Gastric Sleeve Recovery: Timeline, Pain, Diet, & Activity

Reviewed by:  

John Rabkin, MD

Last Updated:  

07/05/2017

Gastric sleeve recovery (vertical sleeve gastrectomy recovery, or “VSG”) includes:

  • Timeline: 4 to 6 weeks to full recovery
    • Hospital Stay: 1 to 3 days
    • Time Off Work: 1 to 3 weeks
  • Pain: Same as experienced after any laparoscopic surgery, managed with medication
  • Diet: Slow transition from clear liquids to solid foods
  • Activity: Slow transition back to regular activity and exercise
  • Challenges: Most side effects like nausea, digestive issues, and body changes go away over time or after adjusting diet/lifestyle habits

Click below for more information about each aspect of gastric sleeve recovery.

01Recovery Timeline
  • Start: 2+ Weeks Before
  • End: 6 Weeks After

Recovery Timeline

gastric sleeve recovery time
BEFORE SURGERYClick for timeline

-2Weeks
  • Education & Goal Setting

Learn as much as possible about the procedure, including how to prepare and what to expect over the short- and long-term.

  • Start by getting a well-rounded understanding of the procedure by thoroughly reviewing our Gastric Sleeve Surgery Patient Guide
  • Attend one of your surgeon’s free seminars/webinars
  • Attend at least one or two in-person support group meetings to learn real-life experiences from other patients (group schedule available through your surgeon’s office)
  • Schedule an in-person consultation with your surgeon to make final decisions and set diet, exercise, and lifestyle goals for long-term success. See our Diet & Life After section for more about what these goals will look like.

-1Week
  • Tour Hospital Facilities

Becoming familiar with the hospital and facility where your surgery will take place will help to reduce any anxiety of being in an unfamiliar place on the day of surgery.

-2Days
  • No Food & Drink
  • Clear Liquids Only

Stop eating all foods and drink only clear liquids during the 2 days before surgery. This will clear out your digestive system before surgery.

Clear liquids 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 eat or drink:

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

-2-4Hours
  • Check In at Hospital
  • Ask About Carbohydrate Drinks

Your surgeon will tell you what time you need to check in.

This is already a big day, so do everything you can to eliminate any other forms of stress. Do your best not to rush around. Set your alarm early to give you more time, and leave your house with plenty of time to spare for any traffic issues.

Talk with your surgeon about taking pre-operative carbohydrate (CHO) supplements (usually in drink form). While some studies show no benefit, others have found it to result in (1)(2):

  • Shorter hospital stays
  • Quicker return of bowel function
  • Less loss of muscle mass

The ERAS protocols referenced above include 2 carbohydrate drinks in the hours leading up to surgery.

DAY OF SURGERYClick for timeline

0Hours
  • 1 to 2 Hour Procedure Time

On average, the gastric sleeve procedure takes between 1 and 2 hours to perform.

If following ERAS protocols, your surgical team will:

  • Give you 8 mg IV dexamethasone at the same time anaesthesia is given
  • Use standardized anaesthesia
  • Use intraperitoneal local anaesthetic (injection directly into the body cavity)
  • Avoid prophylactic nasogastric tubes and abdominal drains

+2-0HOURS
  • Immediate Post-Op Care

After your procedure, your surgical team will:

  • Observe you closely to make sure you are comfortable
  • Use standardized pain and nausea management medications
  • Use standardized methods to prevent deep vein thrombosis
    Deep vein thrombosis (DVT) is a risk after any surgery (bariatric or otherwise) marked by the formation of a thrombus within a deep vein (as of the leg or pelvis) that may be asymptomatic or accompanied by symptoms (such as swelling and pain). DVT is potentially life-threatening if dislodgement of the thrombus results in pulmonary embolism. Preventive measures are extremely important, especially for those with a history of blood clotting problems. Blood thinners and compression stockings help to reduce the risks.

+2-24HOURS
  • Pain Management
  • Start Moving

You’ll be under close observation during the first day of your recovery time after gastric sleeve surgery:

  • Pain: Pain and nausea will be managed with IV medication
  • Diet: No food or drink
  • Activity:
    • You may feel weak or tired, which will start to pass as you transition to your new diet and exercise routine.
    • Start moving around by sitting up, hanging feet off of bed, and standing
POST OPClick for timeline

+1DAY
  • Start Clear Liquids & Basic Exercise

Here’s what to expect the day after gastric sleeve surgery:

