Gastric Sleeve vs Gastric Bypass

Key takeaways

• In 2023, the sleeve accounted for 58.2% and the bypass for 23.4% of an estimated 270,089 U.S. metabolic and bariatric procedures.^[2]
• In the PCORnet study of 65,093 adults, average total weight loss was 31.2% after bypass and 25.2% after sleeve at 1 year, and 25.5% versus 18.8% at 5 years.^[7]
• Major adverse events within 30 days were 5.0% after bypass and 2.6% after sleeve in the same study.^[7]
• Reflux worsened more often after sleeve (31.8%) than after bypass (6.3%) in the SM-BOSS randomized trial.^[9]
• Both operations need lifelong vitamins and blood tests; deficiencies such as iron are more common after bypass.^[12]

Scorecards

	Gastric Sleeve Surgery: eligibility, results, risks and costSurgical	Gastric Bypass: how it works, results and long-term careSurgical
Evidence	High	High
Invasiveness	Surgical	Surgical
Medical supervision	Required	Required
Cost	$$$$	$$$$
Maintenance	Ongoing	Ongoing

No overall score and no winner: what matters depends on you. Hover a value for its definition.

Facts side by side

	Gastric Sleeve Surgery: eligibility, results, risks and costSurgical	Gastric Bypass: how it works, results and long-term careSurgical
Purpose	Medical weight loss	Medical weight loss
Class or type	Bariatric surgery	Bariatric surgery
Regulatory status	Surgical	Surgical
Prescription required	Performed by a clinician	Performed by a clinician
How it works	About 80% of the stomach is stapled and removed, leaving a banana-shaped tube. A smaller stomach fills sooner, and the operation changes gut hormones that affect hunger, fullness and blood sugar. The intestines are not rerouted.	An egg-sized stomach pouch is made and connected to the small intestine; the upper intestine is reconnected about 3 to 4 feet downstream (ASMBS). Food bypasses most of the stomach and the duodenum, limiting how much is eaten and absorbed…
How it is done or taken	Surgical	Surgical
How often	One-time	One-time
Invasiveness	Surgical	Surgical
Evidence strength	High	High
Average outcomes in studies	Average total weight loss 25.2% at 1 year and 18.8% at 5 years (PCORnet, 29,693 sleeve patients). Excess weight loss 49% at 5 years and 43.5% (median) at 10 years in the SLEEVEPASS trial; excess BMI loss 61.1% at 5 years in SM-BOSS.	Average total weight loss 31.2% at 1 year and 25.5% at 5 years (PCORnet, 32,208 patients); 28.4% at 7 years (LABS); 25% at 10 years (Swedish Obese Subjects). Diabetes remission 71.2% at 1 year and 60.2% at 7 years in LABS.
Main risks	Major adverse events within 30 days: 2.6% (PCORnet) Bleeding, infection, staple-line leak, blood clots and, rarely, death (NIDDK) New or worse reflux: worsened in 31.8% at 5 years in SM-BOSS; esophagitis 31% at 10 years in SLEEVEPASS	Major adverse events within 30 days: 5.0% (PCORnet) Bleeding, infection, leaks at the connections, blood clots and, rarely, death (NIDDK) Marginal ulcers, especially with NSAID painkillers or tobacco
Downtime	2+ weeks	2+ weeks
Cost (dated)	from 17,000-26,000 USD average cost range for bariatric surgery overall (ASMBS; not sleeve-specific) (checked October 6, 2026) $$$$	from 17,000-26,000 USD average cost range for bariatric surgery overall (ASMBS; not bypass-specific) (checked October 6, 2026) $$$$
Insurance	Often covered	Often covered
Maintenance	Ongoing	Ongoing
Advantages	Technically simpler and shorter than bypass operations (ASMBS) Fewer major adverse events in the first 30 days than bypass (2.6% vs 5.0%, PCORnet) No intestinal rerouting, so fewer absorption problems than bypass or duodenal switch	More weight loss on average than the sleeve or band (PCORnet) Strong effect on type 2 diabetes and high blood pressure Often improves reflux (remission 60.4% in SM-BOSS)
Limitations	Cannot be reversed: most of the stomach is removed May cause or worsen reflux and esophagitis Somewhat less weight loss and metabolic effect than a bypass on average	Higher early complication rate than the sleeve (5.0% vs 2.6%) More vitamin and mineral deficiencies; lifelong supplements essential Ulcers, bowel obstruction, dumping and post-meal low blood sugar possible
Who performs or prescribes it	Bariatric surgery	Bariatric surgery
Official resources	cms.gov	cms.gov

