Gastric Sleeve Surgery - All You Need to Know

Reviewed by: John M. Rabkin, MD, FACS

gastric sleeve surgery

Gastric sleeve surgery, also called “vertical sleeve gastrectomy”, drastically reduces the size of the stomach which causes patients to feel full sooner and lowers the production of hunger-inducing hormones, leading to significant long-term weight loss and health improvement.

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This page covers everything you need to determine whether gastric sleeve is the right weight loss procedure for you…

Weight Loss
Half to Most of Your Excess Weight

Weight Loss: Half to Most of Your Excess Weight

gastric sleeve surgery

Weight loss after gastric sleeve surgery, also called vertical sleeve gastrectomy (VSG), generally happens quickly with average excess weight loss by month 3 in the 30 to 35% range. By 18 months to 2 years, most patients have reached their low point and have lost about 70% of their excess weight.

Most patients hit a plateau anywhere from 6 to 18 months following surgery. Maintaining or increasing weight loss after this is all about your behavior. Patients who eat healthily and exercise right are usually able to keep the weight off or lose even more. Taking advantage of your surgeon’s dietitian or nutritionist, using a personal trainer, regularly attending support groups, keeping a food journal, support of family and friends, and internal motivation and dedication are each a huge help.

However, many experience weight regain as a result of eating too much, eating the wrong foods, or not exercising enough. Your smaller stomach size does have the ability to stretch over time, especially if you overeat, which can lead to regain. See the “Downsides” section below for more information.

As with any weight loss surgery procedure, the amount of weight you will lose depends on:

  • The surgical team that you choose and how comprehensive their pre- and post-surgery support is
  • How strictly you adhere to the pre- and post-surgery diet, exercise, and behavior regimen prescribed by your surgeon’s team
  • Your body and how well it responds to the gastric sleeve procedure

Average 5-year weight loss, including those who gain back weight, is around 55% of excess weight.

Review Gastric Sleeve Weight Loss Studies

Summary of Findings
Summary of Findings
After 15 years, laparoscopic sleeve gastrectomy (gastric sleeve) has a firm position as a stand-alone procedure to effectively treat morbid obesity. Low morbidity and mortality have been advocated as advantages over more complex procedures such as laparoscopic Roux-en-Y gastric bypass and biliopancreatic diversion with duodenal switch or other restrictive procedures like the laparoscopic adjustable gastric banding that can have serious anatomical complications in the mid- to long-term follow-up. It also avoids intestinal surgery with associated complications such as internal herniation, small bowel obstruction, micronutrient deficiencies, and malnutrition. It has also been argued that the follow-up is less demanding than for the aforementioned procedures. Since long-term reports are starting to appear, some of these facts are now supported in the literature. These are some of the reasons that have made gastric sleeve a technique that is growing in popularity and is offered by most bariatric centers.
After 15 years, laparoscopic sleeve gastrectomy (gastric sleeve) has a firm position as a stand-alone procedure to effectively treat morbid obesity. Low morbidity and mortality have been advocated as advantages over more complex procedures such as laparoscopic Roux-en-Y gastric bypass and biliopancreatic diversion with duodenal switch or other restrictive procedures like the laparoscopic adjustable gastric banding that can have serious anatomical complications in the mid- to long-term follow-up. It also avoids intestinal surgery with associated complications such as internal herniation, small bowel obstruction, micronutrient deficiencies, and malnutrition. It has also been argued that the follow-up is less demanding than for the aforementioned procedures. Since long-term reports are starting to appear, some of these facts are now supported in the literature. These are some of the reasons that have made gastric sleeve a technique that is growing in popularity and is offered by most bariatric centers.
This study reports the longest follow-up of LSG patients thus far [after 6 to 8 years] and supports the effectiveness, safety, and durability of laparoscopic sleeve gastrectomy as a definitive therapeutic option for severe obesity, even in high-risk, high-BMI patients.AD
This study reports the longest follow-up of LSG patients thus far [after 6 to 8 years] and supports the effectiveness, safety, and durability of laparoscopic sleeve gastrectomy as a definitive therapeutic option for severe obesity, even in high-risk, high-BMI patients.AD
In this long-term report of laparoscopic sleeve gastrectomy, it appears that after 6+ years the mean excess weight loss exceeds 50%. However, weight regain and de novo gastroesophageal reflux symptoms appear between the third and the sixth postoperative year. This unfavorable evolution might have been prevented in some patients by continued follow-up office visits beyond the third year. Patient acceptance remains good after 6+ years.AB
In this long-term report of laparoscopic sleeve gastrectomy, it appears that after 6+ years the mean excess weight loss exceeds 50%. However, weight regain and de novo gastroesophageal reflux symptoms appear between the third and the sixth postoperative year. This unfavorable evolution might have been prevented in some patients by continued follow-up office visits beyond the third year. Patient acceptance remains good after 6+ years.AB
From the current evidence, including 36 studies and 2570 patients, LSG is an effective weight loss procedure that can be performed safely as a first stage or primary procedure. From this large volume of case series data, a matched cohort analysis, and 2 randomized trials, LSG results in excellent weight loss and co-morbidity reduction that exceeds, or is comparable to, that of other accepted bariatric procedures. The postoperative major complication rates and mortality rates have been acceptably low. Long-term data are limited, but the 3- and 5-year follow-up data have demonstrated the durability of the SG procedure.Z
From the current evidence, including 36 studies and 2570 patients, LSG is an effective weight loss procedure that can be performed safely as a first stage or primary procedure. From this large volume of case series data, a matched cohort analysis, and 2 randomized trials, LSG results in excellent weight loss and co-morbidity reduction that exceeds, or is comparable to, that of other accepted bariatric procedures. The postoperative major complication rates and mortality rates have been acceptably low. Long-term data are limited, but the 3- and 5-year follow-up data have demonstrated the durability of the SG procedure.Z
Our data have shown that gastric sleeve is a highly effective and safe procedure for achieving weight loss, improving co-morbidities, and improving the quality of life in patients with type 2 diabetes mellitus and morbid obesity during a long-term period.G
Our data have shown that gastric sleeve is a highly effective and safe procedure for achieving weight loss, improving co-morbidities, and improving the quality of life in patients with type 2 diabetes mellitus and morbid obesity during a long-term period.G
Gastric sleeve is reproducible and seems to be an effective treatment to achieve significant weight loss after 12 months follow-up. Gastric sleeve can be used as a standalone operation to obtain weight reduction. Management of postoperative gastric fistula remains a major issue.H
Gastric sleeve is reproducible and seems to be an effective treatment to achieve significant weight loss after 12 months follow-up. Gastric sleeve can be used as a standalone operation to obtain weight reduction. Management of postoperative gastric fistula remains a major issue.H
Summary of Findings
Year of Study
After 15 years, laparoscopic sleeve gastrectomy (gastric sleeve) has a firm position as a stand-alone procedure to effectively treat morbid obesity. Low morbidity and mortality have been advocated as advantages over more complex procedures such as laparoscopic Roux-en-Y gastric bypass and biliopancreatic diversion with duodenal switch or other restrictive procedures like the laparoscopic adjustable gastric banding that can have serious anatomical complications in the mid- to long-term follow-up. It also avoids intestinal surgery with associated complications such as internal herniation, small bowel obstruction, micronutrient deficiencies, and malnutrition. It has also been argued that the follow-up is less demanding than for the aforementioned procedures. Since long-term reports are starting to appear, some of these facts are now supported in the literature. These are some of the reasons that have made gastric sleeve a technique that is growing in popularity and is offered by most bariatric centers.
2015
This study reports the longest follow-up of LSG patients thus far [after 6 to 8 years] and supports the effectiveness, safety, and durability of laparoscopic sleeve gastrectomy as a definitive therapeutic option for severe obesity, even in high-risk, high-BMI patients.AD
2012
In this long-term report of laparoscopic sleeve gastrectomy, it appears that after 6+ years the mean excess weight loss exceeds 50%. However, weight regain and de novo gastroesophageal reflux symptoms appear between the third and the sixth postoperative year. This unfavorable evolution might have been prevented in some patients by continued follow-up office visits beyond the third year. Patient acceptance remains good after 6+ years.AB
2010
From the current evidence, including 36 studies and 2570 patients, LSG is an effective weight loss procedure that can be performed safely as a first stage or primary procedure. From this large volume of case series data, a matched cohort analysis, and 2 randomized trials, LSG results in excellent weight loss and co-morbidity reduction that exceeds, or is comparable to, that of other accepted bariatric procedures. The postoperative major complication rates and mortality rates have been acceptably low. Long-term data are limited, but the 3- and 5-year follow-up data have demonstrated the durability of the SG procedure.Z
2009
Our data have shown that gastric sleeve is a highly effective and safe procedure for achieving weight loss, improving co-morbidities, and improving the quality of life in patients with type 2 diabetes mellitus and morbid obesity during a long-term period.G
2009
Gastric sleeve is reproducible and seems to be an effective treatment to achieve significant weight loss after 12 months follow-up. Gastric sleeve can be used as a standalone operation to obtain weight reduction. Management of postoperative gastric fistula remains a major issue.H
2009
Studies
Studies
Study AF
Study AF
Study AD
Study AD
Study AC
Study AC
Study AB
Study AB
Study R
Study R
Study Z
Study Z
Study N
Study N
Study O
Study O
Study P
Study P
Study Q
Study Q
Studies
# of GS Patients in Study
Study AF
140
Study AD
74
Study AC
20
Study AB
41
Study R
26
Study Z
1,749
Study N
23
Study O
135
Study P
16
Study Q
130
Studies
Weight Loss
(% of Excess Weight Lost at…)
Study AF
1 year – 70.5%
2 years – 65.2%
3 years – 60.2%
4 years – 53.2%
5 years – 57.2%
Study AD
6 years – 52%
7 years – 43%
8 years – 46%
Study AC
1 year – 73% (range 13–105%)
2 years – 78% (range 22–98%)
3 years – 73% (range 28–90%)
8 to 9 years – 68% (range 18–85%)
Study AB
6 Years – 57.3%
Study R
5 Years – 55%
Study Z
Ranging from 3 months to 3 years – 60.4%
Study N
3 Years – 74.58%
Study O
6 months – 38.6%
1 Year – 49.4%
Study P
6 months – 55.5%
1 Year – 69.7%
Study Q
3 months – 33.1%
6 months – 50.8%
1 Year – 62.2%
18 months – 64.4%
2 Years – 67.9%
Studies
Year
Study AF
2015
Study AD
2012
Study AC
2012
Study AB
2010
Study R
2010
Study Z
2009
Study N
2009
Study O
2009
Study P
2008
Study Q
2008

