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A simple guide to help you choose the right procedure
Bariatric (weight loss) surgery is an established treatment for obesity and related conditions such as type 2 diabetes,
high blood pressure, sleep apnoea, and fatty liver disease. Evidence shows that surgical treatment generally results
in greater and more sustained weight loss than lifestyle measures or medication alone, with associated improvements
in overall health and quality of life.
There is no single operation that is suitable for everyone. Each procedure works in a different way, and the most
appropriate option depends on individual health factors, lifestyle, and treatment goals.

Main bariatric surgery options

1. Sleeve Gastrectomy
   This is the most commonly performed bariatric procedure.
   What it involves
   Approximately 70–80% of the stomach is removed, leaving a smaller, tube-shaped stomach.
   How it works
   ● Reduces the amount of food that can be eaten
   ● Reduces hunger through hormonal changes
   Outcomes
   ● Significant long-term weight loss in most patients
   ● Lower complexity compared with gastric bypass procedures
   ● Lower risk of long-term nutritional deficiency compared with bypass surgery
   Considerations
   ● Not reversible
   ● May worsen or cause reflux symptoms in some patients
   ● Long-term outcomes depend on dietary and lifestyle factors
2. Roux-en-Y Gastric Bypass (RYGB)
   A well-established bariatric procedure with long-term data.

What it involves
A small stomach pouch is created and connected directly to the small intestine, bypassing part of the stomach and
small bowel.
How it works
● Reduces food intake
● Reduces calorie absorption
● Affects gut hormones involved in appetite and glucose regulation
Outcomes
● Sustained weight loss in many patients
● Well-documented improvement in type 2 diabetes
● Extensive long-term clinical evidence
Considerations
● Lifelong vitamin and mineral supplementation is required
● Some foods may cause dumping symptoms
● Higher complexity compared with sleeve gastrectomy

3. One-Anastomosis Gastric Bypass (OAGB)
   Also known as mini gastric bypass.
   What it involves
   A long gastric pouch is created and joined to a loop of small intestine with a single connection.
   How it works
   ● Restricts food intake
   ● Reduces calorie absorption
   ● Influences gut hormones related to appetite and metabolism
   Outcomes
   ● Significant weight loss reported in studies
   ● Improvement in metabolic conditions including type 2 diabetes
   ● Shorter operative time compared with Roux-en-Y gastric bypass in some cases
   Considerations
   ● Lifelong vitamin and mineral supplementation is required
   ● Risk of bile reflux in some patients
   ● Long-term comparative data is still evolving

Choosing the right option

All procedures are effective, but differ in technique and risk profile. The choice depends on:
● Weight and metabolic health conditions
● Presence of reflux or diabetes
● Dietary habits and lifestyle factors
● Previous abdominal surgery
● Individual treatment goals and preferences

Our approach: personalised care
We recognise that there is no “one size fits all” approach to bariatric surgery.
Assessment and preparation involve a detailed consultation process, where each patient’s medical history, lifestyle,
and goals are carefully reviewed. This allows a structured discussion of suitable surgical options, including potential
benefits and risks.
To support informed decision-making:
● Patients are routinely reviewed in at least two pre-operative consultations
● Patients are encouraged to involve family members or support persons in consultations
● Adequate time is provided to discuss questions and considerations before surgery
This shared decision-making process supports safe, individualised care and aims to optimise long-term outcomes.