Table 1. Advantages and disadvantages of various types of primary obesity surgery and of primary surgery for metabolic indications.

Technique	Advantages	Disadvantages
Sleeve gastrectomy (SG)	Good risk–benefit profile, can be performed even in patients with very high BMI (two-step approach)	Inferior to RYGB with respect to long-term weight control, reflux control, and diabetes remission
Proximal Roux-en-Y gastric bypass (RYGB)	Good control of reflux disease, superior to SG in its metabolic effect	Same mortality as SG with higher morbidity Risk of dumping syndrome, ulcers, and internal hernias Risk of malabsorption
Omega-loop gastric bypass (MGB)	Lower perioperative morbidity than RYGB, because there is only a single anastomosis	Elevated risk of malabsorption with long biliopancreatic loop Risk of dumping syndrome and internal hernias Unclear effects of potential reflux of bile into the gastric pouch