The different types of bariatric surgery can feel confusing at first. The names are technical, the diagrams look complicated, and it is not always clear why one person is guided toward a sleeve while another is told that a bypass or DS may fit better.
This guide is here to make the options understandable without oversimplifying them.
Each option alters the digestive tract in a specific way, affecting eating patterns, nutrient absorption, and long-term supplementation needs.
We will walk through each procedure, how the main types differ, other procedures you might hear about, and how clinical teams decide which type may best fit.
What this article covers:
- Quick Overview Of The Types Of Bariatric Surgery
- Restrictive Vs Malabsorptive Surgeries
- The Main Types Of Bariatric Surgery
- Other Procedures You Might Hear About
- How The Different Types of Bariatric Surgery Compare At A Glance
- Life After Different Bariatric Surgeries
- Frequently Asked Questions
Quick Overview Of The Types Of Bariatric Surgery
When we talk about the “types” of bariatric surgery, we mean the procedures most commonly used today with long-term clinical evidence behind them.
These surgeries are performed by bariatric surgeons who specialize in metabolic and weight-related care. They are not do-it-yourself interventions, and they are never a one-size-fits-all decision.
Instead, they are medical interventions used alongside nutrition care, movement, follow-up visits, and supportive community resources to help people build healthier routines over time.
The main procedures you will see in modern bariatric care include:
- Sleeve gastrectomy
- Roux-en-Y gastric bypass
- Duodenal switch (BPD-DS)
- SADI-S
- Adjustable gastric banding (less common today)
You may also hear terms like “revision surgery” or “balloons.” Those are real parts of the broader landscape, but they are not the same as primary bariatric procedures, and we will cover them later.
Restrictive Vs Malabsorptive Surgeries
Understanding what is bariatric surgery at a practical level starts with understanding how different procedures change digestion.
That is why clinicians often group the main types by whether they are restrictive, malabsorptive, or a combination of both.
Restrictive Procedures
Restrictive procedures make the stomach smaller. With less stomach volume, food fills the space faster, so fullness tends to arrive sooner, and meals naturally become smaller.
In these surgeries, the small intestine isn't bypassed, so food still travels through the usual absorption pathway. That means nutrient absorption remains largely unchanged, while total intake decreases.
Malabsorptive Procedures
Malabsorptive procedures reroute part of the small intestine so food bypasses sections where calories and nutrients are normally absorbed. Your body still digests what you eat, but it has less surface area and less time to absorb energy, vitamins, and minerals.
Combination Procedures (Restrictive + Malabsorptive)
Many modern surgeries combine both effects. They reduce stomach size and shorten the intestinal absorption route, thereby limiting intake while also lowering absorption. These changes are built into the procedure and reflect anatomy, not someone's willpower or effort.
The Main Types Of Bariatric Surgery
Each surgery below has a distinct anatomical blueprint. We will describe what changes in the body and what that means for you going forward.
Sleeve Gastrectomy (Gastric Sleeve)
A sleeve gastrectomy removes a large portion (up to 80%) of the stomach and reshapes the remaining portion into a narrow tube. Food still follows the normal route into the small intestine, but the smaller stomach holds less at one time, so portions are smaller by necessity.
Many people notice fullness sooner because the stomach fills faster. Hunger signaling may also change because part of the stomach where the main hunger hormone is produced is removed.
From a big-picture view, the sleeve is primarily a restrictive procedure with meaningful hormonal effects. The intestines are not rerouted, so absorption stays mostly intact.
Reduced intake can still lead to nutrient gaps without a consistent bariatric multivitamins routine. Some people are more prone to reflux after a sleeve, which is why teams screen for reflux history and anatomy when considering this option.
Roux-en-Y Gastric Bypass
A Roux-en-Y gastric bypass creates a small stomach pouch and reroutes part of the small intestine. Food enters the pouch and then moves directly into a lower section of the intestine, bypassing most of the stomach and the first segment of the small intestine.
This produces two effects at once: restriction from the small pouch and malabsorption due to the shortened intestinal tract.
Compared with a sleeve, bypass is more complex in anatomy and typically comes with a more robust vitamin plan because absorption changes.
Many people feel strong satiety shifts after bypass due to hormonal changes triggered by the new intestinal pathway.
Long-term follow-up stays important because the bypassed segments affect how certain nutrients are absorbed, and labs guide adjustments over time.
Biliopancreatic Diversion With Duodenal Switch (BPD-DS)
A traditional biliopancreatic diversion with duodenal switch (BPD-DS) happens in two main steps. First, the stomach is reduced to a sleeve-style shape.
Second, the small intestine is rerouted more extensively than in a gastric bypass, so food travels through a shorter common channel where it finally mixes with digestive enzymes. This significantly reduces the absorption of calories and nutrients.
Because a duodenal switch changes how your body absorbs nutrients, it is one of the more nutritionally demanding procedures.
People who've had a duodenal switch generally need highly structured, lifelong supplementation and close lab monitoring to help maintain fat-soluble vitamins and minerals.
This is why a doctor will only perform a duodenal switch when a person's health profile and capacity for long-term follow-up make it a safe fit.
Single Anastomosis Duodeno-Ileal Bypass With Sleeve (SADI-S)
A SADI-S begins with a sleeve gastrectomy, followed by a single intestinal connection that reroutes food into the lower small intestine.
Mechanically, it works like a streamlined duodenal switch. It uses one connection instead of two, which can simplify the surgical construction while still combining restriction with malabsorption.
