Choose the Right Weight Loss Procedure

Man's waist size

Making the decision to lose weight is the first step toward regaining your quality of life and improving your health. If you need a little help, MU Health Care physicians will work with you to choose the best option. 

Andrew Wheeler, MD
Andrew Wheeler, MD

Andrew Wheeler, MD, the chief of metabolic and bariatric surgery, outlines surgical and nonsurgical options.


All bariatric surgeries involve modifying stomach capacity as at least a component of the operation to help control hunger, but each uses a different method to do so. 

Gastric sleeve

The stomach size is reduced by 80 percent. The majority of weight loss comes in the first 18 months, although this option results in the least amount of weight loss compared to other weight loss options.

“With a smaller stomach, you will feel fuller quicker and eat less,” Wheeler said. “In addition, you will feel less hungry between meals due to hormonal changes.” 

The most common long-term side effect is heartburn, and while gastric-sleeve surgery is not quite as effective as the gastric bypass or duodenal switch, it has fewer long-term side effects compared to procedures that involve intestinal modifications. It is not reversible but can be transformed into one of the other surgical weight loss options if necessary.

“The sleeve can be performed in patients with severe medical illnesses, as well as in someone with extensive abdominal surgery,” Wheeler said. “It is a better procedure in someone that may go back to smoking after weight loss surgery as well.” 

Gastric bypass

A small stomach pouch is created and the small intestines are modified to allow for a new food passage from the new pouch to the rest of the digestive tract. The remaining stomach and first part of the intestines are bypassed. Weight loss typically is around 30 pounds in the first month and one to two pounds per week thereafter.

“Gastric bypass lessens the amount of food you can eat and somewhat decreases the calories your body can absorb,” Wheeler said. “In addition, the bypassed intestine helps control hunger through hormonal changes, as well as improve medical conditions such as diabetes. Through weight loss and bypassing a small portion of the intestines, medical conditions such as diabetes can drastically improve.”

The most common side effects are food intolerances or feeling sick after eating. Long-term nutritional deficiencies can happen but are rare, and uncommonly mild to severe gastrointestinal tract obstructions can occur. This procedure is not well-suited for someone with severe medical illnesses or extensive abdominal surgery. 

Biliopancreatic diversion with duodenal switch

This is a gastric-sleeve procedure that is combined with significant bypass of the small intestines. It leads to the most amount of weight loss and improvement in obesity-related medical conditions. Patients generally lose 70 to 80 percent of excess weight within two years. 

“This procedure is well-suited for someone who has a significant amount of weight to lose, diabetes or other serious medical conditions and is willing to take on a higher level of risk to meet his or her goals,” Wheeler said.

Patients can develop severe nutritional deficiencies or issues with gas or diarrhea and occasionally lose too much weight. Like the gastric bypass, this procedure isn’t recommended for someone with severe medical illnesses or extensive abdominal surgery.

Lap band

An adjustable band is placed around the upper portion of the stomach to limit the amount of food you eat by allowing a person to feel full with less food. Based on your nutritional needs and weight loss goals, the band can be adjusted to allow more or less food consumption after the initial surgery. 

Although relatively straightforward to perform, the failure rate can be high. The procedure is more suited for someone desiring modest weight loss and is able to participate in frequent follow-up office visits for evaluation for band adjustments.

Weight loss revisional surgery

If you are struggling with weight loss after bariatric surgery or are dealing with long-term side effects, it might be possible to try another method to achieve your goals or modify your current procedure to improve weight loss. In patients who have development long-term adverse side effects from a weight loss operation, surgical modifications can sometimes improve these side effects. These procedures can be higher risk as often they involve a second operation on the stomach, but for someone struggling with weight regain or adverse symptoms, a revisional operation can provide significant life-changing results.


If a surgical procedure is not right for you, or if you’re not ready for surgery, a gastric-balloon procedure may be appropriate for you. This option helps you feel fuller when eating and offers modest short-term weight loss. While you’re under anesthesia, a balloon is placed down your throat into your stomach, avoiding any surgical incisions. The balloon is filled with a saline solution and after six months, the balloon is removed. 

“With coaching from our staff, you’ll work on healthier meals and exercise options to lose weight,” Wheeler said. “Most patients who choose this method lose the most weight within the first six months and then must rely on a healthy lifestyle to keep the pounds off.”

MU Health Care's bariatric services also offer a comprehensive nonsurgical weight loss program using medications to help control hunger. This program can also be paired with a surgical procedure to maximize your weight loss and keep it off. 


MU Health Care’s bariatric surgery program and bariatric surgeons meet the criteria of excellence established by the American Society for Bariatric Surgery and American College of Surgeons and will help keep you on track to a healthier life. Our team is with you every step of the way.

Our surgeons are also committed to providing care for you for the long term. We strongly believe in being available for our patients, not simply performing an operation then leaving your care to someone else. At MU Health Care we believe that continued engagement with a dedicated bariatric team can help you be successful for the long-term and your care is much more important than checking boxes, it’s about a healthier you.

A large number of insurance plans cover bariatric services, and our staff will assist you in determining if you have bariatric surgery benefits. If you do not have surgical benefits, we can offer nonsurgical options as well. To get started, call 573-882-LOSE or request an appointment online

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