Major Weight Loss

Major weight loss isn’t necessary for everyone, but if your doctor recommends it, there are effective ways to shed the extra pounds. Learn how to safely slim down with both lifestyle changes and weight loss surgery.

Major weight loss isn’t necessary for everyone, but if your doctor recommends it, there are effective ways to shed the extra pounds. Learn how to safely slim down with both lifestyle changes and weight loss surgery.

Medically reviewed by Babak Moeinolmolki, MD, FACSBariatric Surgeon, Board Certified in General Surgery
Written byKaryn RepinskiUpdated on July 6, 2021
RealSelf ensures that an experienced doctor who is trained and certified to safely perform this procedure has reviewed this information for medical accuracy.You can trust RealSelf content to be unbiased and medically accurate. Learn more about our content standards.
Weight Loss 754x484
Weight Loss 754x484

If dieting, healthy eating, and ramping up your physical activity haven’t done enough to help you meet your weight-loss goals, you might be ready to consider weight-loss surgery. For the right people, these procedures can put them on a path to a healthy lifestyle and long-lasting weight control.

Dr. Nicole Basa, a bariatric surgeon in Austin, answers this RealSelf member's top questions about weight loss surgery options, including whether it's Worth It.

These are the bariatric surgery procedures doctors and RealSelf members say deliver the best weight-loss results.

Lap Band (Page Image)Lap Band

surgical

Worth It Rating98%97%82%100%
Average Cost$7825$12225$9568$25125
Downtime1–2 weeks of downtime2–3 weeks of downtime1 week of downtimeUp to 1 week of downtime
AnesthesiaGeneral anesthesiaGeneral anesthesiaGeneral anesthesiaGeneral anesthesia
  • Sleeve gastrectomy (also called gastric sleeve surgery) creates a smaller stomach, for more comfortable portion control that helps you lose weight. Unlike some bariatric surgeries, this procedure does not reconstruct the intestinal tract. Instead, it reduces the size of the stomach by up to 80%, helping patients feel full faster and avoid overeating. It also removes the fundus, the part of the stomach that produces ghrelin, the hormone that makes you feel hungry. After a sleeve gastrectomy, you can expect to lose 60% or more of your excess body weight within one year. You may see even better results if you stick to a healthy meal plan and regular physical activity, including cardio.  Miami surgeon Dr. Reza Keshavarzi says, “We prefer the sleeve to gastric bypass surgery. It’s easier on the patient, and it's much less invasive than the bypass. For even my heaviest patients, I recommend the sleeve and have had great results. You have much less potential for complications with the sleeve.” Find doctors who offer sleeve gastrectomy
  • Gastric bypass surgery divides your stomach into two sections, reducing the size by about 90% so you feel full faster. The surgery also bypasses a portion of the small intestine, so you’ll absorb fewer calories from food. Levels of ghrelin, the hunger hormone, decrease as well. This type of weight-loss surgery is malabsorptive, meaning that your smaller stomach will restrict the number of nutrients your body absorbs. You’ll need to follow a strict diet plan of healthy foods and take nutritional supplements for the rest of your life. Here's the upside: you can expect to lose 70–80% of your excess weight during the first 12 to 18 months after surgery, and research shows that 90% of patients have maintained at least 50% of their weight loss, even up to two decades later.  That being said, some patients do experience weight gain after several years and require a gastric bypass revision, to tighten the stomach pouch. Find doctors who offer gastric bypass
  • The lap band (also known as “gastric band”) is a device placed around your stomach that reduces its overall size and causes you to feel fuller with small portions. It’s adjustable, which allows people to modify their diet and reduce their dependence on the band over time as they become more comfortable with portion control. That being said, “The lap band is a restrictive procedure,” says Cortlandt Manor, New York, general surgeon Dr. Eric Sommer. “You must be willing to make major changes in eating habits and adopt a healthy lifestyle, to be successful.” If you eat or drink more than your stomach pouch can hold, it will stretch—and food can back up into the esophagus, causing nausea and vomiting.  The lap band has a lower success rate than other weight-loss procedures. Research shows it also has a 20% reoperation rate, compared to the 3–9% for gastric bypass and gastric sleeve surgeries. “Generally, the trend for bariatric/metabolic surgery is moving away from gastric band surgery,” says Dr. Moeinolmolki. “However, there are success stories with gastric bands. But as with any procedure, there are risks, side effects, and failure rates.” Find doctors who offer lap bands
  • Duodenal switch restricts the size of your stomach and reroutes the small intestine and digestive loop so you absorb fewer calories and lose body fat. The procedure reroutes food significantly more than a gastric bypass surgery. The amount of weight you can expect to lose is 70% or more of your excess body weight within five years. The procedure initially involves restricting portions, but some people can get back to eating relatively “normal” meals while still maintaining healthy eating.  This surgery is recommended for patients with diabetes. It also reduces the risk of related diseases, such as heart disease and high blood pressure.  Duodenal switch is the most complex and invasive bariatric surgery, with a longer recovery period and a higher risk of complications. Find a board-certified surgeon who performs the procedure frequently, to reduce your risks and optimize your results. Find doctors who offer duodenal switch