Health Benefits
Improves or Cures At Least 15 Conditions

Health Benefits: Improves or Cures At Least 15 Conditions

gastric sleeve surgery

Gastric sleeve surgery has a significant positive impact on health issues associated with obesity. It either improves or “resolves” (cures, as long as weight loss is maintained), at least 15 obesity-related health problems:

Health Issue Associated with Obesity (Comorbidity)
Mortality Reduction/Life Expectancy (5 year mortality)
Asthma
Quality of Life Improvements
Cardiovascular Disease
Depression
Diabetes
Degenerative Joint Disease
Dyslipidemia hypercholesterolemia
Gastroesophageal Reflux Disease (GERD)
High Blood Pressure (hypertension)
Hyperlipidemia (high levels of fat in the blood)
Migraines
Non-Alcoholic Fatty Liver Disease
Metabolic Syndrome
Obstructive Sleep Apnea
Polycystic Ovarian Syndrome, Hirsutism & Menstrual Irregularity
Pregnancy
Pseudotumor cerebri
Stress Urinary Incontinence
Venous Stasis Disease
Improvement or Resolution
89% reduction in risk of death vs obese individuals who do not have bariatric surgery (1) (general bariatric surgery study, not specific to gastric sleeve)
Up to 90% of patients improved or resolved (2)
93% of patients (3)
Significant general improvement in cardiac function (4) (5)
Improvement documented but no aggregate data available (6) (7)
55% have their diabetes resolve or improve after one year (8)
Between 46% and 100% of patients experience improvement or resolution (9)
Resolved or improved in up to 64% of patients (10)
50% have their GERD resolve after one year (11)
68% have their hypertension resolve or improve after one year (12)
35% have their hyperlipidemia resolve after one year (13)
Improvement in up to 40% of patients (14)
Improvement documented but no sleeve-specific percentages available (15)
Complete resolution in up to 62% of patients (16)
62% have their obstructive sleep apnea resolve after one year ( 17)
Improvement or resolution in nearly all women (18) (19)
Up to 58% of previously infertile women are able to become pregnant (20)
Improvement documented but no sleeve-specific percentages available (21)
Up to 90% experience complete resolution or improvement (22)
May be resolved in up to 95% of patients (23) (data is for gastric bypass patients, but researchers cite “surgically induced weight loss” as cause)

To learn more about obesity-related health problems, click here.

Qualify
35+ BMI with Health Issues, 40+ Without

Qualify: 35+ BMI with Health Issues, 40+ Without

According to the National Institutes of Health guidelines and the requirements of most gastric sleeve surgeons, you could be a good candidate for gastric sleeve surgery if one of the following applies:

  • You have a body mass index (BMI) of 40 or more (“morbidly obese” or “super obese”), OR
  • Your BMI is between 35 and 39.9 (“severely obese”) and you have a serious obesity-related health problem

Serious obesity-related health problems most commonly include:

  • High blood pressure
  • High cholesterol
  • Type 2 diabetes
  • Sleep apnea

Other health conditions that may help you qualify for Bariatric Surgery are listed above in the “Health Benefits” section.

If you do not meet one of the above two BMI requirements, you still might qualify for one other less invasive procedure: the Gastric Balloon. See our Gastric Balloon Patient Guide for more information.

Cost
$19,000 Average, Financing & Tax Savings Available

Cost: $19,000 Average, Financing & Tax Savings Available

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Cost Survey Results for MEXICO*


Including Cancun, Guadalajara, Los Cabos, Mexicali, Monterrey, Puerto Vallarta and Tijuana

<-- swipe to see other years -->
 201520162017
Gastric Bypass$7,422 n/a n/a
Gastric Banding (Lap Band)$5,826 n/a n/a
Gastric Sleeve$5,125 n/a n/a
Duodenal Switch$8,060 n/a n/a

* 10 Practices in Mexico were contacted to calculate these averages.

Exact Quote for You

Click here to find a top surgeon near you. Their office will be able to provide you with a more exact quote.

The total cost of gastric sleeve surgery, before insurance, depends on where you have the procedure performed.

For example, within the U.S. alone, gastric sleeve costs range anywhere from $12,000 (Nevada) to $58,000 (Alaska).

Following are averages by country:

United States
United States
Canada
Canada
Australia
Australia
Mexico
Mexico
India
India
Thailand
Thailand
Costa Rica
Costa Rica
 
Gastric Sleeve Surgery Cost
United States
$19,190
Canada
$21,400
Australia
$15,900
Mexico
$5,125
India
$9,400
Thailand
$10,800
Costa Rica
$9,550

Click here to see Costs by each US State

Region Region
Average Cost Average Cost
Region ALABAMA
Average Cost $18,975

ALABAMA surgeons surveyed are located in Birmingham, Decatur, Huntsville, Mobile, Montgomery and Tuscaloosa

Region ALASKA
Average Cost $57,675

ALASKA surgeons surveyed are located in Anchorage

Region ARIZONA
Average Cost $17,553

ARIZONA surgeons surveyed are located in Flagstaff, Mesa, Phoenix, Prescott, Scottsdale, Tempe and Tucson

Region ARKANSAS
Average Cost $13,963

ARKANSAS surgeons surveyed are located in El Dorado, Fayetteville, Fort Smith, Jonesboro, Little Rock and Pine Bluff

Region CALIFORNIA
Average Cost $22,200

CALIFORNIA surgeons surveyed are located in Bakersfield, Burbank, Chico, Fresno, Los Angeles, Orange, La Jolla, Modesto, Oakland, Poway, Riverside, Sacramento, San Diego, San Francisco, San Jose and Santa Barbara

Region COLORADO
Average Cost $15,567

COLORADO surgeons surveyed are located in Colorado Springs, Denver and Fort Collins

Region CONNECTICUT
Average Cost $21,618

CONNECTICUT surgeons surveyed are located in Farmington, Glastonbury, Meriden, Middletown, New Haven, Norwalk, Shelton and Stamford

Region DELAWARE
Average Cost $16,954

DELAWARE surgeons surveyed are located in Dover, Newark and Wilmington

Region FLORIDA
Average Cost $15,726

FLORIDA surgeons surveyed are located in Ft. Meyers, Gainesville, Jacksonville, Miami, Naples, Ocala, Orlando, Sarasota, St. Petersburg, Tallahassee, Tampa and West Palm Beach

Region GEORGIA
Average Cost $16,133

GEORGIA surgeons surveyed are located in Albany, Athens, Atlanta, Augusta, Columbus, Decatur, Macon, Marietta and Savannah

Region HAWAII
Average Cost $20,592

HAWAII surgeons surveyed are located in Aiea, Kailua-Kona, Honolulu and Wailuku

Region IDAHO
Average Cost $17,439

IDAHO surgeons surveyed are located in Boise, Meridian, Montpelier, Nampa, Pocatello and Post Falls

Region ILLINOIS
Average Cost $17,574

ILLINOIS surgeons surveyed are located in Chicago, Champaign, Decatur, Naperville, Peoria, Rockford and Springfield

Region INDIANA
Average Cost $22,224

INDIANA surgeons surveyed are located in Bloomington, Evansville, Fort Wayne, Gary, Indianapolis and South Bend

Region IOWA
Average Cost $20,213

IOWA surgeons surveyed are located in Cedar Rapids, Davenport, Des Moines and Iowa City

Region KANSAS
Average Cost $13,625
Region KENTUCKY
Average Cost $18,890

KENTUCKY surgeons surveyed are located in Lexington, Louisville and other towns.

Region LOUISIANA
Average Cost $14,069

LOUISIANA surgeons surveyed are located in Alexandria, New Orleans, Shreveport and other towns

Region MAINE
Average Cost $25,027

MAINE surgeons surveyed are located in Augusta, Bangor, Portland and other towns

Region MARYLAND
Average Cost $25,198

MARYLAND surgeons surveyed are located in Baltimore, Salisbury and other towns

Region MASSACHUSETTS
Average Cost $21,424

MASSACHUSETTS surgeons surveyed are located in Boston, New Bedford, Pittsfield, Springfield, Worcester and other towns.

Region MICHIGAN
Average Cost $22,100

MICHIGAN surgeons surveyed are located in Ann Arbor, Detroit, Grand Rapids, Lansing and other towns.

Region MINNESOTA
Average Cost $23,733

MINNESOTA surgeons surveyed are located in Minneapolis / St. Paul, Rochester and other towns

Region MISSISSIPPI
Average Cost $12,995

MISSISSIPPI surgeons surveyed are located in Jackson, Hattiesburg, Meridian, Tupelo and other towns.

Region MISSOURI
Average Cost $18,938

MISSOURI surgeons surveyed are located in Columbia, Kansas City, Springfield, St. Louis and other towns

Region MONTANA
Average Cost $18,500

MONTANA surgeons surveyed are located in Billings, Bozeman, Helena and other towns

Region NEBRASKA
Average Cost $16,633

NEBRASKA surgeons surveyed are located in Lincoln, Omaha and other towns

Region NEVADA
Average Cost $13,025

NEVADA surgeons surveyed are located in Henderson, Las Vegas and Reno Areas

Region NEW HAMPSHIRE
Average Cost $20,400

NEW HAMPSHIRE surgeons surveyed are located in Manchester, Nashua and other towns

Region NEW JERSEY
Average Cost $18,033

NEW JERSEY surgeons surveyed are located in Newark, Trenton and Other Areas

Region NEW MEXICO
Average Cost $14,167

NEW MEXICO surgeons surveyed are located in Albuquerque, Las Cruces, Santa Fe and Other Areas

Region NEW YORK
Average Cost $27,620

NEW YORK surgeons surveyed are located in Albany, Buffalo, New York City / Manhattan, Rochester, Watertown and Other Areas

Region NORTH CAROLINA
Average Cost $22,478

NORTH CAROLINA surgeons surveyed are located in Asheville, Chapel Hill, Charlotte, Durham, Greensboro, Greenville, Raleigh, Wilmington, Winston-Salem and Other Areas

Region NORTH DAKOTA
Average Cost $27,500

NORTH DAKOTA surgeons surveyed are located in Bismarck and Grand Forks

Region OHIO
Average Cost $19,333

OHIO surgeons surveyed are located in Akron, Cincinnati, Cleveland, Columbus, Dayton and Other Areas

Region OKLAHOMA
Average Cost $13,432

OKLAHOMA surgeons surveyed are located in Norman, Oklahoma City, Tulsa and Other Areas

Region OREGON
Average Cost $26,133
Region PENNSYLVANIA
Average Cost $17,662

PENNSYLVANIA surgeons surveyed are located in Allentown, Altoona, Harrisburg, Lancaster, Philadelphia, Pittsburgh and Other Areas