  • Pain:
    • You may feel pain in your incision or discomfort from how you were laying during surgery. Some neck or shoulder pain is also common.
    • Each day after surgery you will notice less and less pain. Pain and nausea will continue to be managed with IV medication (you will be able to self-administer the medication as needed with a button).
  • Diet: Start drinking clear liquids after you pass your “leak test” to confirm that your stomach staple line is not leaking
  • Activity:
    • Get out of bed and walk around at least 3 times per day
    • Hourly leg and breathing exercises

+2-3DAYS
  • Leave Hospital
  • Clear Liquids Only

Most patients leave the hospital 2 or 3 days after surgery and transition to the following at-home recovery plan:

Incision Care and Observation:

  • Keep clean: Gently wash with soap and water (no scrubbing), then dry gently but thoroughly
  • Keep covered with sterile bandages
  • Normal healing includes swelling, bruising, and leaking of bloody fluid
  • Contact surgeon if warning signs present, including:
    • Bright red skin around incision
    • Excessive leaking
    • Leaking fluid changes color or thickness
  • Pain: Take prescription pain medication as needed
  • Diet: Continue clear liquids only
  • Activity: Continue your walking, leg, and breathing exercises.

+4DAYS
  • Phone Call with Surgeon

4 days post-op gastric sleeve will be similar to day 3:

  • Incisions: Continue care and observations
  • Pain: Continue prescription pain medication as needed
  • Diet: Continue clear liquids only
  • Activity:
    • Continue your walking, leg, and breathing exercises.
    • Follow up phone call with surgeon

+5DAYS
  • Showers & Light Activity OK

You’ll probably be able to shower and start light activity 5 days in to your gastric sleeve recovery.

  • Incisions: Continue care and observations
  • Pain: Continue prescription pain medication as needed.
  • Diet: Continue clear liquids only
  • Activity:
    • Continue your walking, leg, and breathing exercises.
    • Can start light physical activity (lift no more than 10 lbs/4.5 kg)
    • Can start taking showers or baths (avoid hot tub or jacuzzi)

+1Week
  • Over-the-Counter (“OTC”) Pain Medications
  • Start Liquid/Smooth Foods
  • 2nd Surgeon Call
  • Start Driving

The 7-day mark is a big day for gastric sleeve recovery as you will begin to eat again and can resume driving.

  • Incisions: Continue care and observations
  • Pain: Should no longer need prescription-strength pain meds. Switch to over-the-counter pain medicine like Tylenol and take as needed.
  • Diet:
    • Add thicker drinks and smooth foods (no chunks) (timing varies by surgeon)
    • Nausea or vomiting is common during the first few months following surgery. Some patients also experience constipation, diarrhea, or gas. Adjusting what you eat and how you eat will usually make you feel better.
  • Activity:
    • Continue your walking, leg, and breathing exercises.
    • Continue limiting yourself to light physical activity only (lift no more than 10 lbs/4.5 kg)
    • 2nd follow-up phone call with surgeon
    • Start driving again (unless you are taking any prescription pain meds)
    • Start attending weight loss surgery patient support group meetings through your surgeon’s office (studies show quicker recovery and more weight loss for those who do!)

+2Weeks
  • Pain Gone
  • Start Pureed/Soft Foods
  • Follow-Up Appointment
  • Return to Work

After 2 weeks, the most difficult part of gastric sleeve post-op recovery will be behind you:

  • Incisions:
    • Should be healing nicely and may no longer need bandages, but may still be a bit puffy, itchy, or irritated.
    • Continue care and observations.
    • After the wounds have closed completely, apply special lotions (and sunscreen when exposed to the sun) to minimize scarring.
  • Pain: Should be mostly gone. Continue over the counter medication as needed.
  • Diet:
    • Slowly test pureed & soft solid foods (timing varies by surgeon)
  • Activity:
    • Continue your walking, leg, and breathing exercises.
    • Continue limiting yourself to light physical activity only (lift no more than 10 lbs/4.5 kg)
    • Follow up in-person appointment with surgeon
    • Return to work (ranges from 1 to 3 weeks, depending on patient)
    • Can start using a hot tub or jacuzzi

+3Weeks
  • Start Solid Foods

You’ll get to resume eating solid foods during the 3rd week of your gastric sleeve recovery:

  • Incisions:
    • Continue care and observations.
  • Pain: Probably no longer an issue by this point. Take OTC meds if needed.
  • Diet: Slowly test solid foods (timing varies by surgeon)
  • Activity:
    • Continue your walking, leg, and breathing exercises.
    • Continue limiting yourself to light physical activity only (lift no more than 10 lbs/4.5 kg)

+4-6Weeks
  • Incisions Healed
  • Heavy Lifting OK
  • Start Normal Diet
  • Noticeable Weight Loss

During weeks 4 to 6 of your gastric sleeve surgery recovery time, you’ll transition into your “new normal.” Heavy lifting can resume, and you will begin your new diet and exercise maintenance routine.

