What Is Bariatric Surgery?

13 June 2025

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Struggling with weight can feel overwhelming, especially when it begins to impact your health and quality of life. For many, traditional methods like diet and exercise might not lead to the results they need, which is why options like bariatric surgery and medications such as Ozempic or Mounjaro have become tools on the path to health.

Bariatric surgery, often referred to as weight loss surgery, offers a life-changing solution by addressing severe obesity and its related health conditions. But is surgery the right choice for you, or could a non-surgical option like medication be a better fit? In this blog, we’ll explore what bariatric surgery is, why people choose it and how it compares to alternatives.

We talk to Mohammad Farukhi, M.D., a bariatric and general surgeon with INTEGRIS Health Medical Group Weight Loss South, to learn more.

“As an obesity specialist, I am excited that we have so many options available to help people get healthy and take control of their lives,” Farukhi says. “With over one in three adults facing obesity in the U.S., there is definitely a need to approach this epidemic in a thoughtful, long-lasting way."

"While newer medications are showing a lot of promise, it’s important that we don’t simplify treatment of a complex disease to one injection. A better option is a comprehensive weight loss program which can include diet changes, behavior counseling, exercise plans, medications and even surgery. Fortunately, a lot of these options are safe, effective and easier to access now than in the past.”

Types of bariatric surgery

Catch up quick: Bariatric surgery includes several types of procedures designed to treat severe obesity by altering the digestive system to lose weight. Each type of surgery has different mechanisms and benefits.

Gastric bypass is one of the most common and effective types of bariatric surgery.

The surgeon creates a small pouch at the top of the stomach and connects it directly to the small intestine, bypassing most of the stomach and part of the small intestine.
This reduces the amount of food the stomach can hold and decreases calorie and nutrient absorption.
Significant weight loss (60 to 80 percent of excess weight within one to two years) can occur.

Sleeve gastrectomy involves the removal of about 80 percent of the stomach, leaving a tube-shaped stomach (or "sleeve").

The smaller stomach holds less food and produces less of the hunger hormone ghrelin, which may reduce appetite.
Significant weight loss (50 to 70 percent of excess weight within one to two years) can occur.

Adjustable gastric banding involves placing a silicone band around the upper part of the stomach to create a small pouch that limits food intake.

The band can be adjusted or removed as needed, but this procedure is less commonly performed today due to lower long-term success rates compared to other methods.
The surgery is less effective for long-term weight loss (30 to 50 percent of excess weight).

Biliopancreatic diversion with duodenal switch (BPD/DS) is a more complex procedure that combines a sleeve gastrectomy with a bypass of most of the small intestine.

It significantly reduces calorie and nutrient absorption but carries a higher risk of complications.
The surgery is effective for weight loss (70 to 90 percent of excess weight) and long-term maintenance.

Intragastric balloon (non-surgical option) involves a balloon being placed in the stomach via endoscopy and filled with saline to take up space, reducing hunger and food intake.

The balloon is temporary and typically removed after six months.
The procedure can help jumpstart weight loss before transitioning to other treatments.

Endoscopic sleeve gastroplasty (ESG) is a non-surgical option that involves suturing the stomach via endoscopy to resemble the shape of a traditional sleeve.

This procedure does not require removing the stomach and is considered reversible.
Weight loss is traditionally more durable than most non-invasive procedures.

Why do people get weight loss surgery?

At a glance: People seeking significant weight loss (50 to 70 percent) of their excess weight often turn to surgery. In addition, weight loss surgery also benefits patients in search of improving their health conditions or boosting their quality of life.

Combating severe obesity and its associated health risks is the main reason people get weight loss surgery.

Obesity is a chronic condition that can be difficult to manage through diet and exercise alone, especially for individuals with a high BMI.
Within the first two years of surgery, patients typically lose 50 to 70 percent of their excess body weight.

Certain health conditions can also be improved or resolved through surgery.

Bariatric surgery can significantly improve or even resolve type 2 diabetes, high blood pressure, heart disease, sleep apnea, liver disease, joint pain and GERD.

Life expectancy increases after surgery by reducing associated health conditions.

Obesity is linked to a higher risk of premature death due to complications like heart disease, stroke and certain cancers.

Quality of life improves for both physical and mental health.

