a change in the hormones in the body that helps to reduce hunger.

You would need to take supplemental vitamins and minerals if you have this procedure done.

Gastric Bypass 

With the gastric bypass surgery, a large portion of the stomach is “bypassed” and the upper part of the stomach is made into a pouch can only hold about 2-3 tablespoons of liquid or solid food. The stomach is smaller than with the sleeve surgery. Then a short segment of the small intestine is connected to the small pouch or stomach. The gastric bypass works by decreasing the portion size of a meal and by not absorbing some of the calories and nutrients eaten.

You would need to take supplemental vitamins and minerals if you have this procedure done.

More weight is usually lost with this procedure vs. the sleeve because the stomach is smaller and the “bypass” has an additional effect on your hormones and how food and nutrients are absorbed.  With both the sleeve and the gastric bypass, hunger is diminished in the first 6 months to 1 year. Patients usually lose the most weight during this time period.

Duodenal Switch and SADI

The duodenal switch and SADI procedures are similar. The surgery includes a sleeve gastrectomy with an additional change or re-routing of the small intestine. The result is the same as for the sleeve, meaning there is a smaller stomach, so you would only be able to eat small portions. You would also see an additional decrease in calories and nutrients because they are not completely absorbed. Of all the surgeries, the duodenal switch and the SADI procedure see the most weight loss, even more than for the gastric bypass, because the length of intestine in which nutrients can be absorbed is less than with the gastric bypass surgery.

Both the Duodenal Switch and SADI procedures require more protein, vitamins, and minerals than the sleeve or gastric bypass because more calories and nutrients are not fully absorbed. It is critical to take your vitamins and minerals daily to prevent nutrient deficiencies. It is also critical to follow up with your bariatric team because it’s important to be sure you continue to absorb your vitamins and minerals over the long term.

What are the Benefits of Bariatric Surgery?

The benefits of bariatric surgery include the obvious weight loss, but in addition to that, people report:

  • less pain in knees and back,
  • easier time getting around,
  • more stamina, less shortness of breath,
  • ability to climb stairs,
  • ability to tie shoes.

In addition, many people may be able to decrease the amount of medications they take for certain chronic conditions or come off the drugs entirely. Those chronic conditions include improvement in:

  • Type 2 diabetes
  • Hypertension
  • Heart disease
  • Fatty liver disease
  • Sleep apnea
  • Joint pain

In the long run, bariatric surgery can add years to your life, as well as an improved quality of life.

What are the Risks of Bariatric Surgery?

Like any type of surgery, there are risks and may be complications. It is important to discuss these with your doctor and surgeon prior to surgery. Complications do happen, but many issues that occur after surgery can be prevented by following the directions from your surgical team and communicating with them if you have a problem.

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