What the trials showed

• SLEEVEPASS (NCT00793143) 240 adults, Finland, 10-year follow-up: median excess weight loss 43.5% (sleeve) vs 50.7% (bypass); hypertension remission 8% vs 24%; esophagitis 31% vs 7%; Barrett's 4% vs 4%; reoperation 15.7% vs 18.5%.^[8]
• SM-BOSS (NCT00356213) 217 adults, Switzerland, 5 years: excess BMI loss 61.1% vs 68.3% (not significant); reflux remission 25.0% vs 60.4%; reflux worsened 31.8% vs 6.3%; reoperation or intervention 15.8% vs 22.1%.^[9]
• STAMPEDE 150 adults with type 2 diabetes, 5 years: HbA1c 6.0% or less in 23% (sleeve), 29% (bypass), 5% (medical therapy); weight -19%, -23%, -5%.^[10]

Side effects compared

	Gastric Sleeve Surgery: eligibility, results, risks and costSurgical	Gastric Bypass: how it works, results and long-term careSurgical
From the label	Major adverse events within 30 days: 2.6% (PCORnet) Bleeding, infection, staple-line leak, blood clots and, rarely, death (NIDDK) New or worse reflux: worsened in 31.8% at 5 years in SM-BOSS; esophagitis 31% at 10 years in SLEEVEPASS Barrett's esophagus: 4% at 10 years in SLEEVEPASS Narrowing of the sleeve (stricture), hernias and gallstones after rapid weight loss Vitamin and mineral deficiencies: B12 4-20%, iron under 18%, zinc 19% (ASMBS 2016)	Major adverse events within 30 days: 5.0% (PCORnet) Bleeding, infection, leaks at the connections, blood clots and, rarely, death (NIDDK) Marginal ulcers, especially with NSAID painkillers or tobacco Bowel obstruction, including internal hernia Strictures (narrowing) at the connections Dumping syndrome and low blood sugar after meals

Cost and coverage

Option	Price	Amount	Basis	Checked on
Gastric Sleeve Surgery: eligibility, results, risks and cost	Typical total (national data)	17,000-26,000 USD	average cost range for bariatric surgery overall (ASMBS; not sleeve-specific)	October 6, 2026
Gastric Bypass: how it works, results and long-term care	Typical total (national data)	17,000-26,000 USD	average cost range for bariatric surgery overall (ASMBS; not bypass-specific)	October 6, 2026

Prices change often and depend on pharmacy, plan and location. Insurance can change what you pay. Every price shows the date we checked it.

Things people weigh up

• Weight loss: average total weight loss was higher after bypass in PCORnet (31.2% vs 25.2% at 1 year; 25.5% vs 18.8% at 5 years).
• Reflux: the sleeve can start or worsen reflux; reflux more often improved after bypass in SM-BOSS.
• Early complications: major adverse events within 30 days were 2.6% after sleeve and 5.0% after bypass in PCORnet.
• Nutrition: both need lifelong supplements; the bypass carries higher risks of iron, zinc and other deficiencies.
• Reversibility: the sleeve cannot be reversed; the bypass is difficult to reverse.
• Other conditions: blood-pressure remission was higher after bypass in SLEEVEPASS; diabetes differences were smaller and not significant there.
• Medicines: the bypass carries an ulcer risk with NSAIDs and tobacco; ask how your long-term medicines fit.
• Coverage: Medicare covers bypass nationally and the sleeve at its regional contractors' discretion when criteria are met.

These are the differences people commonly consider, not a recommendation. A clinician can help you decide what fits you.

