Maintaining a healthy weight is one way to lower your risk for many health conditions, including heart disease, which is the number one killer of adults in the U.S. However, there are plenty of people who have tried a number of traditional weight loss techniques that still have trouble getting to a healthy weight. For some of these people, bariatric surgery might be the answer.

“Bariatric surgery certainly isn’t right for everyone, and it’s not a cure-all, but for some patients, it gives them the best shot at leading a normal life and preventing other major health problems,” said Geisinger minimally invasive and bariatric surgeon Ryan D. Horsley, D.O.

Bariatric surgery is best for people who are more than 100 pounds overweight with a body mass index (BMI) over 40. It may also be an option for patients with BMIs over 35 who have health issues such as type two diabetes, heart disease or high blood pressure.

Bariatric surgery is a term for a series of procedures that allow for significant weight loss either by reducing the size of the stomach or restricting how calories are absorbed into the body. There are four types of bariatric surgery:

  • Gastric bypass: This procedure, also called Roux-en-Y Gastric Bypass, is considered the gold standard of weight-loss surgery, according to the American Society of Metabolic and Bariatric Surgery. During gastric bypass, the stomach is divided into two sections, leaving a small pouch at the top of the stomach. The intestine is also divided, and the bottom portion is connected to the small pouch. Finally, the top portion of the small intestine is connected to a lower portion of the intestine to allow enzymes to mix with the food.

“Gastric bypass results in a smaller stomach—meaning you’re eating smaller meals—and fewer calories are absorbed into the body,” said Dr. Horsley.

  • Adjustable gastric band: This procedure is also called gastric band surgery. The gastric band is an inflatable device that creates a small pouch at the top of the stomach and a small opening that allows food to pass through to the rest of the stomach and onto the intestine. Once the band is placed on the stomach, it is inflated slowly over time until the desired size is reached. The result of the gastric band is that the stomach holds less food; therefore, patients will feel fuller faster. However, compared to other types of bariatric surgery, patients who have the adjustable gastric band procedure typically lose less weight, and results take longer to see.

  • Gastric sleeve: During a gastric sleeve procedure, about 80 percent of the stomach is removed, leaving a tube-like pouch. Like other bariatric procedures, the smaller stomach holds less food, which means patients feel full faster. In addition, doctors also believe the gastric sleeve procedure impacts hormones in the gut that affect hunger and satiety and control blood sugar. Because of this, the gastric sleeve procedure is believed to improve type two diabetes.

  • Duodenal switch: The duodenal switch involves removing part of the stomach and creating a gastric sleeve that bypasses a large portion of the small intestine. This means that food travels through the tube-like stomach and bypasses most of the small intestine. Initially, the amount of food the patient can eat is limited; however, over time, he or she may be able to eat larger portions of food. Because food bypasses so much of the small intestine, fewer calories are absorbed into the body. It may also impact gut hormones that affect hunger.

“During some bariatric procedures that result in fewer calories being absorbed, fewer nutrients are absorbed as well, which means that patients need to carefully monitor their diets to ensure they’re getting enough nutrients,” said Dr. Horsley. “Any bariatric procedure is a major surgery, which means that patients should carefully consult with their doctor before making a decision.”