At a height of 5'2" and a weight of approximately 220 pounds, your body mass index (BMI) is around 40.2, which meets the standard criteria for bariatric surgery. Given your goal of reaching 140 to 150 pounds—a weight loss of roughly 70 to 80 pounds—both the gastric sleeve and the laparoscopic adjustable gastric band (lap band) are potential options. However, the gastric sleeve is generally considered the more effective and preferred procedure in current bariatric practice. The sleeve gastrectomy involves removing a portion of the stomach to create a smaller, sleeve-shaped stomach. This not only limits the amount of food you can eat but also reduces hunger by affecting hormonal signals related to appetite. It is a permanent procedure and has been shown to lead to significant and sustained weight loss for many patients. Additionally, it tends to produce better outcomes in terms of resolving or improving obesity-related conditions such as type 2 diabetes, hypertension, and sleep apnea. In contrast, the lap band procedure involves placing an adjustable band around the upper part of the stomach to create a small pouch. While it is less invasive and reversible, it has fallen out of favor in many practices due to lower overall weight loss, higher rates of long-term complications, and a greater likelihood of requiring revision or removal. For most patients with a BMI of 40 or higher, the gastric sleeve offers a more reliable and lasting solution, provided there is a commitment to the necessary lifestyle and dietary changes postoperatively. A consultation with a bariatric surgeon would allow for a more personalized evaluation, taking into account your medical history, weight loss goals, and any underlying conditions that may influence the best surgical choice for you.