Related: It’s Time to Stop Believing These 8 Weight Loss Surgery Myths

  • Gastric balloons take up space in the stomach and prevent overeating. This 10-minute procedure is nonsurgical and noninvasive, and it’s recommended for those with a BMI of 30 to 40. Here’s how it works: The patient swallows a capsule that is attached to a thin tube. The balloon in the capsule is then inflated with gas, causing it to swell in the stomach to about the size of a small orange. Two more balloons are ingested, at two-week intervals, and the balloons remain in your stomach for six months. Once the six months are up, the balloons are removed through an endoscopic procedure. The manufacturer claims that you can lose up to 50 pounds with this procedure, but there are also some downsides associated with it. The procedure can cause nausea, heartburn, burping, bloating, cramping, indigestion, and irregular bowel movements. Patients who have had gastric bypass surgery in the past aren’t eligible for this procedure, and some patients complain about being able to “feel” the balloons in their stomach, especially when lying in bed. While some people do experience hefty weight loss, Realself members are undecided as to whether this procedure is helpful long-term. It currently has just a 43% Worth It Rating on RealSelf. Find doctors who offer gastric balloons

According to the American Society for Metabolic and Bariatric Surgery, people who need to lose upwards of 100 pounds qualify for major weight loss surgery, like bariatric surgery.

Weight gain and obesity put people at risk for a host of health problems, including type 2 diabetes and heart disease. For some people, major weight loss is essential to improve their health.

Popular or fad diet plans (including intermittent fasting) can occasionally result in significant weight loss, but they aren't always healthy or sustainable.

If you're just starting your weight-loss journey, work with your doctor, nutritionist, and/or dietitian on a weight-loss plan that will give you the health benefits of lowering your body fat and becoming more active, without the potential health risks of rapid weight loss.

To qualify for weight-loss surgery, the American Society for Metabolic and Bariatric Surgery recommends that patients meet one of the following criteria.

1. A BMI (body mass index) greater than or equal to 40, or more than 100 pounds beyond a healthy body weight. Calculate your BMI

2. A BMI greater than or equal to 35 and at least one or more obesity-related comorbidities. These may include type 2 diabetes, hypertension, sleep apnea and other respiratory disorders; nonalcoholic fatty liver disease; osteoarthritis; lipid abnormalities; gastrointestinal disorders; or heart disease.

3. An inability to achieve or sustain healthy weight loss for a period of time.

Note that “it can be difficult to obtain insurance coverage when the first two qualifications aren’t met,” according to Los Angeles bariatric surgeon Dr. Babak Moeinolmolki

Some weight-loss surgeries require portion control on your food intake, while others alter the way your food is digested. The right procedure for you will depend on a number of factors, including your overall health, lifestyle, weight-loss goals, and personal preferences.

Whether you need to lose a lot of weight or just a few pounds, the same basic principles apply. The key to successful weight loss is to burn more calories than you take in. A healthy, wholesome diet and a dedicated exercise routine are essential for succeeding at this calorie balancing act. For long-term weight loss, these lifestyle changes need to be permanent.

When it comes to dieting and healthy living, it’s best to consult with your doctor and come up with the ideal eating plan for your body. In general, studies have found that people on a high-protein diet eat 441 fewer calories per day. A 2020 study also confirmed that a very low-carbohydrate diet helped older populations lose weight. Research also suggests that a low carb diet can reduce appetite, which in turn can lead to eating fewer calories and, ultimately, weight loss.

Physical activity is another important component of a weight-loss program and long-term weight management. Cardio workouts and weight lifting can burn extra calories, build muscle, and improve overall health.

Updated July 6, 2021

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