Surgical Procedures for Obesity

People with severe obesity and weight-related health problems may need weight-loss surgery. It is not the first way obesity is treated. Diet, lifestyle changes, and counseling will be tried first. People who do have surgery will still need to make diet and lifestyle changes.

Adjustable Gastric Banding

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Surgery may be done using open surgery or using small incisions. The most common surgeries are:

  • Restrictive surgeries that limit food intake:
    • Laparoscopic adjustable gastric banding (AGB)—uses a hollow band around the stomach to make a small pouch
    • Vertical sleeve gastrectomy (VSG)—removes a large portion of the stomach
    • Vertical banded gastroplasty (VBG)—uses staples and a band to create a small pouch (not as common)
    • Intragastric balloon—a balloon is placed in the stomach and filled with saline
  • Malabsorptive surgeries that limit food absorption:
    • Laparoscopic Roux-en-Y gastric bypass (RGB)—uses staples to create a small pouch that is attached to the small intestine so it bypasses the rest of the stomach
    • Biliopancreatic diversion (BPD)—removes parts of the stomach to create a small pouch that is connected to the small intestine so it bypasses the upper part of the small intestine

Gastric Bypass

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Endocrine Society clinical practice guideline on pharmacological management of obesity can be found in J Clin Endocrinol Metab 2015 Feb;100(2):342-362.
Obesity. Merck Manual Professional Version website. Available at:
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Updated January 2020. Accessed January 31, 2020.
Obesity in adults. EBSCO DynaMed website. Available at: Updated November 30, 2018. Accessed January 31, 2020.
Obesity in children and adolescents. EBSCO DynaMed website. https://www.dyname.... Updated October 30, 2019. Accessed January 31, 2020.
Treatment. National Heart, Lung, and Blood Institute website. Available at: Accessed January 31, 2020.
Last reviewed November 2019 by EBSCO Medical Review Board Daniel A. Ostrovsky, MD
Last Updated: 2/9/2021

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