Restrictive and Malabsorptive Weight Loss Procedures

Restrictive and Malabsorptive Weight Loss ProceduresThere are two ways in which bariatric surgery promotes long-term weight loss. Bariatric procedures are either restrictive, malabsorptive, or a combination of the two.

The leading forms of weight loss surgery use at least one of these two methods:

  • Gastric band surgery
  • Sleeve gastrectomy surgery
  • Gastric bypass surgery
  • Duodenal switch surgery
  • Biliopancreatic diversion procedure

Malabsorptive procedures enhance weight loss by altering the structure of the digestive tract, allowing food to bypass portions of the small intestine. Malabsorptive procedures generally incorporate restrictive methods by also reducing or limiting the capacity of the stomach for enhanced weight loss.

The only strictly malabsorptive weight loss surgery is:

  • Biliopancreatic diversion

The two combination restrictive and  malabsorptive weight loss surgeries are:

  • Roux-en-Y gastric bypass surgery
  • Duodenal switch surgery

Gastric bypass surgery has the longest history of any weight loss surgery performed in the United States. Weight loss after a duodenal switch surgery is higher than with other weight loss procedures but potential for malnourishment issues is also much greater.  Duodenal switch is often used for the so called “super obese” and is often combined with the sleeve gastrectomy and the biliopancreatic diversion into a two stage procedure.

Following a malabsorptive procedure, the number of calories, fat and nutrients that can be absorbed during digestion is reduced. Patients are encouraged to take daily regularly to avoid nutritional deficiencies after this form of weight loss surgery.

Restrictive Weight Loss Surgery

Restrictive procedures promote weight loss by making changes to stomach capacity. This form of weight loss surgery is considered restrictive because the amount of food that you can eat at one time is greatly reduced.

The two leading forms of restrictive weight loss surgery procedures are:

  • Sleeve gastrectomy surgery
  • Gastric band surgery

These two bariatric procedures affect the capacity of the stomach without making any changes to other portions of the digestive tract. Unlike other forms of bariatric surgery, the Lap Band procedure does not make any permanent alterations at all, using a silicone gastric banding device to restrict stomach capacity as needed.

Both restrictive and malabsorptive procedures offer certain benefits. Each procedure can be performed with minimally invasive surgical techniques and offers its own guidelines pertaining to post-surgical lifestyle changes.


University of Rochester Medical Center. (2013, August 2). Fat malabsorption after weight loss surgery.