Sleeve, bypass, balloon or botox? Results after two years

Two years out, the ranking barely changes

At two years the order is consistent: bypass first, sleeve close behind, balloon well back, botox barely on the chart. We plan for roughly 70 to 80% of excess weight lost after a bypass, 60 to 70% after a sleeve, 25 to 35% during the months a balloon is in place, and eight to fifteen kilos from botox. Those are the ranges we quote before you book, not the best cases from a brochure.

Durability is the real difference, not the peak

Every method reaches its lowest weight somewhere around month twelve to eighteen; what separates them is what happens after that. Bypass and sleeve results hold with modest drift when the follow-up is used. A balloon's result depends entirely on whether habits were built while it was in, because the device leaves. Botox fades within months by design. Comparing peak loss between them is the mistake almost every price-comparison page makes.

What each one costs, and cost per kilo held

A sleeve is €3,800, a bypass €5,200, a balloon €2,800 and botox €900, each inclusive of the hospital, anaesthesia, pre-operative tests and, for the two operations, twelve months of dietitian follow-up. Divide by the weight still off at two years and the cheap options stop looking cheap. Two balloons cost more than a sleeve outright and three botox cycles come close to one, yet either can leave you exactly where you started, which is the calculation we walk patients through.

How we choose with a patient, not for one

BMI sets the shortlist, other conditions narrow it, and your own tolerance for a permanent change decides. Reflux or long-standing type-2 diabetes pushes toward a bypass; a straightforward BMI of 38 with no reflux points to a sleeve; a BMI of 32 with a specific deadline may be a balloon or botox. If you fall between two of them we will say so rather than pick the more expensive one, and the assessment costs nothing.