RHODE ISLAND surgeons surveyed are located in Providence

Region SOUTH CAROLINA
Average Cost $19,000

SOUTH CAROLINA surgeons surveyed are located in Anderson, Charleston, Columbia, Greenville, Myrtle Beach, Rock Hill and Other Areas

Region SOUTH DAKOTA
Average Cost $12,500

SOUTH DAKOTA surgeons surveyed are located in Dakota Dunes, Rapid City and Sioux Falls

Region TENNESSEE
Average Cost $18,701

TENNESSEE surgeons surveyed are located in Chattanooga, Knoxville, Memphis and Nashville

Region TEXAS
Average Cost $12,416

TEXAS surgeons surveyed are located in Abilene, Amarillo, Austin, Corpus Christi, Dallas / Ft. Worth, Houston, Lubbock and San Antonio

Region UTAH
Average Cost $14,359

UTAH surgeons surveyed are located in Provo, Salt Lake City and St. George

Region VERMONT
Average Cost $23,650

VERMONT surgeons surveyed are located in Burlington, Montpelier and Springfield

Region VIRGINIA
Average Cost $17,667

VIRGINIA surgeons surveyed are located in Charlottesville, Newport News, Norfolk, Richmond, Roanoke, Virginia Beach and Other Towns

Region WASHINGTON
Average Cost $18,788

WASHINGTON surgeons surveyed are located in Everett, Olympia, Seattle, Spokane, Tacoma, Vancouver and Other Areas

Region WASHINGTON DC
Average Cost $17,850
Region WEST VIRGINIA
Average Cost $17,453

WEST VIRGINIA surgeons surveyed are located in Charleston, Huntington, Morgantown and Vienna

Region WISCONSIN
Average Cost $23,133

WISCONSIN surgeons surveyed are located in Eu Claire, Green Bay, La Crosse, Madison, Milwaukee and Other Areas

Region WYOMING
Average Cost $16,112

WYOMING surgeons surveyed are located in Afton, Cheyenne and Riverton

Click here to see Costs by each Canadian Province

Region Region
Average Cost Average Cost
Region QUEBEC
Average Cost $19,625

Click here to see Costs by each Australian State/Territory

Region Region
Average Cost Average Cost
Region NEW SOUTH WALES
Average Cost $5,225

NEW SOUTH WALES surgeons surveyed are located in Sydney

Region QUEENSLAND
Average Cost $4,388

QUEENSLAND surgeons surveyed are located in Brisbane and Gold Coast

Region SOUTH AUSTRALIA
Average Cost $3,025

SOUTH AUSTRALIA surgeons surveyed are located in Adelaide and Barossa Valley

TASMANIA surgeons surveyed are located in Hobart

Region VICTORIA
Average Cost $4,672

VICTORIA surgeons surveyed are located in Melbourne

Region WESTERN AUSTRALIA
Average Cost $3,500

WESTERN AUSTRALIA surgeons surveyed are located in Perth

The cost of surgery generally has nothing to do with the quality of the surgeon or hospital. It is often driven by unrelated factors such as cost of living, amount of local competition, local medicare and medicaid populations (since self-payers and insurance must offset their lower reimbursement levels), and for-profit/non-profit status of the hospital used.

Further confusing the issue are certain cost-saving “tricks of the trade” such as:

  • Self-Pay Discounts – If you don’t have insurance or insurance won’t cover your surgery, most weight loss surgery programs will offer some sort of self-pay discount or payment plan. Just ask!
  • Other Discounts – Some practices offer additional discounts if you pay the total amount you owe in advance.
  • Same Surgeon, Different Hospitals – Some surgeons can choose between two or more hospitals for the actual procedure to take place. Hospital charges make up the largest portion of the total bariatric surgery bill by far, so ask your surgeon’s office if they have operating privileges at more than one hospital and, if so, which is the less expensive option.

Note that the above averages include total costs incurred during surgery. Some surgeons also include Pre-Op costs in their quoted fees.

However, the above averages do not include Post-Op costs which will be based on your specific circumstances.

Following are all potential gastric sleeve surgery cost categories:

Pre-Op (Costs Before Surgery)

  • Physician-supervised weight loss program (required prior to surgery approval)
  • Dietitian/nutritionist consultations
  • Psychologist (mental health clearance)
  • Cardiologist (heart health clearance)
  • Lab/blood work, echocardiogram (also known as an “ECG” or “EKG”) and/or X-Ray fees
  • Surgeon consultation fees
  • Sleep study

Costs During Surgery

  • Hospital fees
  • Surgeon fees
  • Surgical assistant fees
  • Anesthesia fees
  • Operating room fees
  • Pathologist interpretation (for analyzing bioposies, if necessary) – may not be included in quoted hospital fee
  • Radiologist interpretation (for analyzing x-rays, if necessary) – may not be included in quoted hospital fee

Post-Op (Costs After Surgery)

  • Addressing any complications
  • Follow-up doctor visits
  • Bariatric vitamins
  • Additional food costs (healthier food tends to cost more)
  • Personal trainer and/or gym membership
  • New clothes (wait to go crazy with this until you reach your plateau weight)
  • Plastic surgery to address sagging skin (more on this in the Downsides section below)

Gastric Sleeve Costs Vs. Cost of Not Having Surgery

gastric sleeve surgery

At a total average cost of $19,000, gastric sleeve surgery doesn’t come cheap. But those costs are nothing compared to the long-term costs of obesity-related health problems for morbidly obese people who don’t have surgery.

On average, weight loss surgery patients pay off their entire surgery and start getting ahead financially after only 2 years (24).

To illustrate: One study found that bariatric patients pay as much as $900 less per month as soon as 13 months after surgery than similar people who didn’t have surgery (25). Starting in month 13, that’s almost $11,000 saved per year in total medical costs.

Fewer prescription drugs alone have been found to save patients $3,000 or more per year (26).

Financing Options

Gastric sleeve financing is common and available almost everywhere. If you have insurance, financing may be available for your out of pocket expenses such as your deductible, copays, or coinsurance amounts. With no insurance, patients can obtain financing for the entire cost of surgery.

Options for making surgery more affordable include:

Follow the links above for more information.

Taxes: Several Ways to Save

Depending on your situation and location, you may be able to take advantage of tax savings for out of pocket expenses related to your procedure.

gastric sleeve surgery
  • United States: Might Be Deductible

    Gastric sleeve surgery is tax deductible, which can have a big impact on the total cost of surgery.

    The official IRS rules state that you’re allowed to deduct medical expenses as long as the costs are higher than 10% of your adjusted gross income.

    In order to receive the deductions, you’ll need to complete Schedule A of the IRS Form 1040. You’ll also need to save your medical bills and payment statements as proof. Note that any reimbursed amounts cannot be included (like the portion that your insurance paid).

    Depending on your employment status, money accrued in special savings accounts (or even your IRA) could also be a tax-advantaged option to pay for surgery:

    1. Health Savings Account (HSA) – HSAs can only be opened alongside a “qualified high deductible” health plan. Money contributed to an HSA, accumulated interest from the accounts where the money is invested, AND money taken out of the HSA to pay for qualified medical expenses are all TAX FREE. No other account receives more favorable tax treatment. You may even be able to transfer money already in your IRA into an HSA. See the IRS’s Site for more info.
    2. Archer Medical Savings Account (Archer MSA) – Archer MSAs are very similar to HSAs, except they are for self-employed individuals or small businesses. Click here for the details.
    3. Health Reimbursement Account (HRA) – HRAs can only be offered by your employer, and only your employer can contribute money to them. If your company offers one, make sure your plan allows the use of HRA funds to pay for “all qualified medical expenses” as financing bariatric surgery is not allowed with some plans. More information can be found by clicking here.
    4. Flexible Spending Account (FSA) – Both employers and employees can contribute to an FSA, also known by its IRS code, “Section 125”. FSA’s can be offered alongside any health plan, and withdrawals from this account can be made tax-free as long as they are used to pay for qualified medical expenses. Click here to get the summary from the IRS.
  • Canada: Is Deductible

    Canada is generous compared to other countries when it comes to medical tax deductions. As long as you can substantiate your gastric-sleeve-related expenses with a prescription, receipt, or other documentation, you should be able to write them off.

    Further, if you have surgery covered by insurance, you can still deduct your out of pocket expenses along with your monthly insurance premium.

    If your income is below a certain threshold, you may also qualify for a tax credit called the refundable medical expense supplement.

  • Australia: Might Be Deductible

    If your out of pocket expenses for bariatric surgery (and all other net medical expenses) are over the Australian Taxation Office (ATO) threshold, you can claim an offset on your tax return.

    According to the ATO:

    “To claim the net medical expenses tax offset in your tax return, you will need to know the total medical expenses you incurred for yourself and your dependants. You then deduct any refunds from Medicare, your health fund or any other reimbursements that relate to those expenses received during the financial year.”

    Click here for updated Medicare Benefit Tax Statement information from the Department of Human Services.

Insurance
Covered If Your Policy Includes Bariatric Surgery

Insurance: Covered If Your Policy Includes Bariatric Surgery

gastric sleeve surgery

Click your country for detailed insurance information:

  • United States: Covered If Your Plan Includes Bariatric Surgery

    In the United States, most insurance companies include gastric sleeve surgery as a covered procedure, as long as your specific policy covers bariatric surgery.

    Whether your specific policy covers it depends on what kind of plan you have:

    • Individual/Family Plans & Small Group Plans (through Work, under 50 employees) – The Affordable Care Act (Obamacare) requires insurance companies in many states to include coverage for bariatric surgery. Click here for an updated list of states required to cover bariatric surgery.
    • Large Group Plans (through Work, 50+ employees) – Whether bariatric surgery is covered by your insurance is completely up to your company to decide. Talk with your HR department or contact your insurance company to find out if it’s covered.
    • Medicare & Medicaid – Medicare and Medicaid both cover gastric sleeve surgery, although not all surgeons accept them.

    If Your Policy Covers It: Ask for Free Insurance Check

    Your insurance company will require you to submit documentation from your doctor or surgeon confirming that a medically supervised weight loss program was unsuccessful.

    Many surgeons offer a free insurance check and have a staff that is highly trained and experienced at working with insurance companies. Rather than figuring it out on our own, talk with a surgeon’s office about doing the legwork for you.

    If Your Policy Does NOT Cover It: Seek Partial Coverage

    Even if bariatric surgery isn’t a covered benefit, you’ll probably be able to get some of your expenses covered.

    According to several surgical practices we interviewed during our Annual Weight Loss Surgery Cost Survey, it’s all about how your doctor and hospital submit your claims to your insurance company. As long as your doctor files the claim using a covered “CPT Code” (Current Procedural Terminology Code), then your insurance company will likely cover it as long as the code used accurately reflects the treatment provided.

