Weight Loss Surgery

Why Surgery Works When Other Approaches Don't

Obesity is a chronic disease — one that changes your metabolism and hunger hormones in ways that make it very hard to lose weight and keep it off through diet and exercise alone. When you cut calories, your body responds by slowing down your metabolism. Hunger hormones stay elevated even after you lose weight. That's not a lack of willpower. It's biology.

Surgery works differently. It physically restructures the digestive system in ways that permanently change those hunger hormones and how your metabolism functions. Blood sugar often starts improving within days of surgery — before significant weight loss has even happened. That's why surgery can resolve Type 2 diabetes in a way no diet can.

For patients who have tried everything and keep ending up back where they started, that distinction matters. Surgery doesn't make it easier to eat less. It changes the biology that made eating less so hard in the first place.

The Five Procedures We Offer

Dr. Brown performs five bariatric procedures. Each one works differently, produces different results, and has different tradeoffs. Choosing the right one depends on your BMI, your health history, your goals, and what you're willing to commit to after surgery — not a default recommendation.

Sleeve Gastrectomy

About 80% of the stomach is removed, leaving a narrow tube. This limits how much you can eat and significantly lowers ghrelin — the main hunger hormone. Sleeve is the most commonly performed bariatric procedure and produces 60–70% excess weight loss at one to two years. It has the lowest complication rate of the procedures we offer. The main downside is a real risk of new or worsening acid reflux. If you already have significant reflux, bypass is usually the better choice. Learn more about sleeve gastrectomy →

Roux-en-Y Gastric Bypass

Bypass creates a small stomach pouch and reroutes the digestive tract. This limits both how much you eat and how much your body absorbs. It produces stronger hormonal changes than sleeve and typically results in 70–80% excess weight loss. It's the preferred option for patients with significant acid reflux, hard-to-control Type 2 diabetes, or those who need a more powerful metabolic result. The tradeoffs include a slightly more complex operation, a risk of marginal ulcer, and dumping syndrome — a reaction to eating too much sugar or fat too quickly — in some patients. Learn more about gastric bypass →

SADI-S

SADI-S combines a sleeve with a single intestinal bypass, producing 85–95% excess weight loss at one to two years. It's the most powerful metabolic procedure we offer. Dr. Brown is a nationally recognized SADI-S expert and a Da Vinci robotic system national proctor — this procedure requires significant surgical experience, and it's not widely available at this level of expertise. SADI-S requires more intensive long-term nutritional management than sleeve or bypass. It's the right choice for the right patient — not an automatic upgrade for everyone. Learn more about SADI-S →

Duodenal Switch (BPD/DS)

The duodenal switch combines a sleeve with a longer intestinal bypass than SADI-S. It's reserved for patients with very high BMIs — typically 50 and above — or serious metabolic disease that hasn't responded to less aggressive procedures. Weight loss outcomes are similar to SADI-S, with 80–90% excess weight loss, and diabetes resolution rates are among the highest of any bariatric procedure. The nutritional management requirements are the most demanding of any procedure we offer. Dr. Brown performs BPD/DS when insurance doesn't cover SADI-S or when it's the better clinical fit for a specific patient. Learn more about duodenal switch →

Lap Band Removal

Adjustable gastric banding has largely been phased out of bariatric surgery because of high long-term failure and complication rates. Many patients who had a band placed years ago are now looking to have it removed — with or without conversion to a more effective procedure. We perform lap band removals and evaluate each patient for conversion at the time of removal based on their current health picture. Learn more about lap band removal →

What Results to Expect

The fastest weight loss happens in the first three to six months. Most patients reach their maximum weight loss between twelve and eighteen months after surgery. SADI-S patients often continue losing through twenty-four months. But the results go well beyond the scale — for many patients, the health changes are what matter most.

Type 2 diabetes improves or goes into remission in most surgical patients, often within days of surgery. High blood pressure resolves in about 70–75% of patients. Sleep apnea resolves in 86–95% of patients within a year. Heart disease risk drops significantly. Cancer risk — especially for obesity-related cancers — is meaningfully reduced in long-term data. For a full breakdown by condition, see our surgery results page.

Our patients describe what this looks like in practice better than statistics can:

"It was life giving, life changing, and I have no regrets. I live a fully balanced life that has only gotten richer. Most importantly, I was able to do it with love for my body then and my body now. I am forever grateful for this tool." — Lydia, lost 110 pounds following SADI-S

"I have more energy, and more stamina. My sleep is better, I no longer deal with sleep apnea, and my blood pressure has dramatically improved. My fibro and arthritis do not flare as often as they did. I feel so much happier. I want to go out and live life and have new experiences that I never could before." — Kimberly, lost 240 pounds following SADI-S

Do You Qualify?

Current ASMBS guidelines say bariatric surgery is appropriate for adults with a BMI of 35 or above, and for adults with a BMI of 30–34.9 who have obesity-related health conditions like Type 2 diabetes or high blood pressure. Insurance coverage is most reliable for patients with a BMI of 40 or above, or 35–39.9 with documented health conditions. Below those thresholds, what insurance covers varies a lot by carrier. For patients in the 30–34.9 range who qualify clinically, self-pay is often the faster and more reliable path. For a full breakdown by BMI tier, see our qualification page.

If your BMI is 25 or above but you don't qualify for surgery — or you want to start with medication first — our Momentum GLP-1 program offers physician-supervised treatment with the same level of clinical care we bring to surgery.

Cost and Insurance

Most major insurance plans — including Medicare and AHCCCS — cover bariatric surgery for qualifying patients. Coverage usually requires completing a supervised program first, which can take three to twelve months. For patients who don't want to wait, or whose coverage is uncertain, our self-pay program starts at $10,750 for sleeve gastrectomy — all-inclusive, no surprise bills. We verify your insurance benefits before your consultation and help you understand exactly what your plan requires. For a full cost breakdown, see our cost page.

What We Tell Patients in Consultation

The first conversation we have with most patients covers the same ground: what they've already tried, where their health is right now, and what they're hoping surgery will change. That conversation shapes everything — which procedure makes sense, whether surgery is even the right next step, and what realistic results look like for that specific person.

Dr. Brown has performed more than 1,000 bariatric procedures with complication rates well below the national average. She performs every surgery herself using the Da Vinci robotic system — shorter hospital stays, less pain, and faster recovery than traditional open surgery. When you come to us, you're not being handed off to a resident or a rotating team. You're working with a surgeon who does this exclusively and has done it at significant volume.

What we ask of patients in return is engagement. Surgery changes the biology. The supplements, the follow-up appointments, the dietary progression, the long-term monitoring — those are on you, and we say that clearly from the first visit. Patients who understand what surgery will and won't do tend to have the best long-term outcomes. A consultation isn't a sales appointment. It's a conversation to make sure whatever decision you make is based on accurate information.