After more than 10 years of development in China, bariatric surgery has not only learned from foreign experience and technology, but also developed a surgical standard suitable for the national population according to the characteristics of the Asia-Pacific region, and has developed more mature. Currently, two types of bariatric surgery are mainly used in China, namely sleeve gastrectomy and gastric bypass surgery, and in terms of results, gastric bypass surgery is often better than sleeve gastrectomy. Compared with sleeve gastrectomy, gastric bypass surgery not only limits the amount of food eaten, but also reduces the efficiency of absorption, and is more effective than sleeve gastrectomy in preventing regain of weight and treating diabetes. But if this is the case, why do so many doctors and patients choose sleeve gastrectomy? Although sleeve gastrectomy is not as effective as gastric bypass surgery, it is simpler than gastric bypass surgery in terms of its surgical principle and less harmful to the body, so it is also simpler to perform, and therefore, sleeve gastrectomy is often used as a first-stage treatment option for very severe patients, allowing patients to eliminate the relevant high-risk factors first and then follow up with treatment according to the actual situation. At the same time, sleeve gastrectomy has fewer complications than gastric bypass due to its relatively simple principle, and has less impact on patients’ postoperative life. Moreover, according to a large number of clinical cases, sleeve gastrectomy can achieve satisfactory results in the treatment of patients with less severe cases. Also, since sleeve gastrectomy does not affect the patient’s absorption, it may be more suitable for patients at a younger age.