    For example, there are many non-bariatric surgery reasons for your doctor to recommend:

    • Cardiology exam
    • Lab work
    • Medically supervised diet program
    • Psychological exam
    • Sleep study

    While these can be ordered for other reasons not related to bariatric surgery, each is also essential before your surgeon will approve your surgery.

    If your surgeon or primary care physician submits the above claims using a weight loss surgery CPT code, your insurance is unlikely to cover it. However, if your doctor submits the above claims using a NON-weight loss surgery CPT code, the claims will likely be considered covered benefits.

    While this may sound “sneaky”, in actuality it is an ethical practice. These tests will be beneficial regardless of whether you move forward with surgery, and improving your health is always a good thing.

    The U.S. Insurance Approval Process

    From start to finish, the entire gastric sleeve insurance approval process can take anywhere from 1 to 12 months, depending on your situation.

    The typical approval process usually something like:

    1. Your minimum body mass index (BMI) requirements are confirmed by your physician:
      • BMI over 40 –OR–
      • BMI over 35 with one or more of the following:
        • Clinically significant obstructive sleep apnea
        • Coronary heart disease
        • Medically refractory hypertension
        • Type 2 diabetes mellitus
        • Other obesity-related health issues
    2. Complete 3 to 7 consecutive months of a medically supervised diet program, depending on your insurance company (can be coordinated by your bariatric surgeon).
    3. Schedule a consultation with your bariatric surgeon.
    4. Schedule a consultation with your primary care physician to obtain a medical clearance letter.
    5. Schedule a psychiatric evaluation to obtain a mental health clearance letter (usually coordinated by your bariatric surgeon).
    6. Schedule a nutritional evaluation from a Registered Dietitian (usually coordinated by your bariatric surgeon).
    7. Send all of the above documentation to your insurance company along with a detailed history of your obesity-related health problems, difficulties and treatment attempts. The review process typically happens in under one month (usually coordinated by your bariatric surgeon).
    8. Insurance company sends approval or denial letter:
      • If approved, your surgeon’s bariatric coordinator will contact you for scheduling.
      • If denied, you can choose to appeal the denial.

    Your surgeon’s office will do most of this leg-work for you. They will be highly experienced in managing the process and may even have all of the required personnel on staff (e.g. registered dietitian, psychiatrist, bariatric coordinator, etc.).

    Click here to access the weight loss surgeon directory to get started. Most offices will check your insurance for free to confirm coverage criteria.

    For more information about gastric sleeve insurance, see our Bariatric Surgery Insurance Compete Patient Guide.

    Disability Insurance During Recovery

    Disability insurance (DI) is usually only available through an employer, although you can continue coverage as an individual if you leave the company.

    It pays you a percentage of your monthly income if you are unable to work. Short term disability insurance (STD) most commonly pays 66 2/3% of your salary for the first 90 or 180 days of disability or sickness (also known as your disability period for bariatric surgery recovery).

    Disability insurance usually includes pre-existing conditions limitations. In other words, insurance companies won’t let you buy coverage one month and go out on disability the next for something that you knew about before you signed up.

    The best way to get around this for bariatric surgery is to enroll with your employer during the initial enrollment period (i.e., when you’re hired). You may not be allowed to enroll at any other time.

    You must then remain enrolled for the entire “pre-existing conditions exclusionary period,” which usually lasts between 6 and 12 months. Call your insurance company, talk with HR or review your plan documents for details.

  • Canada: Covered, But Long Wait Times

    Gastric sleeve surgery is covered by Jurisdictional Health Care plans in several provinces including:

    • Alberta
    • British Columbia
    • Manitoba
    • Newfoundland and Labrador
    • Nova Scotia
    • Ontario
    • Quebec
    • Saskatchewan

    Unfortunately, if you want insurance to pay, wait times can get ridiculous, ranging from 2 years to over 10 years.

    If you don’t want to wait, you have two options:

    1. Insurance may pay for you to have surgery outside of your province, although most provinces will not cover any expenses other than the surgery itself.
    2. Finance bariatric surgery on your own and receive treatment in a private facility.

    The majority of weight loss surgery patients in Canada take the self-pay option: public facilities only perform about one-third of all bariatric surgeries in Canada, while private-pay clinics account for the remaining two-thirds (27).

    See our Weight Loss Surgery in Canada Patient Guide for more information.

    Click here to find a private-pay clinic in Canada or the United States.

  • Australia: Covered by Medicare & Private Insurance

    Australian Medicare will provide some reimbursement for gastric sleeve surgery, although the rebate amount will still leave the majority of costs up to you and your private insurance.

    To determine your rebate amount, Medicare applies a set rate to each covered procedure (that is much lower than the actual surgery costs), then they give you a rebate of 75% of that set rate.

    For example, if the total procedure costs $10,000 but Medicare’s set rate is $850, then Medicare will pay $637.50 of the total bill ($850 X 0.75), and you and your private insurance will be responsible for the balance.

    Click here to access the Medicare Benefits Schedule (MBS) database and type in Gastric Sleeve Item Number 31575 for current reimbursement levels.

    Private insurance in Australia usually covers bariatric surgery, although you will still have out of pocket fees (between $1,700 and $5,300 after Medicare rebates).

    Since obesity is considered a pre-existing condition, you will probably have to wait 12 months between joining a health fund and getting approved for surgery.

    To get the specific coverage information and your out of pocket costs from your health fund, contact them directly and provide them with the same Medicare Item Number: 31575.

    Click here for a full list of Australian health funds and their contact information.

    Click here to find a top bariatric surgeon in Australia or here for our Australia Patient Guide.

Procedure
Laparoscopic, Makes Stomach 80+% Smaller

Procedure: Laparoscopic, Makes Stomach 80+% Smaller

gastric sleeve surgery

Preparing for Surgery

Your surgeon will work closely with you during the weeks leading up to surgery, including:

  • Pre-procedure health assessment, where you will be asked questions about your medical history, medications, and surgical history
  • Order certain tests like an ECG, x-ray, and blood tests
  • Establish a pre-surgery diet regimen, including:
    • 2 Weeks Before
      • No sugar
      • Lower carbs
      • Increased protein
      • Increased veggies
      • Plenty of fluids
    • 2 Days Before
      • Clear liquids, broth, one protein shake per day only
      • Talk with your surgeon about whether you should stop taking any medications
    • 12 Hours Before
      • No food or drink, no tobacco

In addition to formal action items like the above, there’s also one very important general preparation step that’s up to you: lose as much weight as possible before surgery.

Here’s why:

  • The more weight you lose pre-op, the more weight you will lose after surgery
  • The lower your pre-op weight, the lower your risk of complications
  • Gastric sleeve surgery will not work over the long-term if you slip back into old habits. The sooner you can start establishing good diet and exercise habits, the more likely you will be to maintain them after surgery

See our Preparing for Weight Loss Surgery page for more information.

How Gastric Sleeve Is Performed

How Gastric Sleeve was “Discovered”: Gastric sleeve first came about as the first step in the two-step duodenal switch (DS) procedure. Surgeons observed significant weight loss and health improvement before performing the second step which led to gastric sleeve becoming its own stand-alone procedure. Today, the DS is usually performed as a single procedure, but the sleeve remains a primary component of it.

The gastric sleeve surgery procedure reduces the size of your stomach by 80% or more, making you feel full sooner and resulting in long-term weight loss. It can usually be performed laparoscopically in one to two hours. It has been performed on patients of all ages, from children to the elderly.

Before the procedure, you’ll perform the typical pre-surgery routine: remove all clothes and jewelry, put on your hospital gown, meet with your nurse and anesthesiologist, start your IV, and receive medication for relaxation and sleep. When you wake up, it will all be done.

During the procedure, your surgeon will remove a large portion of your stomach, leaving a banana-shaped “sleeve” that connects the esophagus to the small intestines. Many surgeons will then reinforce the staple line to reduce the risk of leaks.

Recovery
2 – 3 Days in Hospital, Back to Work in 2 Weeks, 4 – 6 Weeks to Full Recovery

Recovery: 2 – 3 Days in Hospital, Back to Work in 2 Weeks, 4 – 6 Weeks to Full Recovery

gastric sleeve surgery

Hospital stays for gastric sleeve patients typically last two or three days, and full recovery usually happens within 6 weeks. Here’s what to expect:

  1. Wake Up: When you first awake after surgery, you’ll be sore and a little “out of it.” You’ll be on medication to control the pain and will likely have a bedside button to deliver additional pain meds through your IV as needed.
  2. Move Around: Your surgeon will have you up and walking around as soon as possible after you wake up to reduce the risk of blood clots and jump-start your body’s healing process. Continue to walk as much as possible, increasing it a little each day.
  3. Get Released: Before releasing you, your surgical team will run a number of tests to ensure:
    1. You are able to drink enough to stay hydrated
    2. You can urinate normally after your catheter is removed
    3. You have adequate pain relief from your pain meds
  4. Look for Warning Signs: Fever, no improvement or worsening of pain, signs of incision infection (pus, swelling, heat, or redness), difficulty swallowing, and ongoing nausea or vomiting are all a concern. Call your surgeon immediately if any of these happen.
  5. Transition Your Diet: Your smaller stomach will be sensitive, especially at first, so you’ll be on a liquid diet for a couple of weeks before slowly transitioning back to solid foods (read more about this in the Diet section of this page). Since you’ll be eating less, you may feel tired and lethargic until your body adjusts.
  6. Ease Off Medications: Your surgeon will prescribe pain and digestion medication as needed and may adjust your pre-surgery medications until you’re fully healed. Follow their instructions to the letter.
  7. Return to Your “New Normal” Life: Avoid swimming or bathing until your incisions have fully healed. Many patients return to normal life and work within a couple of weeks, but plan for up to 4 to 6 weeks off to be on the safe side. Full exercise and heavy lifting typically resume within one to two months.
  8. Have Follow-Up Visits During First Year: Follow-ups with your surgeon’s team will happen about one week post-op, then 4 weeks post-op, then every 3 or 4 months to ensure that everything is on track, including:
    1. Discuss weight loss
    2. Encourage regular exercise
    3. Obtain lab work and make necessary adjustments to medications and dietary supplements
    4. Understand diet and identify any potential eating disorders
    5. Determine whether any potential complications may be arising
    6. Monitor status of obesity-related health issues
    7. Involve your family physician to help evaluate progress and ensure a successful transition
  9. Transition to Semi-Annual or Yearly Follow-Up Visits – After you’ve reached your “low point” weight, your surgeon will probably still want to see you at least once per year (28). During those visits you may meet with several team members, including your surgeon, dietitian, and mental health care provider. They will probably request lab work to ensure that vitamin levels and other indicators are where they should be. If you experience any issues in between visits, don’t wait for your next visit… call your doctor right away.