In short: The gastric sleeve and the gastric bypass are the two most common weight-loss operations in the U.S.: in 2023 they made up 58.2% and 23.4% of an estimated 270,089 procedures. The sleeve removes about 80% of the stomach and leaves a banana-shaped tube; the bypass creates an egg-sized pouch and reroutes the small intestine. On average, the bypass led to somewhat more weight loss and better reflux and blood-pressure outcomes in long-term studies, while the sleeve is a simpler, shorter operation with fewer complications in the first month and fewer nutrient deficiencies, but it can cause or worsen reflux. Neither is “better” for everyone: an accredited bariatric team decides with you after a full evaluation.

This page is for research before or between appointments. Surgery is a major, mostly permanent decision. Read widely, talk with a licensed bariatric surgeon and your primary care clinician, and complete the evaluation an accredited program requires before deciding anything. InstaTuck does not refer to, sell or recommend any operation or surgeon.

How each operation works

	Gastric sleeve (sleeve gastrectomy)	Gastric bypass (Roux-en-Y)
What the surgeon does	Removes about 80% of the stomach; what remains is the size and shape of a banana	Divides the stomach into a small pouch about the size of an egg, then connects the small intestine to it so food bypasses most of the stomach and the first part of the intestine; the bowel is reconnected about 3 to 4 feet downstream
How it is usually done	Laparoscopically (small cuts), under general anesthesia	Laparoscopically, under general anesthesia; technically more complex
Reversible?	No: part of the stomach is permanently removed	Difficult to reverse, although a surgeon may do it if medically necessary
Main advantages listed by ASMBS	Technically simple, shorter surgery; can be done in some higher-risk patients; can be a first step for severe obesity or a bridge to bypass or SADI-S	Reliable, long-lasting weight loss; effective for remission of obesity-related conditions; standardized technique
Main disadvantages listed by ASMBS	May worsen or cause new reflux and heartburn; less impact on metabolism than bypass procedures	More vitamin and mineral deficiencies; risk of small-bowel complications and obstruction; ulcers, especially with NSAIDs or tobacco; dumping syndrome, especially after sweets

Both operations limit how much a person can eat, and both change gut hormones that affect hunger and blood sugar, which is why they are called metabolic and bariatric surgery. The bypass adds a change in how food moves through the intestine, which is part of why it affects absorption of vitamins and minerals more. Our bariatric surgery guide covers all the procedures, including the endoscopic sleeve and gastric balloon.

• Sleeve
• Bypass

201128,12457,986

2019152,41345,744

2020122,05641,280

2021152,86656,527

2022160,60962,097

2023157,25463,132

U.S. sleeve and bypass operations per year (estimates)

Item	Sleeve	Bypass
2011	28,124	57,986
2019	152,413	45,744
2020	122,056	41,280
2021	152,866	56,527
2022	160,609	62,097
2023	157,254	63,132

ASMBS best estimates. The sleeve overtook the bypass during the 2010s and has been the most common operation since.

Source: ASMBS, Estimate of Bariatric Surgery Numbers, 2011-2023 (checked on October 6, 2026)

Who these operations are for

The 2022 guidelines from the American Society for Metabolic and Bariatric Surgery (ASMBS) and the International Federation for the Surgery of Obesity (IFSO) recommend metabolic and bariatric surgery for people with a BMI of 35 or more regardless of other conditions, and say it should be considered for people with a BMI of 30 to 34.9 who have metabolic disease. For people of Asian descent, lower thresholds apply (surgery considered from a BMI above 27.5). The guidelines set no upper age limit but call for careful assessment of frailty, and they say adolescents can be considered in specific circumstances. These are criteria for being evaluated, not a decision: whether surgery is safe for a specific person, and which operation, is decided by the surgical team. You can check your BMI with our BMI calculator.

Some factors commonly come up when a team discusses which operation fits. The ASMBS lists reflux as a known downside of the sleeve and lists the bypass as more effective for remission of obesity-related conditions; type 2 diabetes, severe reflux, the need for long-term medicines that are hard on the stomach (such as NSAIDs), smoking, and the ability to take lifelong supplements are all topics to raise with your surgeon.

