My mom got gastric bypass because she's older (48) and had a very significant amount of weight to lose (she's lost 200 pounds!) She felt that the band wouldn't do the trick because of the fact that her metabolism is slow due to age and because of the overwhelming amount of weight she had to lose. She's about 130 pounds now... I think that gastric bypass is a better choice for some people, especially if they are older and over 200 pounds overweight. If your metabolism just isn't strong enough to get healthy by restriction alone, I can understand why someone would get GB. It was definitely tough for her though, she did lose a lot of hair and have problems keeping food down. She's 2 years post-op now, though, and has regained all her hair and is very healthy and happy (and looks great, too!)