Diet & Life After
Restricted Diet with Supplementation, Regular Exercise, Less Hungry, Changing Relationships

Diet & Life After: Restricted Diet with Supplementation, Regular Exercise, Less Hungry, Changing Relationships

Weight loss and health improvement following gastric sleeve surgery often take center stage during the decision making process. But it’s also important to consider what day-to-day life will be like.

Your surgery is only a tool, and long-term success requires diligence and sometimes difficult change in other areas.

Food & Drink

Timeframe
2+ Weeks Before Surgery

Recovering from surgery and adjusting to your new stomach size have their own set of challenges. Do not wait until after surgery to start your new life… establish the following long-term diet habits ahead of time to:

  1. Optimize your body’s immune system for a quicker recovery
  2. Ease the transition into your new diet after surgery
  3. Make you much more likely to reach and maintain your weight loss goals

Long-Term Habits to Begin Before Surgery

Food

  • Eat as healthy as possible, protein first
  • 60+ grams of protein per day
  • Small portion sizes
  • Cut food into small pieces
  • Eat slowly, chew food thoroughly
  • No more than 3 small meals per day
  • Limit snacking (no more than 2 small snacks per day)
  • Limit high-fat foods
  • No fibrous foods like asparagus, celery, or broccoli
  • No starchy foods like rice, pasta, or bread
  • No greasy or spicy foods
  • No whole milk products
  • No sugar
  • Take your vitamins

Drinks

  • Plenty of low-calorie fluids (64+ oz [2+ liters] per day)
  • Sip fluids, don’t gulp
  • Do not drink anything 30 minutes before, during, or after meals
  • No sodas or sugary drinks
  • Limit caffeine

Other Habits

2 Weeks Before Surgery

Your surgeon will have you on a special diet starting 2 weeks before surgery to reduce the risk of complications.

In addition to the full ‘2+ Weeks Before’ list above, also begin…

  • No caffeinated drinks
  • No carbonated drinks
  • No over-the-counter herbal supplements

The typical 2 week pre-op meal plan includes:

  • Breakfast: Protein shake that is low-sugar and low-carbs
  • Lunch: Lean meat and vegetables
  • Dinner: Lean meat and vegetables

The purpose of this diet is to:

  • Make surgery easier to perform, reduce operating time and reduce the risk of complications – this diet will shrink your liver and reduce your intra-abdominal fat, making your organs easier to see and work with during surgery.
  • Help you lose weight prior to surgery – the lower your weight, the lower your risk of complications
  • Optimize your immune system for a quicker recovery

Click below for a deeper dive into your 2 Week Pre-Op diet and the complications it will help you avoid.

1 Week Before Surgery

In addition to the “2+ Weeks” and “2 Weeks Before” restrictions listed above, your surgeon will ask you to stop taking several medications one week prior to surgery such as:

  • Any arthritis medications
  • Any time-released meds – switch to non-time-released
  • NSAIDs (nonsteroidal anti-inflammatory drugs), such as:
    • Acetaminophen (Tylenol)
    • Aspirin (many brands)
    • Ibuprofen (Advil, Motrin)
    • Naproxen (Aleve)
  • Other anticoagulants, such as:
    • Enoxaparin (Lovenox)
    • Clopidogrel (Plavix)
    • Dipyridamole (Persantine)
    • Ticlopidine (Ticlid)
    • Warfarin (Coumadin)

Avoiding these meds will reduce the risk of bleeding and stomach problems after surgery.

Consult with your doctor or pharmacist prior to stopping or changing any of your medications.

2 Days Before Surgery

In order to fully clean out your digestive system prior to surgery, your surgeon will ask you to stop all foods and drink only clear liquids during the 2 days before surgery.

Clear fluids options include…

  • Clear broth (beef, chicken, or vegetable)
  • Jell-O (sugar free)
  • Juice without pulp or added sugar (such as apple juice or pulp-free orange juice)
  • Popsicles (sugar-free)
  • Tea (caffeine-free, unsweetened)
  • Water

Do NOT consume…

  • Food of any kind
  • Thick or pulpy drinks of any kind
  • Caffeinated drinks
  • Carbonated drinks
  • Sugary drinks
Midnight Before Surgery

Your digestive system must be completely free of food or liquids when surgery is performed.

The main reason is to reduce the risk of pulmonary aspiration which happens when stomach contents get into the lungs, causing all sorts of problems like serious infection or pneumonia.

While recommended for most gastric sleeve patients, the after-midnight fasting instructions are especially important for patients with gastroesophageal reflux disease (GERD) or gastric paresis (paralysis of the stomach which is more common among people with diabetes). (29)

When you brush your teeth before heading to the hospital, rinse and spit out the water (don’t swallow).

In Hospital (1 -2 Days) thru Day 7 After Surgery

After surgery, your surgical team will slowly transition you into drinking “richer” clear liquids along with the following guidelines:

  • Sip your liquids slowly… no gulping
  • Do not use a straw or drink from a bottle as this can cause gas bubbles to form

Drinks that your nurse will provide may include:

  • Water or Ice (since you can’t eat anything yet, chewing ice may be more satisfying)
  • Clear broth (beef, chicken, or vegetable)
  • Drink mixes (sugar-free), like Crystal Light or Kool-Aid
  • Jell-O (sugar-free)
  • Thin juice or drinks without pulp or added sugar (such as apple juice, Propel Water, Powerade Zero, etc.)
  • Popsicles (sugar-free)
  • Tea (caffeine-free, unsweetened)

Your stomach is in healing mode, so go very easy on it when you return from the hospital.

Be sure to drink plenty of fluids, but don’t drink too quickly. Maintain the same sugar-free, clear liquids only diet that you were on in the hospital.

Take all vitamins and supplements recommended by your surgeon.

If you have no nausea or vomiting before the 7 day mark, your surgeon may allow you to slowly try thicker “Week 2” items ahead of schedule (expand that section below for examples).

Other Habits

Week 2 After Surgery

Your healing should be well underway, and it’s time to slowly introduce thicker drinks and pureed foods. As soon as you’re ready, your surgeon will start you on multiple small “meals” per day which may include:

  • Clear liquids list from previous stages
  • Protein shakes
  • Clear broths (beef, chicken or vegetable)
  • Cream of Wheat
  • Cream soups (no chunks)
  • Carnation Instant Breakfast (sugar free)
  • Greek Yogurt
  • Natural applesauce
  • Sherbet (sugar-free)
  • Skim or Lactose-Free Milk Products
  • Thicker sugar-free juices like low-sodium V-8 or pulp-free orange juice
  • Vitamins and supplements

Remember: No soft or solid food and no drinks with chunks or seeds.

You can also drink clear liquids between meals.

While drinking anything:

  • Take small sips
  • Stop immediately as soon as you feel full or feel any pressure
Week 3 After Surgery

By the 3rd week after surgery it should be safe to add softer solids to your diet, but take it slowly!

When you’re ready to introduce pureed foods, do so by blending water, skim milk, broth, or sugar-free juice with one of the following:

  • Beans
  • Cooked vegetables
  • Eggs
  • Fish
  • Ground meats (lean)
  • Soft fruits

As soon as the pureed foods are going down without a problem, work your way into soft foods like:

  • Cooked vegetables
  • Ground meats (lean)
  • Soft fruits (no seeds or skin)

And remember those habits you formed in the weeks and months leading up to surgery? Here’s where they start to come in really handy.

General diet guidelines during the 3rd week post-op include:

Food

  • Test one new food at a time to confirm you can tolerate it
  • Eat as healthy as possible, protein first
  • 60+ grams of protein per day
  • Small portion sizes
  • Cut food into small pieces
  • Eat slowly, chew food thoroughly
  • No more than 3 small meals per day
  • Limit snacking (no more than 2 small snacks per day)
  • Limit high-fat foods
  • No fibrous foods like asparagus, celery, or broccoli
  • No starchy foods like rice, pasta, or bread
  • No greasy or spicy foods
  • No whole milk products
  • No sugar
  • Take your vitamins

Drinks

  • Plenty of low-calorie fluids (64+ oz [2+ liters] per day)
  • Sip fluids, don’t gulp
  • Do not drink anything 30 minutes before, during, or after meals
  • No sodas or sugary drinks
  • Limit caffeine

Other Habits

Weeks 4+ After Surgery

From this point forward you will complete your slow transition to your “new normal” long-term diet.

Continue the guidelines outlined under Week 3 while keeping the following in mind:

  • Test one food at a time to make sure you can tolerate it
  • Eat healthy “whole” foods (avoid processed foods)
  • Protein first
  • Eat slowly and chew thoroughly
  • No starchy foods like rice, bread, and pasta
  • No whole milk products
  • 64+ oz (2+ liters) of fluids spread throughout the day
  • No drinking 30 minutes before or after meals
Diet Requirements
Timeframe – Diet Requirements

Recovering from surgery and adjusting to your new stomach size have their own set of challenges. Do not wait until after surgery to start your new life… establish the following long-term diet habits ahead of time to:

  1. Optimize your body’s immune system for a quicker recovery
  2. Ease the transition into your new diet after surgery
  3. Make you much more likely to reach and maintain your weight loss goals

Long-Term Habits to Begin Before Surgery

Food

  • Eat as healthy as possible, protein first
  • 60+ grams of protein per day
  • Small portion sizes
  • Cut food into small pieces
  • Eat slowly, chew food thoroughly
  • No more than 3 small meals per day
  • Limit snacking (no more than 2 small snacks per day)
  • Limit high-fat foods
  • No fibrous foods like asparagus, celery, or broccoli
  • No starchy foods like rice, pasta, or bread
  • No greasy or spicy foods
  • No whole milk products
  • No sugar
  • Take your vitamins

Drinks

  • Plenty of low-calorie fluids (64+ oz [2+ liters] per day)
  • Sip fluids, don’t gulp
  • Do not drink anything 30 minutes before, during, or after meals
  • No sodas or sugary drinks
  • Limit caffeine

Other Habits

Your surgeon will have you on a special diet starting 2 weeks before surgery to reduce the risk of complications.

In addition to the full ‘2+ Weeks Before’ list above, also begin…

  • No caffeinated drinks
  • No carbonated drinks
  • No over-the-counter herbal supplements

The typical 2 week pre-op meal plan includes:

  • Breakfast: Protein shake that is low-sugar and low-carbs
  • Lunch: Lean meat and vegetables
  • Dinner: Lean meat and vegetables

The purpose of this diet is to:

  • Make surgery easier to perform, reduce operating time and reduce the risk of complications – this diet will shrink your liver and reduce your intra-abdominal fat, making your organs easier to see and work with during surgery.
  • Help you lose weight prior to surgery – the lower your weight, the lower your risk of complications
  • Optimize your immune system for a quicker recovery

Click the buttons below for a deeper dive into your 2 Week Pre-Op diet and the complications it will help you avoid.