Severe obesity can limit mobility, cause chronic pain and lead to social stigma or discrimination.
It can also lead to depression, anxiety and low self-esteem, so surgery alleviates some of these psychological burdens.

Who is bariatric surgery for?

Key points: Weight loss surgery is not for everyone. It is geared toward people who meet certain medical and psychological criteria.

Bariatric surgery is meant for people with a specific BMI, have associated health conditions, have failed other weight loss methods and who are committed to long-term lifestyle changes.

Candidates should have a BMI of 40 or higher or 35 to 39.9 with at least one serious obesity-related health condition.
Candidates are usually people who have made serious attempts to lose weight through diet, exercise and medical programs but have not achieved or maintained significant weight loss.
People with conditions like type 2 diabetes, heart disease or severe joint pain that are directly linked to their weight may benefit from surgery.
Surgery is not a quick fix, and candidates must be willing to follow a strict post-surgery diet, take vitamin and mineral supplements, engage in regular physical activity and attend follow-up appointments and counseling.

Deciding between medications like Ozempic or surgery for weight loss

What to know: Deciding between weight loss surgery and a medication like Ozempic (semaglutide) for weight loss depends on many factors, including your health, weight loss goals, medical history and personal preferences. Both options have their benefits and limitations. The choice should be made in consultation with a health care provider.

Ozempic (semaglutide) is a prescription medication (GLP-1 receptor agonist) that regulates appetite and blood sugar.

It has become a popular choice for weight loss due to its ability to mimic a hormone (GLP-1) to reduce hunger, slow digestion and promote a feeling of fullness.

Mounjaro (tirzepatide) is a more powerful weight loss drug having both GLP-1 as well as a glucose-dependent insulinotropic polypeptide (GIP) agonist properties.

Other medications are approved by the FDA and have varying degrees of success for patients. Some common ones include Qsymia (phentermine/topiramate) and Contrave (bupropion/naltrexone).

The severity of obesity is among the main factors to consider.

Weight loss surgery is beneficial for people with severe obesity who need significant, sustained weight loss.
Medications are more suitable for people with moderate obesity (BMI over 30) or overweight (BMI over 27) with related health conditions – it’s less invasive and may be a good first-line option for those not yet eligible for surgery.

Weight loss goals, whether moderate or dramatic, will shape the decision-making process.

Weight loss surgery offers more dramatic and sustained weight loss, making it ideal for those with significant weight loss needs.
Medications like Ozempic, Mounjaro, etc. provide moderate weight loss, which may be sufficient for people with less severe obesity or those looking for a non-surgical option.

Pre-existing health conditions typically guide people’s decision making.

Weight loss surgery is particularly effective for resolving or improving obesity-related conditions such as type 2 diabetes, high blood pressure and sleep apnea.
Ozempic and Mounjaro were originally developed for type 2 diabetes, so it’s effective at controlling blood sugar levels and treating diabetes.

Commitment to lifestyle changes must be considered.

Weight loss surgery requires a lifelong commitment to dietary changes, regular exercise and follow-up care that includes taking supplements and attending regular check-ups.
Ozempic and Mounjaro require healthy eating and exercise to maximize results, but the medication itself is less invasive and does not permanently alter the body. However, most people regain their lost body weight upon discontinuing their weight loss medications.

Risks and side effects can guide people in one direction or the other.

Weight loss surgery involves surgical risks such as infection, blood clots and complications from anesthesia, not to mention long-term risks including nutrient deficiencies and dumping syndrome (when the food moves too quickly through the digestive track and causes stomach and bowel issues).
Ozempic and Mounjaro side effects include nausea, vomiting, diarrhea and constipation, in addition to fluctuations in blood sugar, risk of pancreatitis and even risk of thyroid cancer.

Cost and accessibility may deter some people from getting surgery.

Weight loss surgery has a higher upfront cost, but insurance often covers it for eligible patients.
Medication requires ongoing use, which can be expensive without insurance coverage, although it may be more accessible for those not ready or eligible for surgery.

Next steps: A doctor or bariatric specialist can assess your medical history, weight loss goals and overall health to recommend the best option. Consider how much weight you want to lose and whether you’re prepared for the lifestyle changes required by surgery or medication. Contact the INTEGRIS Health Medical Group Weight Loss South clinic today at 405-636-7900.