The key practical point is that SADI-S still changes absorption in a meaningful way. Long-term vitamin and mineral support remains essential, and labs determine what needs to be added beyond a primary multivitamin.
For people living with SADI-S anatomy, routines that feel simple and repeatable matter a lot because supplementation is a form of daily maintenance.
Adjustable Gastric Banding (Less Common Today)
Adjustable gastric banding places a silicone band around the upper stomach to create a small pouch.
The band can be tightened or loosened through office visits, changing how quickly food passes from the pouch into the rest of the stomach. It is restrictive only and does not reroute the intestines, so nutrient absorption stays normal.
Banding is less common today because results are more variable over time, and revision or removal is more frequent compared with sleeve or bypass.
Still, it can be a reasonable option in select cases when a person and surgeon decide it matches medical needs and preference for a reversible, adjustable tool.
Other Procedures You Might Hear About
Bariatric care has evolved, so people often hear terms that sound like separate surgeries. Two important ones to understand are revision procedures and non-surgical devices.
Revision Surgery
Revision surgery refers to an operation done after a previous bariatric procedure. It may involve repairing a complication, converting from one type of surgery to another, or adjusting anatomy to better match current health needs.
Revisions are individualized and can be more complex than a first surgery because the digestive tract has already been altered. A bariatric surgeon evaluates the reason for revision, current anatomy, labs, and risks before recommending anything.
Intragastric Balloons Or Non-Surgical Options (Not Bariatric Surgery)
Intragastric balloons and specific endoscopic devices can support short-term appetite control or portion reduction. Still, they are not considered bariatric surgery because they do not permanently alter the stomach or intestines.
They are placed without traditional surgery and removed later. People may explore these tools when surgery is not appropriate or when they want a temporary, medically supervised option.
How The Different Types of Bariatric Surgery Compare At A Glance
|
Procedure |
How It Works |
Typical Use Cases (General) |
Key Considerations |
|
Sleeve Gastrectomy |
Restrictive + hormonal shifts |
Common first-line option |
Possible reflux risk for some, absorption mostly intact |
|
Roux-en-Y Gastric Bypass |
Restrictive + malabsorptive |
Used when metabolic needs or reflux history suggest bypass |
More complex anatomy, more structured vitamin routine |
|
Duodenal Switch (BPD-DS) |
Restrictive + stronger malabsorptive |
Used in select cases needing higher malabsorption |
Highest long-term nutrient monitoring demands |
|
SADI-S |
Restrictive + malabsorptive (single connection) |
Newer DS-style option in select cases |
Still requires high-structure supplementation |
|
Adjustable Gastric Band |
Restrictive only, adjustable |
Less common, selected cases |
Variable long-term results, revision/removal more common |
Life After Different Bariatric Surgeries
Even though the anatomy differs, life after any bariatric procedure shares a few steady themes. Meals are smaller, protein tends to come first, and eating slowly helps you notice comfort and fullness cues.
Where procedures differ most is in nutrient absorption. After restrictive surgeries, absorption is mostly unchanged, but intake is lower, so vitamins help maintain coverage.
After malabsorptive or combination surgeries, intake drops and absorption decreases, requiring structured supplementation guided by labs.
Many people choose bariatric multivitamins to simplify the backbone of that routine. If your plan includes iron, a bariatric multivitamin with iron options can support a streamlined daily habit.
If calcium is part of your long-term plan, bariatric calcium supplements are often spaced throughout the day to support absorption, with the schedule guided by labs and procedure type.
For people who prefer a chewable daily multi early on or long term, Bariatric Multivitamin Soft Chew is one once-daily format many people find easy to stick with.
For DS or SADI-S anatomy, a procedure-specific base like the DS/SADI Core Multivitamin can support your daily vitamin routine for higher malabsorption needs, while labs guide what else you may need to add.
Frequently Asked Questions
What's The Most Common Type Of Bariatric Surgery Today?
The sleeve gastrectomy is currently the most commonly performed bariatric procedure in many places, largely because the anatomy is simpler than bypass, and it fits a wide range of health profiles.
How Do Sleeve and Bypass Differ?
A sleeve makes the stomach much smaller but leaves the intestines in their normal path, so it works mainly by restricting how much you can eat. A bypass creates a small stomach pouch and reroutes part of the small intestine, so it limits intake and reduces absorption.
What's The Difference Between DS and Sadi-S?
Both start with a sleeve stomach. The DS surgery creates two intestinal connections and a shorter common channel, leading to stronger malabsorption.
The SADI-S uses one intestinal connection and a slightly different bowel route, so it is considered a streamlined DS-style procedure. Both require high-structure long-term supplementation and labs.
Is Gastric Banding Still Done?
Yes, but much less often. Some surgeons still perform adjustable banding in selected cases, especially when a person values adjustability and reversibility and understands that long-term results are more variable.
Conclusion
The different types of bariatric surgery (sleeve, bypass, DS, SADI-S, and banding) each affect digestion in different ways, and those differences matter for eating patterns, absorption, and supplementation.
This surgery is one tool in a bigger health journey. The better you understand the options, the more empowered you are to partner with your care team and choose what fits your body and your life.
At Pro Care Health, we believe your nutrition routine should feel clear, not complicated. Use your labs and your bariatric or metabolic team's guidance to build a simple daily plan you can stick with.
When you're ready, explore our bariatric multivitamins and bariatric multivitamin with iron for once-daily support, and add bariatric calcium supplements if your plan calls for them.
We're here to help you keep things steady, affordable, and doable for the long haul.
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