Weight loss: what the studies showed

The largest U.S. comparison, the PCORnet Bariatric Study, followed 65,093 adults treated in 41 health systems between 2005 and 2015. Average total weight loss was 31.2% after bypass and 25.2% after sleeve at 1 year, and 25.5% versus 18.8% at 5 years. People with diabetes, people with a BMI under 50, people 65 or older, and African American and Hispanic patients lost less weight on average. It was an observational study, so the groups were not randomly assigned.

• 1 year
• 5 years

Gastric bypass31.2%25.5%

Gastric sleeve25.2%18.8%

Average total weight loss after sleeve and bypass (PCORnet)

Item	1 year	5 years
Gastric bypass	31.2%	25.5%
Gastric sleeve	25.2%	18.8%

Percent of starting weight. Observational data; individual results vary.

Source: Arterburn D et al., Annals of Internal Medicine 2018 (PCORnet Bariatric Study, 65,093 adults) (checked on October 6, 2026)

Two randomized trials compared the operations directly. In SLEEVEPASS (Finland, 240 adults), median excess weight loss at 10 years was 43.5% after sleeve and 50.7% after bypass; the two were not equivalent, but both produced lasting weight loss. In SM-BOSS (Switzerland, 217 adults), excess BMI loss at 5 years was 61.1% after sleeve and 68.3% after bypass, a difference that was not statistically significant after adjustment. “Excess weight” means weight above a reference healthy weight, so these percentages are larger than total weight loss figures.

Diabetes, blood pressure and reflux

• Sleeve
• Bypass

Type 2 diabetes remission26%33%

High cholesterol (dyslipidemia) remission19%35%

Sleep apnea remission16%31%

High blood pressure remission8%24%

Esophagitis on endoscopy31%7%

Barrett's esophagus4%4%

SLEEVEPASS at 10 years: remission of conditions and reflux findings

Item	Sleeve	Bypass
Type 2 diabetes remission	26%	33%
High cholesterol (dyslipidemia) remission	19%	35%
Sleep apnea remission	16%	31%
High blood pressure remission	8%	24%
Esophagitis on endoscopy	31%	7%
Barrett's esophagus	4%	4%

Only the blood-pressure and esophagitis differences were statistically significant. Small trial; 85% completed weight follow-up.

Source: Salminen P et al., JAMA Surgery 2022 (SLEEVEPASS randomized trial, 10-year follow-up) (checked on October 6, 2026)

Reflux. In SM-BOSS, reflux went away more often after bypass (60.4%) than after sleeve (25.0%), and got worse more often after sleeve (31.8%) than after bypass (6.3%). In SLEEVEPASS, esophagitis (inflammation of the food pipe) was found in 31% after sleeve versus 7% after bypass at 10 years, while Barrett’s esophagus was 4% in both groups. If you already have significant reflux, ask your surgeon how it affects the choice and what follow-up endoscopy they recommend.

• Sleeve
• Bypass

Reflux went away25%60.4%

Reflux got worse31.8%6.3%

Reflux 5 years after surgery (SM-BOSS)

Item	Sleeve	Bypass
Reflux went away	25%	60.4%
Reflux got worse	31.8%	6.3%

Source: Peterli R et al., JAMA 2018 (SM-BOSS randomized trial, 217 adults) (checked on October 6, 2026)

Type 2 diabetes. In the STAMPEDE trial (150 adults with type 2 diabetes and a BMI of 27 to 43), 29% after bypass, 23% after sleeve and 5% with intensive medical therapy alone reached an HbA1c of 6.0% or less at 5 years. Weight fell 23%, 19% and 5%. More on surgery and diabetes in our page on insulin resistance.

Risks and complications

The ASMBS puts the overall risk of death from bariatric surgery at about 0.1% and the overall chance of a major complication at about 4%, varying by procedure. In PCORnet, major adverse events within 30 days were 5.0% after bypass and 2.6% after sleeve. Over the longer term, reoperation or another intervention was needed in 15.8% (sleeve) and 22.1% (bypass) of SM-BOSS patients over 5 years, and in 15.7% and 18.5% of SLEEVEPASS patients over 10 years.

