Let's start with the sleeve, because it's the world's most popular bariatric procedure — 70 to 80 percent of all weight loss surgeries globally. Here's what most people don't know: it was invented by accident. In 1999, a surgeon designed it as step one before bypass for extremely heavy patients. But the patients lost so much weight from the sleeve alone that most never needed the second surgery. An accident that became the gold standard.

Now the bypass. And let me address the naming problem first: there's no such thing as a "mini" bypass in the way the word implies. The word "mini" is marketing. Both the Roux-en-Y bypass and the one-anastomosis bypass are major operations that reroute your digestive system. Calling one "mini" makes patients think it's a small, simple thing. It's not. It's a different technique, not a smaller one.

Then there's the balloon — and this one is completely different. It's not surgery at all. A gastroenterologist inserts a saline-filled balloon into your stomach through your mouth — no incisions. It fills about 500 to 600 milliliters and makes you feel full faster. But here's what people need to understand: it's temporary. Six months maximum, then it must come out or it causes ulcers. And if it ruptures? It passes naturally — it's not dangerous. It's a bridge, not a destination.

When a patient sits with us, we don't start with which procedure. We start with their medical history, their BMI, their comorbidities, their lifestyle, and their expectations. Then my father and I discuss the case together — sometimes we disagree on the approach, and that's healthy. Two opinions are better than one, especially when one comes from 30 years of experience and the other from the latest international guidelines.