In addition to the “2+ Weeks” and “2 Weeks Before” restrictions listed above, your surgeon will ask you to stop taking several medications one week prior to surgery such as:

  • Any arthritis medications
  • Any time-released meds – switch to non-time-released
  • NSAIDs (nonsteroidal anti-inflammatory drugs), such as:
    • Acetaminophen (Tylenol)
    • Aspirin (many brands)
    • Ibuprofen (Advil, Motrin)
    • Naproxen (Aleve)
  • Other anticoagulants, such as:
    • Enoxaparin (Lovenox)
    • Clopidogrel (Plavix)
    • Dipyridamole (Persantine)
    • Ticlopidine (Ticlid)
    • Warfarin (Coumadin)

Avoiding these meds will reduce the risk of bleeding and stomach problems after surgery.

Consult with your doctor or pharmacist prior to stopping or changing any of your medications.

2 Days Before Surgery – Clear liquids only

In order to fully clean out your digestive system prior to surgery, your surgeon will ask you to stop all foods and drink only clear liquids during the 2 days before surgery.

Clear fluids options include…

  • Clear broth (beef, chicken, or vegetable)
  • Jell-O (sugar free)
  • Juice without pulp or added sugar (such as apple juice or pulp-free orange juice)
  • Popsicles (sugar-free)
  • Tea (caffeine-free, unsweetened)
  • Water

Do NOT consume…

  • Food of any kind
  • Thick or pulpy drinks of any kind
  • Caffeinated drinks
  • Carbonated drinks
  • Sugary drinks
Midnight Before Surgery – Nothing to eat or drink

Your digestive system must be completely free of food or liquids when surgery is performed.

The main reason is to reduce the risk of pulmonary aspiration which happens when stomach contents get into the lungs, causing all sorts of problems like serious infection or pneumonia.

While recommended for most gastric sleeve patients, the after-midnight fasting instructions are especially important for patients with gastroesophageal reflux disease (GERD) or gastric paresis (paralysis of the stomach which is more common among people with diabetes). (29)

When you brush your teeth before heading to the hospital, rinse and spit out the water (don’t swallow).

In Hospital (1 -2 Days) thru Day 7 After Surgery – Sugar-free clear liquids only

After surgery, your surgical team will slowly transition you into drinking “richer” clear liquids along with the following guidelines:

  • Sip your liquids slowly… no gulping
  • Do not use a straw or drink from a bottle as this can cause gas bubbles to form

Drinks that your nurse will provide may include:

  • Water or Ice (since you can’t eat anything yet, chewing ice may be more satisfying)
  • Clear broth (beef, chicken, or vegetable)
  • Drink mixes (sugar-free), like Crystal Light or Kool-Aid
  • Jell-O (sugar-free)
  • Thin juice or drinks without pulp or added sugar (such as apple juice, Propel Water, Powerade Zero, etc.)
  • Popsicles (sugar-free)
  • Tea (caffeine-free, unsweetened)

Your stomach is in healing mode, so go very easy on it when you return from the hospital.

Be sure to drink plenty of fluids, but don’t drink too quickly. Maintain the same sugar-free, clear liquids only diet that you were on in the hospital.

Take all vitamins and supplements recommended by your surgeon.

If you have no nausea or vomiting before the 7 day mark, your surgeon may allow you to slowly try thicker “Week 2” items ahead of schedule (expand that section below for examples).

Other Habits

Your healing should be well underway, and it’s time to slowly introduce thicker drinks and pureed foods. As soon as you’re ready, your surgeon will start you on multiple small “meals” per day which may include:

  • Clear liquids list from previous stages
  • Protein shakes
  • Clear broths (beef, chicken or vegetable)
  • Cream of Wheat
  • Cream soups (no chunks)
  • Carnation Instant Breakfast (sugar free)
  • Greek Yogurt
  • Natural applesauce
  • Sherbet (sugar-free)
  • Skim or Lactose-Free Milk Products
  • Thicker sugar-free juices like low-sodium V-8 or pulp-free orange juice
  • Vitamins and supplements

Remember: No soft or solid food and no drinks with chunks or seeds.

You can also drink clear liquids between meals.

While drinking anything:

  • Take small sips
  • Stop immediately as soon as you feel full or feel any pressure

By the 3rd week after surgery it should be safe to add softer solids to your diet, but take it slowly!

When you’re ready to introduce pureed foods, do so by blending water, skim milk, broth, or sugar-free juice with one of the following:

  • Beans
  • Cooked vegetables
  • Eggs
  • Fish
  • Ground meats (lean)
  • Soft fruits

As soon as the pureed foods are going down without a problem, work your way into soft foods like:

  • Cooked vegetables
  • Ground meats (lean)
  • Soft fruits (no seeds or skin)

And remember those habits you formed in the weeks and months leading up to surgery? Here’s where they start to come in really handy.

General diet guidelines during the 3rd week post-op include:

Food

  • Test one new food at a time to confirm you can tolerate it
  • Eat as healthy as possible, protein first
  • 60+ grams of protein per day
  • Small portion sizes
  • Cut food into small pieces
  • Eat slowly, chew food thoroughly
  • No more than 3 small meals per day
  • Limit snacking (no more than 2 small snacks per day)
  • Limit high-fat foods
  • No fibrous foods like asparagus, celery, or broccoli
  • No starchy foods like rice, pasta, or bread
  • No greasy or spicy foods
  • No whole milk products
  • No sugar
  • Take your vitamins

Drinks

  • Plenty of low-calorie fluids (64+ oz [2+ liters] per day)
  • Sip fluids, don’t gulp
  • Do not drink anything 30 minutes before, during, or after meals
  • No sodas or sugary drinks
  • Limit caffeine

Other Habits

From this point forward you will complete your slow transition to your “new normal” long-term diet.

Continue the guidelines outlined under Week 3 while keeping the following in mind:

  • Test one food at a time to make sure you can tolerate it
  • Eat healthy “whole” foods (avoid processed foods)
  • Protein first
  • Eat slowly and chew thoroughly
  • No starchy foods like rice, bread, and pasta
  • No whole milk products
  • 64+ oz (2+ liters) of fluids spread throughout the day
  • No drinking 30 minutes before or after meals
  • Weeks 4+ Meal Plans & Shopping List
  • Complete Gastric Sleeve Diet Guide

Vitamins & Supplements

In addition to making changes to your diet and exercise, you will also need to start taking a vitamin regime for the rest of your life. This will help you make up for any nutrients you might not be getting in your daily diet. Here is a list of the vitamins your doctor will probably ask you to begin taking:

  • Lifelong Vitamins:
    • Colored icon set (to be used throughout site) for each type of vitamin that patient will need:
      • Multivitamin
      • Calcium
      • Folate
      • Iron
      • Vitamin B12
      • Vitamin D

Vitamin tier 2 details:

  • Animation: replace icons with a chart that contains them
Vitamins
Multivitamin (30) (31)

A daily multivitamin with mineral supplements will help prevent hair loss and general nutrition problems.

  • 1 to 2 per day
  • Forms that are easier to digest, like chewable or liquid versions instead of tablets
  • At least 200% of the Recommended Dietary Allowance (RDA) of iron, folic acid, thiamine, copper, selenium, and zinc
Calcium (32)

Calcium nitrate supplements will keep your bones strong.

  • Must be calcium citrate (NOT other forms of calcium)
  • 500 – 600 mg doses
  • Take 3 times per day forever
  • Chewable and liquid versions are best
  • Try to find one that includes Vitamin D
Folate (folic acid) (33)

Patients who don’t get enough folate are at a higher risk of anemia.

For some patients, the folic acid found in a good multivitamin is not enough (40). Some surgeons do not prescribe additional folate, so ask them to test your folate levels as time goes on to be on the safe side.

Iron (34) (35)

Patients low on iron are more likely to have a stroke, heart attack, or other blood-related problems.

In some patients, the iron found in a good multivitamin is not enough (41). Ask your surgeon to monitor your iron levels to avoid any problems.

Vitamin B12 (36)

Your central nervous system relies on Vitamin B12, and not getting enough of it could lead to serious issues like numbness, memory loss, or even paralysis.

  • Available in many forms (tablet, liquid, injections or nasal spray)
  • Dose and frequency depends on form used
Vitamin D (37) (38) (39)

Without enough Vitamin D, you’re at risk of developing rickets, a weakening of the bones, muscles, and teeth.

  • Chewable or liquid forms are best
  • 3,000 International Units per day
  • Take with food
  • Take 2 hours apart from any Iron supplement (including a multivitamin that contains iron)

Talk with your surgeon to be sure, but you may be able to find a calcium supplement that fulfills your Vitamin D requirements.

Body Part Affected
Vitamins – Body Part Affected
Multivitamin (30) (31) – Entire body

A daily multivitamin with mineral supplements will help prevent hair loss and general nutrition problems.

  • 1 to 2 per day
  • Forms that are easier to digest, like chewable or liquid versions instead of tablets
  • At least 200% of the Recommended Dietary Allowance (RDA) of iron, folic acid, thiamine, copper, selenium, and zinc
Calcium (32) – Bones

Calcium nitrate supplements will keep your bones strong.

  • Must be calcium citrate (NOT other forms of calcium)
  • 500 – 600 mg doses
  • Take 3 times per day forever
  • Chewable and liquid versions are best
  • Try to find one that includes Vitamin D
Folate (folic acid) (33) – Blood

Patients who don’t get enough folate are at a higher risk of anemia.

For some patients, the folic acid found in a good multivitamin is not enough (40). Some surgeons do not prescribe additional folate, so ask them to test your folate levels as time goes on to be on the safe side.

Iron (34) (35) – Blood

Patients low on iron are more likely to have a stroke, heart attack, or other blood-related problems.

In some patients, the iron found in a good multivitamin is not enough (41). Ask your surgeon to monitor your iron levels to avoid any problems.

Vitamin B12 (36) – Brain

Your central nervous system relies on Vitamin B12, and not getting enough of it could lead to serious issues like numbness, memory loss, or even paralysis.

  • Available in many forms (tablet, liquid, injections or nasal spray)
  • Dose and frequency depends on form used
Vitamin D (37) (38) (39) – Entire Body

Without enough Vitamin D, you’re at risk of developing rickets, a weakening of the bones, muscles, and teeth.

  • Chewable or liquid forms are best
  • 3,000 International Units per day
  • Take with food
  • Take 2 hours apart from any Iron supplement (including a multivitamin that contains iron)

Talk with your surgeon to be sure, but you may be able to find a calcium supplement that fulfills your Vitamin D requirements.

