What Are the Different Types of Bariatric Surgery?

Tue 27th May 2025

Bariatric surgery encompasses a range of surgical procedures for weight loss. Typically, the surgery involves making your stomach smaller so you feel full after eating a small amount of food. Such a procedure often results in significant long-term weight loss and improved health outcomes in clinically severely obese individuals. In Australia, the most common types of bariatric surgery are gastric sleeve, gastric bypass and lap band surgery.

Eligibility For Weight Loss Surgery

Weight loss surgery is not a tool for those who want to lose a small amount of weight or are after a ‘quick fix’. Instead, it is a tool to help people who are suffering either mentally or physically as a result of their weight.

To determine your eligibility for weight loss surgery, you’ll need to see an appropriately trained doctor who will perform a preoperative assessment that includes a detailed history and physical examination.

Bariatric surgery is performed by General Surgeons Specialising in the upper gastrointestinal tract. Whilst Plastic Surgeons do not perform any bariatric surgery, they frequently treat patients after they have successfully had bariatric surgery and now need to address the often problematic excess skin they have.

Qualifying for bariatric surgery largely depends on your BMI (Body Mass Index). It is usually offered to people with a BMI over 35 or those with a BMI over 30 who have other serious health problems, such as heart disease or diabetes. However, your eligibility will also be assessed on other factors.

Your weight history (age of onset of obesity), previous weight loss attempts (including diet and exercise, medications and previous weight loss surgery), and triggers for weight gain will also help determine your eligibility for the procedure.

Eligible candidates will not have any other health problems that may be causing excess body weight gain, as this decreases the likelihood of a successful surgical outcome.

Age is also a consideration. Typically, candidates need to be between the ages of 16 and 65, as older individuals often have pre-existing health conditions, heal more slowly and have reduced life expectancy, all of which can influence the efficacy and safety of the procedure. Each individual is assessed on a case-by-case basis, so speak to your specialist Bariatric Surgeon for more information.

Finally, eligible candidates must be willing to make substantial lifestyle modifications, including changing their eating habits, exercising and not drinking alcohol in excess.

Types of Bariatric Surgery

The two most common types of bariatric surgery in Australia are gastric sleeve and gastric bypass surgery. Adjustable gastric banding (lap band) surgery is also performed, but this is less commonly recommended these days due to the relatively high complication rates. These surgeries are usually performed via keyhole (laparoscopic) surgery, making small incisions in the abdomen. Occasionally, open surgery with a larger incision is required.

Gastric Sleeve Surgery

Gastric sleeve surgery is the most common bariatric surgery in Australia. It removes most of the stomach, leaving a small sleeve to hold ingested food. Gastric sleeve surgery is often called a ‘restrictive’ procedure as it restricts how much you can eat. You will not feel as hungry because a smaller stomach produces lower levels of the hormone ghrelin, which gives you the sensation of hunger.

Gastric Bypass Surgery

Gastric bypass surgery involves creating a small stomach pouch by stapling the stomach. This pouch is joined directly to the small intestine. This way, food bypasses most of the stomach, so fewer calories are absorbed.

Adjustable Gastric Banding

Also known as lap band surgery or laparoscopic adjustable gastric banding (LAGB), an adjustable ring is placed around the top part of the stomach. This creates a small pouch so food remains in the top of the stomach for longer. The ring contains salt water and can be made larger or smaller by injecting or removing the fluid from the band.

Maintaining Weight Loss Long Term

After your surgery, you must follow your surgeons instructions and take all the medications and vitamins prescribed. Initially, you will lose a lot of weight as your body looks for calories to maintain your bodily functions. However, your body may also break down muscle as a form of energy during this time. To avoid this, eat plenty of protein and incorporate resistance training such as weights, strong yoga or Pilates to maintain more muscle. Additionally, take note of the following tips:

Exercise regularly and build strength to prevent weight gain
Maintain portion control
Eat adequate protein and nutrient-dense foods
Avoid snacking and liquid calories
Avoid emotional eating
Stay in contact with your medical team for adequate support

What Can Be Done About Excess Skin After Losing Weight?

