I think that the malabsorptive intervention provides the best results, particularly in extremely obese patients or in patients with uncontrollable crises of bulimia attacks.
In this surgery, although there is limitation of the quantity of food because of the sleeve included in, malabsorption plays the principal role.
Definitely, food comes in contact with liver and pancreas digestive juices, in a small part of the small intestine where is obtained the digestion and absorption.
This procedure is performed laparoscopically , only by highly experienced surgeons. The duration is approximately 3 hours.
The malabsorption in case of poor “management” may in long term cause lack of vitamins, minerals and dehydration.