Exercise
2.5 hours per week, spread out over 2 to 4 days

Exercise: 2.5 hours per week, spread out over 2 to 4 days

gastric sleeve surgery

Exercise is an afterthought for many patients, but it’s almost as important as your diet when it comes to long-term success:

  • Patients who exercise regularly lose more weight over the long-term
  • Physical and mental health benefits are incredible

How much exercise do you need to for noticeable results?

While we were not able to find any gastric-sleeve-specific exercise studies, one study of gastric bypass patients found that 2.5 hours per week resulted in 5.7% greater excess weight loss (42).

Working out for one hour a couple of times per week also tends to lead to quicker and more significant improvement in obesity-related health problems following surgery (43).

To help you stay on track, block out time to exercise at the same times on the same days of the week.

Also, spread your 2.5 hours per week out over 3 or 4 days (in other words, 30 to 45 minutes 3 or 4 days per week). This will make it less intimidating to get started each day and will help you build endurance.

Exercise Types

There should be 3 main goals of your exercise routine:

  • Endurance – walking, stationary bike, and especially swimming
  • Flexibility – well-rounded stretching routine, ideally yoga since it incorporates proper breathing and uses your own body weight to build strength
  • Strength – exercise balls, weights, and especially yoga

Learn more about exercise after weight loss surgery.

Your Brain
Less Hungry, Careful About Food Addiction, New Mentality Will Change Behavior & Relationships

Your Brain: Less Hungry, Careful About Food Addiction, New Mentality Will Change Behavior & Relationships

Ghrelin Hormone & Hunger

gastric sleeve surgery

The above diet changes may feel slightly less intimidating due to one convenient “feature” of gastric sleeve surgery: you may permanently feel less hungry following surgery.

When your stomach is empty, it secretes a hormone called ghrelin into your bloodstream which causes your brain to generate hunger impulses. After you eat, the amount of secreted ghrelin drops then slowly rises until your next meal. Since your stomach will be significantly smaller following gastric sleeve surgery, the amount of ghrelin it secretes – and your resulting feelings of hunger – may also go down.

See our page about Obesity & Genetics for more information.

Food Addiction

Our bodies secrete certain hormones, like ghrelin mentioned above, that tell us when we’re hungry and full, but hyperpalatable food (delicious junk food) may be overriding those hormone signals by overstimulating our reward centers, much like our bodies and brains react to an addictive drug.

You may have a bona fide food addiction if your desire for food takes priority over other parts of your life that you acknowledge to be more important, such as personal health, family, friends, work, your appearance, or avoiding obesity related health issues like hypertension, sleep apnea, or diabetes.

If left unchecked, food addiction can lead to obesity. Importantly for gastric sleeve patients, if not addressed prior to surgery, it can also lead to weight regain.

To find out if you may be suffering from food addiction, take our Food Addiction Quiz.

Relationships After Weight Loss

gastric sleeve surgery

Being thin again, or being thin for the first time, may be a shocking experience. Many patients express amazement at:

  • No longer dealing with obesity discrimination and watching the “discrimination pendulum” swing the other way. For example, strangers tend to be more cordial and respectful to thin people, and people are more likely to make eye contact with you and smile.
  • Being treated with more respect
  • Getting more romantic interest from others
  • Building deeper relationships by being able to physically keep up with kids and more physically fit friends
  • Getting more compliments from others
  • Increased self-confidence and the effect that has on others

With so many positives of dramatic weight loss after gastric sleeve surgery, it’s understandable that many don’t consider the potential negatives of being thin.

One of the most overlooked but life-impacting aspects of your new body are how important people in your life will treat the “new you”. People who you’ve known for a long time will not be used to the way you look and may not know how to act around you:

  • How will overweight friends or family members feel when you’re losing weight but they are not?
  • Will your new healthier diet and smaller portion sizes make meals with others awkward?
  • Could intimacy with your spouse or partner be affected?
  • Could your spouse or partner become jealous now that others are noticing you more?
  • How will your coworkers react? Should you even tell them you are having surgery?
  • If they’re not making diet and lifestyle changes as well, will your friends or family make it more difficult for you to stay on track?
  • Could your new self-confidence create conflict with people who are used the “old” you?

Another potentially difficult adjustment will be the new “lens” through which you will view other people after you have lost so much weight. Commonly reported concerns include:

  • Would this person be treating me the same way if I hadn’t lost all of this weight?
  • How do I handle obesity discrimination now that I’m on the “other side”?

Be mentally and emotionally prepared for both the good and the challenging “shocks” of dramatic weight loss following surgery.

For real life experiences and advice from other patients, see our Relationships After Weight Loss surgery page.

Downsides
Risk of Complications, Side Effects, & Weight Regain

Downsides: Risk of Complications, Side Effects, & Weight Regain

The relatively simple gastric sleeve procedure results in an extremely low mortality rate (0.31%, or 1 out of 320 patients) (45). However, complications can arise, especially in higher-risk patients.

Preventing Gastric Sleeve Complications

gastric sleeve surgery

In many cases, the patient is very unfortunately to blame for complications, most often because the patient didn’t follow their doctor’s instructions.

Behaviors that will dramatically reduce your risk of gastric sleeve complications include:

  • Pick a good surgeon
  • Follow your surgical team’s advice to the letter
  • Educate yourself
  • Educate your family
  • Lose as much weight as possible prior to surgery
  • Eat a healthy diet in the months leading up to surgery
  • Get tested for sleep apnea syndrome several weeks before surgery (and address the issue if it exists before moving forward)
  • Plan for at least 2 weeks of recovery time
  • Exercise as quickly as possible after surgery
  • Use compression stockings, pneumatic compression devices, and/or blood thinners after surgery (talk with your surgeon) to reduce risk of blood clots
  • Have an effective support system of friends, family, and weight loss surgery support groups

See our Bariatric Surgery Complications page for more information about each of these points.

Serious Gastric Sleeve Complications

The three most common serious complications associated with gastric sleeve surgery include:

However, the staple line leak rate studies (and mortality rate studies, for that matter) were conducted with less effective surgical techniques. Newer procedures that reinforce the staple line appear to dramatically reduce this risk.

Before surgery, talk with your surgeon about how they will reinforce your staple line to reduce the risk of leaks.

As with any surgery, blood clots are always a concern, and your surgeon will take several steps to reduce the risk including blood thinners, compression stockings after surgery, and having you up and moving as soon as possible after surgery.

For more information about serious complications, visit our complications page, where you can see a list and explanation of the complications you might encounter.

Gastric Sleeve Side Effects: Digestion & Sagging Skin

Digestion Issues

Gastroesophageal reflux disease (GERD) is a common minor complication, with about 1 in every 5 patients experiencing it by the one year mark. The good news is that this tends to be a shorter-term issue. After 3 years, the GERD rate drops to around 3% (50).

Other potential gastric sleeve side effects include (51) (52):

  • Indigestion (Dyspepsia)
  • Gallstones
  • Intolerance to certain foods
  • Nausea and vomiting
  • Vitamin and mineral deficiency

Sagging Skin

For most obese patients, the skin has been stretched out for so long to accommodate the extra weight that it has lost its elasticity. Gastric sleeve surgery causes most patients to lose a lot of weight very quickly, and your skin simply can’t keep up.

In addition to causing embarrassment with and without clothes on, the sagging skin can cause several issues ranging from minor to severe, including:

  • Difficulty getting dressed
  • Difficulty exercising, which may impact long-term weight maintenance and health
  • Skin fold rashes or breakdown of skin
  • Skin fold infections

In some cases, sagging skin can be managed with body-contouring undergarments. In more serious cases, plastic surgery can be performed to remove the excess skin. Surgery to remove excess skin is often covered by insurance if your doctor determines that it’s medically necessary.

See our Plastic Surgery After Weight Loss page for more information.

Weight Regain

After two years, about 1 out of 20 gastric sleeve patients have gained back some weight. That number increases to 3 out of every 4 patients after 6 years (53).

Long-term, the average gastric sleeve patient regains about 25% of the weight they lost (54).

Equally concerning, the more weight you gain back, the more likely your health problems are to come back. For example, one study of 443 gastric sleeve patients showed that complete remission of Type 2 diabetes fell from 56% of patients after year 1 to 20% of patients after year 5, which directly correlated with the percentage of patients who regained weight (55).

The reason for weight regain?

It is possible that the surgeon did not remove enough of the stomach in the initial procedure.

But most patients “slip” in their dedication and start to overeat which can stretch out their smaller stomachs. They go against the advice of their surgeon and eat too many large meals, binge eat, or drink carbonated beverages. Each of these can eventually cause the stomach to stretch out and lead to weight regain.

Remember… gastric sleeve may be one of the best tools out there for rapid and long-term weight loss, but it is only a tool. To avoid weight regain, you’ll need to continue to eat the right foods and make the right lifestyle choices.

See our Weight Regain After Bariatric Surgery page for advice on how to avoid weight regain after gastric sleeve surgery.

See the Revision section below for options to surgically address weight regain.

Revision
Surgical Options to Address Weight Regain

Revision: Surgical Options to Address Weight Regain

Weight regain can happen after gastric sleeve surgery if your smaller stomach stretches over time (more on this in the Downsides section below). This leads some patients to consider gastric sleeve revision surgery.

You have a few surgical options for addressing weight regain:

  • Another sleeve procedure, sometimes called a “re-sleeve”, which is performed exactly like the initial procedure
  • Conversion to a different type of bariatric surgery, such lap band (“band over sleeve”), gastric bypass, or duodenal switch.
  • Gastric plication surgery, whereby the surgeon creates folds inside your stomach to reduce stomach size

While rare, revision may also be required in the case of persistent complications like acid reflux with hiatal hernia (44).

Contact a top surgeon to discuss your options.

Vs Other Types of Surgery
High Weight Loss & Health Benefits Relative to Risk, Less Hunger, Not Reversible

Vs Other Types of Surgery: High Weight Loss & Health Benefits Relative to Risk, Less Hunger, Not Reversible

Gastric sleeve surgery has skyrocketed in popularity.

In the United States, it now makes up over 60% of all weight loss surgery procedures performed, up from 24% in late 2011. During the same time frame, gastric bypass dropped from 62% to 37% of all procedures performed, while gastric banding (e.g. Lap-Band) fell from 7.5% to 0.8% of all procedures performed (56).

Relative newcomers like gastric balloon and vBloc Therapy may also shake things up, depending on how longer-term studies play out.