Most individuals lose a significant amount of weight after bariatric surgery. Although this is an excellent achievement, often, the individual is left with substantial amounts of excess skin — even if they exercise and do weight training. This excess skin can cause physical and emotional stress, as the excess skin and skinfolds cause serious skin hygiene issues, while clothing, physical mobility, and social issues are also affected. The only way to remedy this problem is through surgery—specifically, Body Contouring Surgery.

Body Contouring Surgery encompasses a range of surgical reconstructive procedures tailored to your needs, addressing the often significant functional and aesthetic concerns associated with excess skin.

Various surgical body contouring procedures are available, depending on an individual’s issues. Dr Dona has developed a system where he has grouped the key surgical procedures frequently required after dramatic weight loss. He calls these ‘The 7 ‘B’s of Body Contouring Surgery’. They are:

Brachioplasty (Arm Reduction)
Breasts – Lifts, Reductions and Augmentations
Bra Lipectomy(Upper Body Lift)
Belly – Abdominoplasty (Tummy Tuck)
Belt Lipectomy (Lower Body Lift, 360 Tummy Tuck)
Buttock Surgery
Below the Waistline Surgery – Genital And Thigh Surgery

To determine which procedures would benefit you, you’ll need a formal consultation with Dr Dona. After thoroughly assessing you and determining your suitability for surgery, he can create a precise surgical plan incorporating one or more of the above 7 ‘B’s.

As gastric surgery leads to significant weight loss, more than one surgery is often required. Fortunately, two or more of these 7 ‘B’s can often be combined. Typical combinations include:

Brachioplasty (Arm Reduction) with Breast Surgery
Breast Surgery with Belly Surgery (Abdominoplasty/Tummy Tuck)
Belly Surgery (Abdominoplasty/Tummy Tuck) with Buttock Surgery
Bra Lipectomy with an Open Book Tummy Tuck (Abdominoplasty)

How Much Weight Can I Expect To Lose After Bariatric Surgery?

Weight loss after bariatric surgery varies from person to person. Only your bariatric surgeon can help you estimate the weight you’ll likely lose. Your weekly weight loss will depend on various factors, such as your BMI, gender, age, health and how well you adhere to diet and exercise recommendations. The amount of weight loss will also depend on the type of bariatric surgery you have, such as:

Gastric band surgery: 30 to 40% loss of excess body weight
Gastric sleeve surgery: 50 to 60% loss of excess body weight
Gastric bypass surgery: 60 to 70% loss of excess body weight

The time it takes to lose weight will also vary. For example, gastric sleeve surgery takes approximately 12 months for patients to reach their goal, while gastric bypass takes patients approximately 18 months. Weekly, this translates to losing approximately 0.5 to 2 kilograms per week, depending on your initial weight.

How Long After Bariatric Surgery Before You Can Have Body Contouring Surgery?

You would typically need to wait at least twelve months after your Bariatric Surgery, and at least six months after achieving your goal sustainable weight before undergoing any Body Contouring Surgery.

References

Health direct: A guide to bariatric surgery

https://www.healthdirect.gov.au/guide-to-bariatric-surgery

Australian Journal of General Practice: Bariatric surgery

https://www1.racgp.org.au/ajgp/2025/april/bariatric-surgery

Dr Eddy Dona

Dr Eddy Dona (FRACS) is a Specialist Plastic Surgeons in Sydney, and a member of the Australian Society of Plastic Surgeons (ASPS). Following his medical degree at the University of Sydney in 1996, Dr Dona then began a further 11 years of intensive training to become a Specialist Plastic & Reconstructive Surgeon. Since starting private practice in 2007, Dr Dona has had patients from all over Australia seeking his expertise and specialist management. Dr Dona’s practice has grown and become heavily focused on breast and body reconstructive procedures, especially after massive weight loss including post-pregnancy. Despite running a busy private practice, Dr Dona spent the first 15 years of his specialist practice dedicating part of his time to one of Sydney’s largest teaching public hospitals, including training future plastic surgeons. This was where Dr Dona was often required to reconstruct the bodies of those affected by trauma and cancer.