  • Incisions: Should be mostly healed.
  • Pain: Probably no longer an issue. Take OTC meds if needed.
  • Diet: Start full long-term maintenance diet (timing varies by surgeon)
  • Activity: Back to normal daily activities and exercise, including heavy lifting

By this point, you will already be noticing significant weight loss. Click here to calculate your weight loss projections.

To learn what to expect after recovery from gastric sleeve, see our Diet & Life After Gastric Sleeve Surgery section.

Click to Collapse SectionClick to Learn More

Enhanced Recovery After Surgery (ERAS)

Patients who use the enhanced recovery after surgery (ERAS) protocols included on this page have (3)(4):

  • 1 day shorter hospital stay, on average
  • Lower costs
  • Possible lower risk of complications

Before moving forward with surgery, ask your surgeon if they are familiar with ERAS gastric sleeve recovery protocols. Share this link if they are not, and note that this page adds to the protocols based on additional best practices.

Q & A: Recovery Time for Gastric Sleeve Surgery

02Incision Care
  • Cleaning instructions
  • Warning signs
  • How to minimize scarring

gastric sleeve recovery time
Click to Collapse SectionClick to Learn More

During your gastric sleeve recovery, do not rush back into your normal daily routine, and don’t lift anything heavy for at least a few weeks. Having sex is okay as soon as you feel up to it, but be extra careful with your healing incisions.

Incision Cleaning Instructions

Keep your incisions clean and covered by:

  1. Gently washing them with soap and water (no scrubbing or soaking)
  2. Air dry them or pat dry with a clean towel
  3. Dress the incisions with sterile bandages/wound dressing

Warning Signs

Swelling, bruising, and leaking a little bloody fluid is normal. But contact your surgeon if you see any of the following warning signs during your gastric sleeve recovery:

  • Bright red skin
  • Excessive leaking
  • Leaking fluid changes color or thickness

Minimize Scarring

After the wounds have completely closed (usually takes about 2 weeks), use the following tips to finish the healing process and minimize scarring:

  • Apply special lotions to minimize the scarring
  • Use sunscreen on your scars when they are exposed to the sun

See our Gastric Sleeve Scars page for more information.

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03Pain During Recovery
  • Managed with IV, prescription, and over-the-counter medication
  • Completely gone in 2 to 3 weeks

gastric sleeve recovery time
Click to Collapse SectionClick to Learn More

The pain experienced during gastric sleeve recovery is similar to what you would experience after any laparoscopic surgery (surgery with small incisions):

  • In-hospital: Right after surgery, pain will be controlled with IV pain medication. You will probably have the ability to “self-administer” your meds as needed by pressing a button.
  • 1st week home: After you leave the hospital, you’re pain will be managed with prescription pain meds
  • 2nd week home: After the first week, pain should have subsided enough for you to switch to over-the-counter pain medicine like Tylenol.
  • 3rd week home: Your pain should be mostly gone. Continue over-the-counter meds as needed.

04Diet During Recovery
  • Diet transition schedule
  • Water & fluid guidelines

gastric sleeve recovery time
Click to Collapse SectionClick to Learn More

Your diet during gastric sleeve recovery will start with clear liquids and slowly transition back to solid foods. However, the speed at which you will transition varies widely by surgeon. Click below to learn more.

Diet Transition Schedule

Conservative Diet Transition

  • Day 1: Nothing to eat or drink
  • Days 2 through 7: Clear liquids only
  • Week 2: Add thicker drinks & smooth foods (no chunks)
  • Week 3: Slowly test pureed & soft solid foods
  • Weeks 4+: Slowly test solid foods

Aggressive Diet Transition

  • Day 1: Start clear liquids and possibly test thicker drinks and smooth foods (no chunks)
  • Day 2: Test pureed & soft solid foods
  • Day 3: Test solid foods

Talk with your surgeon to find which gastric sleeve diet transition schedule they recommend.

See our Gastric Sleeve Diet Page for more information about what you will eat after surgery.

Water & Fluid Guidelines During Recovery

It is important that you drink a lot of fluids during your gastric sleeve recovery – between 48 and 64 ounces per day. That’s equal to about 8 cups or 1/2 a gallon. You may find this tough to keep up with considering the smaller size of your stomach.

Use these tips to keep your water intake up and prevent problems:

  • Keep a low-calorie drink next to you and sip a little every 15 to 20 minutes
  • Designate a special container, measure out your daily amount of fluids every morning and put it in the fridge. Spread your consumption throughout the day so that the container is empty before you go to bed.
  • Do not drink any liquids during your meals or within an hour afterwards. This can flush your meals through your new stomach which can cause you to eat more and contribute to vitamin deficiency.

