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Bariatric surgery is an important tool for many people who cannot lose weight on their own, especially people who are at high risk of mortality because of their weight. Choosing the right type of bariatric surgery services is an important decision to have the best chance of success.

1. Consider Your Starting Weight

In many cases, the recommended surgery will depend on your starting weight. People who do not have a tremendous amount of weight to lose, such as less than 200 pounds, might be recommended to have the vertical sleeve gastrectomy (VSG). In this procedure, the stomach is banana-like in size and shape at the end of the procedure. 

All the weight you lose from the procedure is based on the restriction of the amount of food you can eat at once. For people who are much heavier, especially those who are 500 or more pounds, doctors are more likely to recommend gastric bypass (GB) or VSG with duodenal switch (DS). Both procedures combine food restriction by reducing the size of the stomach with malabsorption.

2. Determine Accessibility

Although you may want a specific type of bariatric surgery, you may face hurdles when finding surgeons in your area. There are fewer surgeons who perform DS than VSG or GB. Some surgeons who perform DS do a modified version. You also may need to consider whether your insurance will pay for a specific surgery. Some people face problems when trying to gain approval from their insurance company, either because there may be exclusions, or their insurance may only approve a specific type of surgery. If the latter is a problem, some people find bariatric centers that allow them to finance the procedure. To keep the procedure more affordable, they may opt for the least complicated of bariatric procedures, which is VSG.

3. Think About Long-Term Issues

You should select the surgery that will most likely help you reach your goals, but you should also consider any long-term benefits or concerns. Although there is always the risk of complications, the less complex the procedure, the less likely you may experience complications. Additionally, if a specific procedure cannot be performed laparoscopically, this can also sway your decision. All bariatric patients are encouraged to stick to a regimen of supplements.

Since they cannot eat as much food, they may experience vitamin and mineral deficiencies. For procedures that have a malabsorption component, especially DS, lifelong supplementation is necessary to avoid serious complications. If you cannot commit to routine follow-up visits and testing indefinitely, you may want to avoid GB or DS.

Thinking carefully about your bariatric surgery options is important before making the commitment. Not only do you need the procedure that is most likely to result in successful weight loss, but you also want the option that will give you a good chance at keeping the weight off indefinitely.