Picture of Procedure (click to expand)
Picture of Procedure (click to expand)
Video of Procedure
Video of Procedure
External Device Placed Inside Body?
External Device Placed Inside Body?
Year Device/Product Approved
Year Device/ Product Approved
Average Total Cost Before Insurance (U.S.)
Average Total Cost Before Insurance (U.S.)
Covered by Insurance?
Covered by Insurance?
Financing Available?
Financing Available?
BMI Requirements
BMI Requirements
Avg % Excess Weight Loss After 5 Years
Avg % Excess Weight Loss After 5 Years
Health Improvement
Health Improvement
Procedure Type
Procedure Type
Complication Rate
Complication Rate
Mortality Rate
Mortality Rate
Reversible?
Reversible?
Time Until Removed
Time Until Removed
Alters Path of Digestion (Higher Risk of Mal-absorption)?
Alters Path of Digestion (Higher Risk of Mal-absorption)?
Procedure Time (Average)
Procedure Time (Average)
Hospital Stay (Average)
Hospital Stay (Average)
Recovery Time (Back to Work) – Average
Recovery Time (Back to Work) – Average
Diet Challenges (Procedure-Specific; Click here for general diet changes to expect)
Diet Challenges (Procedure-Specific; Click here for general diet changes to expect)
Food Cravings Likely to Decrease?
Food Cravings Likely to Decrease?
Difficulty Swallowing? (due to food backing up because of smaller stomach)
Difficulty Swallowing? (due to food backing up because of smaller stomach)
Digestion & Bowel Movement Post-Recovery (Relatively common issues)
Digestion & Bowel Movement Post-Recovery (Relatively common issues)
Qualified Surgeons
Qualified Surgeons
Patient Guides
Patient Guides
 
Gastric Sleeve
Picture of Procedure (click to expand)
Video of Procedure
Gastric Sleeve
External Device Placed Inside Body?
No
Year Device/Product Approved
n/a
Average Total Cost Before Insurance (U.S.)
$19,000
Covered by Insurance?
Yes (other than some individual policies)
Financing Available?
Yes
BMI Requirements
35 – 39.9 with health problems; 40+ without
Avg % Excess Weight Loss After 5 Years
64 – 75%
Health Improvement
Compare % excess weight loss; the more weight loss, the more health improvement
Procedure Type
Laparoscopic
Complication Rate
Up to 10%
Mortality Rate
0.19%
Reversible?
No
Time Until Removed
n/a
Alters Path of Digestion (Higher Risk of Malabsorption)?
No
Procedure Time (Average)
~2 hours
Hospital Stay (Average)
2 to 3 days
Recovery Time (Back to Work) – Average
~2 weeks
Diet Challenges (Procedure-Specific; Click here for general diet changes to expect)
Potential problem foods: Dairy
Food Cravings Likely to Decrease?
Maybe
Difficulty Swallowing? (due to food backing up because of smaller stomach)
Possible
Digestion & Bowel Movement Post-Recovery (Relatively common issues)
GERD (reflux) in ~1 out of 5 patients after 1 year, drops to 1~ out of 33 patients after 3 year. Some patients experience diarrhea.
Qualified Surgeons
Broad Network – Click Here to Find Surgeon
Patient Guides
(this page)
 
vBloc
Picture of Procedure (click to expand)
Video of Procedure
vBloc
External Device Placed Inside Body?
Yes
Year Device/Product Approved
2015(FDA9)
Average Total Cost Before Insurance (U.S.)
$18,500
Covered by Insurance?
Possible with aggressive negotiation and appeals
Financing Available?
Yes
BMI Requirements
35 – 39.9 with health problems; 40 – 45 without (none over 45)
Avg % Excess Weight Loss After 5 Years
17 – 28%
Health Improvement
Compare % excess weight loss; the more weight loss, the more health improvement
Procedure Type
Laparoscopic
Complication Rate
3 – 4%
Mortality Rate
Close to 0%
Reversible?
Yes
Time Until Removed
Patient-Specific (not necessarily required)
Alters Path of Digestion (Higher Risk of Malabsorption)?
No
Procedure Time (Average)
60 to 90 minutes
Hospital Stay (Average)
Outpatient
Recovery Time (Back to Work) – Average
3 – 4 days
Diet Challenges (Procedure-Specific; Click here for general diet changes to expect)
None, but healthier eating recommended for better results
Food Cravings Likely to Decrease?
Yes
Difficulty Swallowing? (due to food backing up because of smaller stomach)
No
Digestion & Bowel Movement Post-Recovery (Relatively common issues)
None
Qualified Surgeons
Fewer Options – Click Here to Find Surgeon
 
Gastric Bypass
Picture of Procedure (click to expand)
Video of Procedure
Gastric Bypass
External Device Placed Inside Body?
No
Year Device/Product Approved
n/a
Average Total Cost Before Insurance (U.S.)
$24,000
Covered by Insurance?
Yes (other than some individual policies)
Financing Available?
Yes
BMI Requirements
35 – 39.9 with health problems; 40+ without
Avg % Excess Weight Loss After 5 Years
50 – 70%
Health Improvement
Compare % excess weight loss; the more weight loss, the more health improvement
Procedure Type
Laparoscopic
Complication Rate
Up to 15%
Mortality Rate
0.24%
Reversible?
No
Time Until Removed
n/a
Alters Path of Digestion (Higher Risk of Malabsorption)?
Yes
Procedure Time (Average)
~4 hours
Hospital Stay (Average)
2 to 3 days
Recovery Time (Back to Work) – Average
~2 weeks
Diet Challenges (Procedure-Specific; Click here for general diet changes to expect)
Potential problem foods:Sugars, Refined fats, Carbs, Dairy. Malabsorption will require life-long vitamin supple-mentation.
Food Cravings Likely to Decrease?
Maybe
Difficulty Swallowing? (due to food backing up because of smaller stomach)
Possible
Digestion & Bowel Movement Post-Recovery (Relatively common issues)
Dumping syndrome occurs in ~80% of patients who eat sugar, refined fats, or carbs.
Qualified Surgeons
Broad Network – Click Here to Find Surgeon
 
Lap Band
Picture of Procedure (click to expand)
Video of Procedure
Lap Band
External Device Placed Inside Body?
Yes
Year Device/Product Approved
2011 (FDA10)
Average Total Cost Before Insurance (U.S.)
$15,000
Covered by Insurance?
Yes (other than some individual policies)
Financing Available?
Yes
BMI Requirements
35 – 39.9 with health problems; 40+ without
Avg % Excess Weight Loss After 5 Years
25 – 80% (extremely variable among patients)
Health Improvement
Compare % excess weight loss; the more weight loss, the more health improvement
Procedure Type
Laparoscopic
Complication Rate
Up to 33%
Mortality Rate
0.10%
Reversible?
Yes
Time Until Removed
Patient-Specific (not necessarily required)
Alters Path of Digestion (Higher Risk of Malabsorption)?
No
Procedure Time (Average)
~1 hour
Hospital Stay (Average)
Outpatient to 1 day
Recovery Time (Back to Work) – Average
~2 weeks
Diet Challenges (Procedure-Specific; Click here for general diet changes to expect)
Potential problem foods: Dairy. Should not drink anything within 30 minutes before or after eating
Food Cravings Likely to Decrease?
No
Difficulty Swallowing? (due to food backing up because of smaller stomach)
Possible
Digestion & Bowel Movement Post-Recovery (Relatively common issues)
Reflux and vomiting common if band too tight (can be adjusted). Some patients experience constipation.
Qualified Surgeons
Broad Network – Click Here to Find Surgeon
Patient Guides
 
Gastric Balloon
Picture of Procedure (click to expand)
Video of Procedure
Gastric Balloon
External Device Placed Inside Body?
Yes
Year Device/Product Approved
2015 (FDA11)
Average Total Cost Before Insurance (U.S.)
$8,150
Covered by Insurance?
Possible with aggressive negotiation and appeals
Financing Available?
Yes
BMI Requirements
Between 30 & 40 in U.S. (above 27 elsewhere)
Avg % Excess Weight Loss After 5 Years
n/a (must be removed after 6 months; weight loss during that time is 26 – 46%)
Health Improvement
Compare % excess weight loss; the more weight loss, the more health improvement
Procedure Type
Through Mouth
Complication Rate
Up to 10%
Mortality Rate
Close to 0%
Reversible?
Yes
Time Until Removed
6 months max
Alters Path of Digestion (Higher Risk of Malabsorption)?
No
Procedure Time (Average)
30 minutes or less
Hospital Stay (Average)
Outpatient
Recovery Time (Back to Work) – Average
3 – 4 days
Click here for general diet changes to expect)
Potential Problem Foods: Pasta and other foods that might stick to balloon in stomach.
Food Cravings Likely to Decrease?
No
Difficulty Swallowing? (due to food backing up because of smaller stomach)
Unlikely
Digestion & Bowel Movement Post-Recovery (Relatively common issues)
Vomiting possible (but often avoidable with proper habits). “Feeling bloated” reported by some patients.
Qualified Surgeons
Fewer Options – Click Here to Find Surgeon
 
Duodenal Switch
Picture of Procedure (click to expand)
Video of Procedure
Duodenal Switch
External Device Placed Inside Body?
No
Year Device/Product Approved
n/a
Average Total Cost Before Insurance (U.S.)
$27,000
Covered by Insurance?
Yes (other than some individual policies)
Financing Available?
Yes
BMI Requirements
35 – 39.9 with health problems; 40+ without (but more common for 50+)
Avg % Excess Weight Loss After 5 Years
65 – 75%
Health Improvement
Compare % excess weight loss; the more weight loss, the more health improvement
Procedure Type
Laparoscopic
Complication Rate
Up to 24%
Mortality Rate
Up to 1.1% (but procedure tends to be performed on heavier patients who have higher risk)
Reversible?
No
Time Until Removed
n/a
Alters Path of Digestion (Higher Risk of Malabsorption)?
Yes
Procedure Time (Average)
3.5 – 4.5 hours
Hospital Stay (Average)
2 to 3 days
Recovery Time (Back to Work) – Average
~2 weeks
Diet Challenges(Procedure-Specific; Click here for general diet changes to expect)
Malabsorption will require life-long vitamin supple-mentation.
Food Cravings Likely to Decrease?
Maybe
Difficulty Swallowing? (due to food backing up because of smaller stomach)
Possible
Digestion & Bowel Movement Post-Recovery (Relatively common issues)
Might be significant, including frequency, diarrhea, and/or foul-smelling stools/ flatulence.
Qualified Surgeons
Fewer Options – Click Here to Find Surgeon
gastric sleeve surgery

Gastric Sleeve Positives

Generally speaking, gastric sleeve has earned its place as the most popular procedure for several reasons:

  • Weight loss is usually as good as or better than gastric bypass and much better (on average) than after lap band surgery, gastric balloon, or vBloc Therapy.
  • Health Improvement is generally better than after Lap Band, Gastric Balloon, or vBloc Therapy:
    • Diabetes – 55% have their diabetes resolve or improve after one year (57) vs. 44% for lap band surgery
    • High Blood Pressure (hypertension)