Not just water!

If you only drink water, you may develop electrolyte abnormalities such as water intoxication syndrome. Make it a point to mix in low-calorie liquids such as unsweetened, caffeine-free herbal tea.

Talk with your team for recommendations specific to you, but most patients are instructed to limit water to no more than half of all fluid intake.

05Activity During Recovery
  • 4 week transition schedule

gastric sleeve recovery time
Click to Collapse SectionClick to Learn More

It will take anywhere from 4 to 6 weeks to transition back to normal activity after gastric sleeve surgery.

  • Day 1: Start simple movements, leg, and breathing exercises as soon as possible: sit up, hang your feet off the bed, and stand.
  • Day 2: Start walking
  • Day 5: Start light physical activity (lift no more than 10 lbs./4.5 kg), and start taking showers or baths (no hot tub or jacuzzi)
  • Day 7: Start driving
  • Day 14: Can start using hot tub or jacuzzi
  • Weeks 4 to 6 (depends on patient): Back to normal daily activities and exercise, including heavy lifting

06Challenges During Recovery
  • Nausea
  • Digestive Issues
  • Body Changes

gastric sleeve recovery time

NAUSEA OR VOMITING

After your stomach is fully healed, you’ll quickly learn what it can and can’t handle. How you eat is as important as what you eat when it comes to preventing nausea and vomiting… avoid eating and drinking too quickly or too much, take small bites and chew your food thoroughly.

BODY ACHES

Body aches should pass with time. If they become too uncomfortable, talk with your doctor about which pain relievers are safe. You should typically avoid NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen or Aleve.

EMOTIONAL DIFFICULTIES

Your emotional state may be a little shaky immediately following surgery. It’s common for patients to feel scared, uncertain, or moody due to hormonal changes and to the emotional effects of adjusting to a new life after weight loss surgery. See the Help & Support section below for more information about how to handle these challenges.

WEAK OR TIRED FEELING

Most likely the result of your body healing and adjusting to less food. It should pass with time, especially once your new bariatric diet is in place and, as soon as you are feeling up to it, begin your exercise program.

FEELING COLD

This is caused by metabolism and weight loss and the fact that you have less fat insulating your body.

CONSTIPATION

Drinking more fluids, eating fibrous foods or taking fiber supplements and moving around regularly should help.

DIARRHEA OR LOOSE STOOLS

Usually diet related and requires the avoidance of “trigger” foods that disagree with your stomach.

GAS

Gas also diet-related.

GURGLING NOISES

Not necessarily uncomfortable, but it’s worth noting. Gurgling noises are completely normal and are due to the different way your smaller gastric sleeve stomach pushes air through. The best way to prevent gurgling noises is to avoid swallowing air (i.e. avoid carbonated beverages, sipping through a straw, eating or drinking too quickly and chewing gum).

HAIR LOSS

This can be an alarming side effect of rapid weight loss, but it is only temporary. It happens in about half of all patients in the year following surgery. Proper nutrition is the best defense, including protein and the right bariatric vitamins. Several other treatments can also help, including the application of special shampoos and oils (Nioxin shampoo, flax seed oil, biotin tablets or powder).

SKIN CHANGES

Such as acne or dry skin occur with some patients. The right bariatric diet and bariatric vitamins are your best defense. There are also many over the counter creams and lotions that can help. Worst case, partner with your dermatologist to find a treatment that works.

THRUSH (YEAST INFECTION)

This can be a side effect of the antibiotics you are on to prevent infection. Symptoms include changes to your tongue such as a white coating, redness or inflammation. Thrush is easily cured with medicine, so let your doctor know if it starts to develop.

Click to Collapse SectionClick to Learn More

Most side effects experienced during your gastric sleeve recovery typically go away over time or after you adjusting your diet or lifestyle habits.