• Sleeve
• Bypass

Major adverse events, 30 days (PCORnet)2.6%5%

Reoperation or intervention, 5 years (SM-BOSS)15.8%22.1%

Reoperation, 10 years (SLEEVEPASS)15.7%18.5%

Complications and reoperations

Item	Sleeve	Bypass
Major adverse events, 30 days (PCORnet)	2.6%	5%
Reoperation or intervention, 5 years (SM-BOSS)	15.8%	22.1%
Reoperation, 10 years (SLEEVEPASS)	15.7%	18.5%

Different studies and definitions; the SLEEVEPASS reoperation difference was not significant.

Source: Arterburn D et al., Ann Intern Med 2018; Peterli R et al., JAMA 2018; Salminen P et al., JAMA Surg 2022 (checked on October 6, 2026)

Risk	Sleeve	Bypass
Early risks of any bariatric operation (NIDDK)	Bleeding, infection, leaks where the stomach or intestine was stapled or sewn, diarrhea, blood clots in the legs that can travel to the lungs or heart
Reflux and heartburn	May start or worsen	Often improves
Ulcers	Not listed by ASMBS as a sleeve disadvantage	A known risk, higher with NSAIDs and tobacco
Small-bowel complications and obstruction	Not listed by ASMBS as a sleeve disadvantage	A known risk
Later problems with any operation (NIDDK)	Poor nutrient absorption (anemia, bone loss), gallstones, strictures (narrowing), hernias; about one-third of people need a follow-up procedure, surgery or hospital stay within 5 years
Dumping syndrome (fast emptying of food, often sweets)	Can occur	Listed as a disadvantage; more typical
Gallstones with rapid weight loss	Possible with both; some teams prescribe preventive medicine for about 6 months
Alcohol	Alcohol is absorbed faster and peaks higher after both; in one large study (LABS-2), alcohol use disorder was about twice as likely after bypass as after a band

Vitamins and minerals for life

Both operations require lifelong vitamin and mineral supplements and regular blood tests; the bypass carries a higher risk of deficiencies, because the first part of the small intestine, where iron and other nutrients are mainly absorbed, is bypassed. The 2016 ASMBS nutrition guideline reports these rates of deficiency in the years after surgery:

• Sleeve
• Bypass

Iron18%55%

Vitamin B1220%20%

Zinc19%40%

Vitamin D (up to)100%100%

Reported nutrient deficiencies after surgery (highest rates in the guideline ranges)

Item	Sleeve	Bypass
Iron	18%	55%
Vitamin B12	20%	20%
Zinc	19%	40%
Vitamin D (up to)	100%	100%

Ranges: iron sleeve under 18%, bypass 20-55%; B12 sleeve 4-20%, bypass under 20% (2-5 years); copper deficiency 10-20% after bypass (no sleeve figure given); vitamin D deficiency up to 100% in people with obesity. Deficiency can occur even with supplements.

Source: Parrott J et al., ASMBS Integrated Health Nutritional Guidelines 2016 Update: Micronutrients (checked on October 6, 2026)

The 2019 AACE/TOS/ASMBS guideline recommends at least two adult multivitamins a day after either operation, plus specific supplements chosen by the team, with blood tests every 3 to 6 months in the first year and then yearly. Protein matters too: at least 60 grams a day is a common minimum. Our protein calculator and protein shakes guide can help you prepare questions for your dietitian.

Recovery and the first months

Your program will give you its own schedule, which overrides any general outline. The American College of Surgeons notes that many people return to normal activity in one to three weeks after surgery in general and are often told not to lift more than 10 pounds for four to six weeks; ask your surgeon for specifics. Pregnancy is usually advised against for 12 to 18 months after bariatric surgery, and the guideline recommends non-oral contraception after bypass. Long-term success depends on follow-up visits, activity (the guideline suggests at least 150 minutes a week, building toward 300) and support; see keeping weight off and strength training.

Cost and coverage (checked on October 6, 2026)

The ASMBS says the average cost of bariatric surgery ranges from $17,000 to $26,000; it does not give separate national prices for each operation. A study presented at the ASMBS 2026 meeting (May 5, 2026; all-payer claims 2017-2023, people with type 2 diabetes and a BMI of 35 or more) estimated total health care costs over two years:

Gastric bypass$51,300

Gastric sleeve$41,400

Total health care costs over 2 years after each operation

Item	Value
Gastric bypass	$51,300
Gastric sleeve	$41,400

Includes the operation and other medical costs over two years; conference data, not yet peer reviewed. Your own cost depends on your plan and center.

