A surgeon removes a portion of the stomach to induce weight loss by restricting food consumption. After approximately 75% of the stomach is removed laparoscopically, the stomach takes on the shape of a tube or “sleeve”.

• Cost $15k to $23k
• Weight loss: An average of 70% of excess weight lost after one year
• Cons: Risk for long-term nutrient deficiencies, stomach stretched back to its original size, staple line leaks (2% of patients), bleeding (1%), stenosis/ strictures (1%), and digestion issues (more common)

A soft silicone ring with an expandable balloon at the center is placed around the top part of the stomach. The stomach is banded into two sections so that patients only eat enough to fill the top section of the stomach. Eventually, food passes through the opening of the band and digests normally.

• Cost $12,5k to $23k
• Weight loss: An average of 40% of excess weight lost after one year
• Cons: In the long-term, between 15 and 60% of patients need re-operation for implant malposition, slippage, erosion, frequent vomiting, or weight loss failure, requires a strict adherence to the postoperative diet and to postoperative follow-up visits, can cause discomfort

A surgeon staples off a large section of the stomach, creating a small pouch, which the surgeon then connects to the small intestine. This procedure leads to weight loss because the patient can only accommodate small amounts of food at a time in the small pouch.

• Cost $8k to $35k
• Weight loss: An average of 65% excess weight loss after 1 year
• Cons: to prevent nutrient deficiencies, must keep a strict diet: an adequate intake of protein, taking vitamin and mineral supplements, including a multivitamin, B12, folate, iron and calcium, and avoiding sweets and fatty foods, at risk for weight regain and ‘Dumping syndrome’ in which the consumption of sugar causes abdominal cramping and diarrhea can occur, Operative complications include bleeding or intestinal leakage (occur in less than 2%)

A surgeon inserts a narrow tube through the mouth and into the stomach. A tiny instrument that carries the balloon device is placed through the tube. Once in the stomach, this balloon is delivered and then inflated with about 24-36 ounces of fluid. By taking space in the stomach, the balloon helps to decrease appetite, which leads patients to eat less frequently and eat smaller portions.

• Cost (without insurance): $8k
• Weight loss: On average, patients lost 30% of excess weight in the first year
• Cons: Immediate side effects included discomfort, nausea and vomiting, 4.2% of patients had their gastric balloon removed early due to their discomfort, Rare side effects include migration and bowel obstruction (.8%)