Possible sleeve gastrectomy recovery challenges include:

  • Nausea or vomiting – After your stomach is fully healed, you’ll quickly learn what it can and can’t handle. How you eat is as important as what you eat when it comes to preventing nausea and vomiting… avoid eating and drinking too quickly or too much, take small bites and chew your food thoroughly.
  • Body aches should pass with time. If they become too uncomfortable, talk with your doctor about which pain relievers are safe. You should typically avoid NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen or Aleve.
  • Emotional difficulties – Your emotional state may be a little shaky during your gastric sleeve recovery time. It’s common for patients to feel scared, uncertain, or moody due to hormonal changes and to the emotional effects of adjusting to a new life after weight loss surgery. See the Help & Support section below for more information about how to handle these challenges.
  • Weak or tired feeling – Most likely the result of your body healing and adjusting to less food. It should pass with time, especially once your new bariatric diet is in place and, as soon as you are feeling up to it, begin your exercise program.
  • Feeling cold – this is caused by metabolism and weight loss and the fact that you have less fat insulating your body.
  • Constipation – drinking more fluids, eating fibrous foods or taking fiber supplements and moving around regularly should help.
  • Diarrhea or loose stools – usually diet related and requires the avoidance of “trigger” foods that disagree with your stomach.
  • Gas – also diet-related.
  • Gurgling noises – not necessarily uncomfortable, but it’s worth noting. Gurgling noises are completely normal and are due to the different way your smaller gastric sleeve stomach pushes air through. The best way to prevent gurgling noises is to avoid swallowing air (i.e. avoid carbonated beverages, sipping through a straw, eating or drinking too quickly and chewing gum).
  • Hair loss – this can be an alarming side effect of rapid weight loss, but it is only temporary. It happens in about half of all patients in the year following surgery. Proper nutrition is the best defense, including protein and the right bariatric vitamins. Several other treatments can also help, including the application of special shampoos and oils (Nioxin shampoo, flax seed oil, biotin tablets or powder).
  • Skin changes such as acne or dry skin occur with some patients. The right bariatric diet and bariatric vitamins are your best defense. There are also many over the counter creams and lotions that can help. Worst case, partner with your dermatologist to find a treatment that works.
  • Thrush (yeast infection) – this can be a side effect of the antibiotics you are on to prevent infection. Symptoms include changes to your tongue such as a white coating, redness or inflammation. Thrush is easily cured with medicine, so let your doctor know if it starts to develop.

Between two and six weeks of gastric sleeve recovery time will need to pass before you start feeling balanced and “back to (your new) normal”. For the full list of potential issues, see our Gastric Sleeve Complications page.

07Help & Support
  • Support groups
  • Ask the expert
  • Patient experiences

gastric sleeve recovery time

Patient Experiences

Ask the Expert & Patient Experiences*

Have questions about what to expect during gastric sleeve recovery? Please be as detailed as possible with your question and circumstances so we can get you the answers you need.

Already had surgery?
Other people considering surgery would really benefit from your experiences and advice, so please share them.

Support Groups: Quicker Recovery & More Weight Loss

Regular weight loss surgery support group participation has been found to:

  • Reduce post-op gastric sleeve recovery time
  • Lead to as much as 12% more weight loss

Expert and peer feedback during support group meetings help with countless post-surgery challenges including:

  • Fear before surgery
  • Questions about the future
  • Temptations and how to overcome them
  • Impatience or frustration regarding how quickly the weight is coming off
  • Learning how to interact with the world in your new body
  • Overcoming depression relating to your new diet and changes to existing relationships (both in and out of the home)
  • Diet and recipe tips
  • Relationship advice for at-home and work relationships
Click for Form & Visitor Submissions

Ask the
Expert

Ask the Expert & Patient Experiences*

Have questions about what to expect during gastric sleeve recovery? Please be as detailed as possible with your question and circumstances so we can get you the answers you need.

Already had surgery?
Other people considering surgery would really benefit from your experiences and advice, so please share them.

Support Groups: Quicker Recovery & More Weight Loss

Regular weight loss surgery support group participation has been found to:

  • Reduce post-op gastric sleeve recovery time
  • Lead to as much as 12% more weight loss

Expert and peer feedback during support group meetings help with countless post-surgery challenges including:

  • Fear before surgery
  • Questions about the future
  • Temptations and how to overcome them
  • Impatience or frustration regarding how quickly the weight is coming off
  • Learning how to interact with the world in your new body
  • Overcoming depression relating to your new diet and changes to existing relationships (both in and out of the home)
  • Diet and recipe tips
  • Relationship advice for at-home and work relationships
Click to Collapse SectionClick Here for Recovery FAQ’s & Surgeon Guidelines

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08Find a Top Gastric Sleeve Surgeon
  • Ask for a free insurance check or cost quote
  • Attend a free seminar or webinar
  • Schedule a phone or in-person consultation (both often free)

Search the gastric sleeve surgeon directory below to find a top surgeon by country and region:

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* Disclaimer: The information contained in this website is provided for general information purposes and your specific results may vary depending on a variety of circumstances. It is not intended as nor should be relied upon as medical advice. Rather, it is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her existing physician(s). Before you use any of the information provided in the site, you should seek the advice of a qualified medical, dietary, fitness or other appropriate professional. Read More