Hello Mollymay. The frustration of fluctuating the same 5 pounds over and over is something almost all my patients experience before surgery; your body's metabolism is simply fighting your efforts. At 5'6" and 220 lbs, your BMI is 35.5. While a surgeon needs to review your full medical history to give you a completely accurate diagnosis, based on the numbers you shared, a Gastric Sleeve is more than enough for you. To answer your question directly: No, you likely do not need a Gastric Bypass. For a starting BMI of 35, a Gastric Bypass is generally considered too aggressive unless you also suffer from severe, medication-dependent Acid Reflux (GERD) or advanced diabetes. You are a picture-perfect candidate for the Gastric Sleeve (VSG). It is a simpler, safer procedure that physically limits portion size and removes the part of the stomach that produces the "hunger hormone" (Ghrelin). This resets your metabolism and will easily help you break through that 220 lb plateau without the severe malabsorption and strict vitamin requirements of a Bypass. I highly recommend scheduling a consultation with a board-certified bariatric surgeon to review your health history and discuss the Gastric Sleeve. It is the perfect tool to help you drop the weight for good. Warmly, Dr. Sandy Martinez