Which Option is Best for You?

Weight-loss, or bariatric, surgery helps you lose weight and lowers your risk of medical problems associated with obesity. There are three basic approaches to weight loss surgery: restrictive, malabsorptive and combined restrictive and malabsorptive.


Bands or staples are used to section off a part of the stomach, creating a pouch. Because this stomach pouch is so small, the amount of food one can eat is limited. Food continues to be digested through the normal digestive and absorption process. Most restrictive procedures involve the use of a polymeric silicone ring or mesh band around the stomach. This band provides stability by not allowing the pouch outlet to expand. The LAP-BAND and REALIZE adjustable gastric bands are examples of restrictives procedures.


Malabsorptive procedures, such as the Biliopancreatic Diversion (BPD) techniques, involve rearrangement of the small intestine to decrease the functional length or efficiency of the intestinal mucosa for nutrient absorption. Malabsorptive procedures restrict both food intake and the amount of calories and nutrients the body absorbs.

Restrictive and Malabsorptive

This procedure restricts both food intake and the amount of calories and nutrients the body absorbs. In addition to creating a small gastric pouch, the surgery disrupts the body's normal digestive process. As a result, food bypasses a large part of the stomach and some of the small intestine. The Roux-en-y gastric bypass would be an example of this type of procedure.

Types of Weight Loss Surgery

At UNC REX, our bariatric surgeons perform several types of weight loss surgery. Most types of weight loss surgery are performed in Rex Hospital's state-of-the-art operating rooms in Raleigh. We have designated inpatient rooms specifically designed to accommodate you during your inpatient stay. Gastric banding can be performed on an outpatient basis on our main campus or at Rex Surgery Centers of Cary and Wakefield.

Gastric banding

An inflatable band is placed around the upper stomach to restrict the flow of food through the stomach. This procedure requires you to eat slowly and makes you feel full sooner. Gastric banding typically results in a smaller percentage of weigh loss when compared to other types of weigh loss surgery. However, gastric banding is a reversible procedure.

Gastric bypass surgery

Gastric bypass surgery separates the stomach into two parts: a lower remnant stomach and an upper functioning pouch. The small upper portion of the stomach is attached to the small intestine close to the large intestine. By skipping or bypassing a significant portion of the small intestine, your body has less time to absorb calories from the food you eat.

Sleeve gastrectomy

The sleeve gastrectomy removes two-thirds of the stomach, leaving a long pouch or "sleeve". This restricts the amount of food intake. It differs from a gastric bypass in that no portion of the intestines are re-routed.

Duodenal Switch

Bilio-pancreatic diversion with duodenal switch, more commonly referred to as duodenal switch, is both a restrictive and a malabsorptive procedure. The stomach is reduced in size by about 70% and connected to the small intestine close to the large intestine. The liver is also connected to the small intestine, creating a common channel that reduces the amount of time you absorb calories from food.

For more information about weight loss surgery, visit REX Bariatric Specialists or call (919) 784-7874.

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