The LBPD is the most aggressive and effective bariatric surgery. It has a triple mechanism to produce weight loss: restriction, malabsorption, and metabolic. The first part of the operation is constructing a sleeve gastrectomy. The second part is re-routing the intestine to produce a short segment for absorption of fats, producing loss of fat through stools. The result is major weight loss.

This procedure is very good for patients with diabetes and excellent for controlling high cholesterol and high triglycerides.
The operation can be performed in one or two steps. Advances in minimally invasive techniques have made this complex operation very safe. It takes about 3 hours to perform the LBDS and requires a 24 to 48 hour hospital stay. Compared to the other procedures, the LBDS produces the most weight loss, but potential nutritional complications require careful follow-up care, as well as strict nutritional and vitamin supplementation.