Gastric sleeve surgery for weight loss

Gastric sleeve surgery and other bariatric surgery types were developed for people who struggle with serious obesity and haven’t been successful with other weight loss options. If you struggle with weight loss and have a considerable amount to lose, your doctor may recommend bariatric surgery.

Bariatric surgery is currently the most effective treatment for morbid obesity and weight loss when compared with nonsurgical approaches. Overall, about 13% of the world’s adult population (more than 600 million people) are obese.

Gastric sleeve surgery permanently reduces the size of your stomach to help with weight loss. Your doctor likely will advise you that gastric sleeve surgery is only a tool and that reaching and maintaining a healthy weight requires significant diet and lifestyle changes after the procedure.

Preparing for gastric sleeve surgery

After meeting with your doctor and surgeon, you'll receive a series of medical tests and health screenings. You may also have a psychological evaluation to assess your mood, social and family support, substance use, cognitive function, psychosocial status, motivation and willingness to undertake behavioral changes, as well as a nutritional evaluation.

Most nutritional evaluations involve a clinical interview to assess your knowledge and expectations about bariatric surgery. You also may be asked about when you began having weight problems and if you have a family history of obesity. Other questions may pertain to your eating behaviors and habits, previous weight loss regimens and your physical activity.

Before your surgery you'll attend medical weight management classes to learn how surgery will change your eating habits and life. A supervised weight management program, including a low-calorie diet, is also often recommended. 

Modest weight loss before surgery has been associated with advantages, such as shortening the time of the surgery and providing a protective effect in people with nonalcoholic fatty liver disease. This condition makes the liver more susceptible to bleeding during surgery. A small weight loss can help reduce the size of the liver and the risk of bleeding.

What to expect during and after gastric sleeve surgery

During gastric sleeve surgery, the surgeon removes part of the stomach, and the remaining stomach resembles a slender tube or sleeve. After the process, you’ll have a smaller appetite, so you’ll eat less and feel fuller longer. This helps encourage slow, steady weight loss. Most people are able to lose 55% to 65% of their extra weight after gastric sleeve surgery.

Surgeons usually perform gastric sleeve surgery laparoscopically with very precise instruments. This means you’ll have only a few small incisions, so you’ll spend a shorter time in the hospital and heal faster with less scarring. The process takes about two hours, and most people go home two days later.

Recovery after gastric sleeve surgery

Most people go back to work a week or two after gastric sleeve surgery. You’ll be on a liquid diet at first, and then gradually return to eating regular foods. You’ll still be able to eat the foods you previously enjoyed including burgers, pizza, bread and rice as long as you limit quantities and follow the dietary guidelines recommended by your health care team. You’ll need to avoid anti-inflammatory medications like ibuprofen and steroids for a month.

Dietary recommendations after gastric sleeve surgery

You’ll need to modify your eating habits after surgery because your stomach will be much smaller. Recommended eating behaviors after gastric sleeve surgery include:

• Chewing well in a relaxed manner
• Dividing food intake into four to six meals throughout the day
• Drinking liquids 15 minutes before or 30 minutes after meals
• Eliminating carbonated beverages
• Ending meals when feeling comfortably full
• Limiting alcohol consumption
• Limiting sugar intake
• Reducing consumption of calorie-dense foods and beverages such as smoothies, ice cream, milkshakes, juices, candy, cakes and cookies
• Taking small bites

Long-term weight loss after gastric sleeve surgery requires regular and supportive management by qualified health care professionals. Adhering to a follow-up program will result in fewer postoperative adverse events and greater excess body weight loss.

Continued dietary management after gastric sleeve surgery covers not only nutritional recommendations but numerous aspects related to promoting a healthy lifestyle, such as physical activity and quitting smoking. In addition, self-monitoring with regular weight checks and keeping food diaries is recommended to prevent weight regain.

Qualifying for gastric sleeve surgery

Your doctor will evaluate your overall health, weight and medical history to determine if you’re an appropriate candidate for gastric sleeve surgery.

According to the American Society for Metabolic and Bariatric Surgery, in order to qualify for bariatric surgery you must have a body mass index (BMI) of at least 40 (or be more than 100 pounds overweight) or have a BMI of 35 or more and have at least one of the following obesity-related medical conditions:

• Diabetes
• Gastrointestinal disorders
• Heart disease
• High cholesterol
• Hypertension
• Nonalcoholic fatty liver disease
• Osteoarthritis
• Sleep apenea

You also must have failed to achieve and sustain a healthy weight loss with prior weight loss efforts. Qualifications can also vary for health insurance approval to pay for your surgery.

Other types of bariatric surgery

In addition to gastric sleeve weight loss surgery, there are many other kinds of bariatric surgery available through Advocate including gastric bypass, duodenal switch, gastric balloon, gastric banding (restrictive) and adjustable banding. Your doctor and bariatric surgical team can help you determine which type is best for you.