Source: ASMBS news release, May 5, 2026 (study presented at ASMBS 2026; STATinMED all-payer claims 2017-2023) (checked on October 6, 2026)

• Medicare covers bariatric surgery for people with a BMI of 35 or more, at least one obesity-related condition and previously unsuccessful medical treatment. Gastric bypass is covered nationally; coverage of the stand-alone sleeve is decided by the regional Medicare contractor when the same criteria are met (CMS NCD 100.1).
• Private plans set their own criteria, often with prior authorization and a documented history. The 2022 ASMBS/IFSO guideline calls insurer-mandated preoperative weight loss “discriminatory, arbitrary, and scientifically unfounded.”
• Costs beyond the operation: lifelong supplements, lab tests, follow-up visits and, for some people, later skin surgery. See the insurance hub and the costs hub.

Who performs it, and how to check a center

Both operations are done by bariatric surgeons in hospitals with a bariatric program. The American College of Surgeons’ MBSAQIP program accredits nearly 1,000 centers that meet its standards, and its website has a center search. Our directory of bariatric surgeons is being built. Medication options to compare first, or after surgery if weight returns, are covered in GLP-1 medication vs bariatric surgery.

Questions to ask a professional

• Given my reflux, diabetes and other conditions, which operation do you suggest and why?
• How many of each operation does your center perform each year, and is it MBSAQIP accredited?
• What are your center's complication and reoperation rates?
• Which supplements and blood tests will I need for life?
• How would my long-term medicines (for example NSAIDs) fit with each operation?
• What does my insurance require before approval?

Frequently asked questions

Which is better, the gastric sleeve or the gastric bypass?

Neither is better for everyone. On average, the bypass led to somewhat more weight loss and better reflux and blood-pressure outcomes, while the sleeve had fewer early complications and nutrient deficiencies but more reflux. A bariatric team decides with you after a full evaluation.

How much weight do people lose?

In the PCORnet study, average total weight loss was 25.2% after sleeve and 31.2% after bypass at 1 year, and 18.8% and 25.5% at 5 years. Individual results vary widely.

Can the sleeve or bypass be reversed?

The sleeve cannot be reversed because part of the stomach is removed. The bypass is difficult to reverse, although a surgeon may do it if medically necessary.

Does the gastric sleeve cause acid reflux?

It can. ASMBS lists new or worse reflux as a disadvantage of the sleeve. In SM-BOSS, reflux worsened in 31.8% after sleeve vs 6.3% after bypass; in SLEEVEPASS, esophagitis was found in 31% vs 7% at 10 years.

Which surgery is safer?

Both are major operations. In PCORnet, major adverse events in the first 30 days were 2.6% after sleeve and 5.0% after bypass. Over 5 to 10 years, reoperation rates were 15% to 22% in the randomized trials. ASMBS puts the overall risk of death at about 0.1%.

Do I need vitamins for life after either surgery?

Yes. Guidelines recommend lifelong supplements and regular blood tests after both operations; the bypass carries a higher risk of deficiencies such as iron and zinc.

Which is better for type 2 diabetes?

In STAMPEDE, 29% after bypass and 23% after sleeve reached an HbA1c of 6.0% or less at 5 years, versus 5% with medicines alone. In SLEEVEPASS, diabetes remission at 10 years was 26% vs 33%, not a significant difference. Your team will weigh your own situation.

How much does each cost?

ASMBS says bariatric surgery averages $17,000 to $26,000, without separate national prices per operation. A study presented in May 2026 estimated total two-year health care costs of $41,400 after sleeve and $51,300 after bypass. Coverage depends on your plan.

Does Medicare cover the sleeve and the bypass?

Medicare covers bariatric surgery for people with a BMI of 35 or more, an obesity-related condition and prior unsuccessful medical treatment. Bypass is covered nationally; the stand-alone sleeve is covered at the discretion of the regional Medicare contractor.

References

1. Bariatric Surgery Procedures. American Society for Metabolic and Bariatric Surgery. (accessed October 6, 2026) Society statement
2. Estimate of Bariatric Surgery Numbers, 2011-2023. American Society for Metabolic and Bariatric Surgery. (accessed October 7, 2026) Society statement
3. Metabolic and Bariatric Surgery (fact page, incl. average cost). American Society for Metabolic and Bariatric Surgery. (accessed October 6, 2026) Society statement
4. Types of Weight-loss Surgery. National Institute of Diabetes and Digestive and Kidney Diseases (NIH). (accessed October 6, 2026) Government page
5. Side Effects of Weight-loss Surgery. National Institute of Diabetes and Digestive and Kidney Diseases (NIH). (accessed October 6, 2026) Government page
6. Symptoms and Causes of Dumping Syndrome. National Institute of Diabetes and Digestive and Kidney Diseases (NIH). (accessed October 6, 2026) Government page
7. Arterburn D, et al.. Comparative Effectiveness and Safety of Bariatric Procedures for Weight Loss: A PCORnet Cohort Study. Annals of Internal Medicine, 2018. doi:10.7326/M17-2786 · PMID 30383139 · NCT02741674 (accessed October 6, 2026) Other
8. Salminen P, et al.. Sleeve Gastrectomy vs Roux-en-Y Gastric Bypass at 10 Years (SLEEVEPASS). JAMA Surgery, 2022. doi:10.1001/jamasurg.2022.2229 · PMID 35731535 · NCT00793143 (accessed October 6, 2026) Randomized trial
9. Peterli R, et al.. Sleeve Gastrectomy vs Roux-en-Y Gastric Bypass on Weight Loss (SM-BOSS). JAMA, 2018. doi:10.1001/jama.2017.20897 · PMID 29340679 · NCT00356213 (accessed October 6, 2026) Randomized trial
10. Schauer PR, et al.. Bariatric Surgery versus Intensive Medical Therapy for Diabetes: 5-Year Outcomes (STAMPEDE). New England Journal of Medicine, 2017. doi:10.1056/NEJMoa1600869 · PMID 28199805 · NCT00432809 (accessed October 6, 2026) Randomized trial
11. Eisenberg D, Shikora SA, Aarts E, et al.. 2022 ASMBS and IFSO: Indications for Metabolic and Bariatric Surgery. Surgery for Obesity and Related Diseases, 2022. doi:10.1016/j.soard.2022.08.013 · PMID 36280539 (accessed October 6, 2026) Guideline
12. Parrott J, Frank L, Rabena R, et al.. ASMBS Integrated Health Nutritional Guidelines for the Surgical Weight Loss Patient 2016 Update: Micronutrients. Surgery for Obesity and Related Diseases; American Society for Metabolic and Bariatric Surgery, 2017. PMID 28392254 (accessed October 6, 2026) Guideline
13. Mechanick JI, Apovian C, Brethauer S, et al.. Clinical Practice Guidelines for the Perioperative Nutrition, Metabolic, and Nonsurgical Support of Patients Undergoing Bariatric Procedures: 2019 Update (AACE/TOS/ASMBS/OMA/ASA). Endocrine Practice, 2019. doi:10.4158/GL-2019-0406 · PMID 31682518 (accessed October 6, 2026) Guideline
14. King WC, et al.. Prevalence of Alcohol Use Disorders Before and After Bariatric Surgery. JAMA, 2012. doi:10.1001/jama.2012.6147 · PMID 22710289 (accessed October 6, 2026) Other
15. Recovering from Surgery. American College of Surgeons. (accessed October 6, 2026) Society statement
16. Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP). American College of Surgeons. (accessed October 7, 2026) Society statement
17. Study Finds Bariatric Surgery Less Costly Than GLP-1 Drugs Over Time (news release). American Society for Metabolic and Bariatric Surgery, 2026. (accessed October 6, 2026) News (reported facts only)
18. National Coverage Determination 100.1: Bariatric Surgery. Centers for Medicare and Medicaid Services. (accessed October 7, 2026) Government page

Facts checked on October 6, 2026

Educational information, not medical advice. Talk with a qualified healthcare professional about your own situation. In an emergency call 911.