If you are 80 or more pounds overweight, gastric sleeve surgery is one of the safest and most reliable options for significant, fast, and long-term weight loss.
During the procedure, your surgeon will drastically reduce the size of your stomach.
From Day 1, you won’t feel as hungry, and you won’t be able to eat nearly as much as you used to. As a result, you’ll lose most of your excess weight within one year.
For example, a patient who is 5 feet, 4 inches tall and weighs 220 pounds can expect to lose up to 55 pounds in the first year. Someone who is 5 feet, 9 inches tall and weighs 300 pounds will lose up to 95 pounds that first year.
To see if you qualify for surgery and to learn about the risks, benefits, and what to expect, continue reading below.
TABLE OF CONTENTS
Click on any of the topics below to jump directly to that section
- Qualification Requirements
- How the Gastric Sleeve Works
- Calculate Your Weight Loss
- Health Benefits to Expect
- Risks, Side Effects, & Challenges
- Cost of Gastric Sleeve: Insurance Coverage Vs. “Self Pay”
- Surgery Preparation & Recovery
- Your New Post-Op Diet & Lifestyle
- Compare Other Weight Loss Procedures
- Take the Gastric Sleeve Knowledge Quiz
- Questions & Answers from Other Patients
- Find a Surgeon
The gastric sleeve procedure is done for patients of all ages, although it is most commonly performed on adults between 18 and 65 years old.
In order to qualify for gastric sleeve surgery, your body mass index (BMI) needs to be at least 35.
If you do not suffer from ANY obesity-related health issues (hypertension, sleep apnea, diabetes, joint problems, etc), then your BMI must be at least 40.Click Here to See Your BMI
The gastric sleeve procedure, also called vertical sleeve gastrectomy, is done laparoscopically (using small incisions) and takes 1 to 2 hours.
During surgery, your surgeon will make between 1 and 5 small incisions in your abdomen (which minimizes scars), insert various laparoscopic instruments, and remove about 80% of your stomach. This leaves a banana-shaped “sleeve” that connects the esophagus to the small intestines.
Your much smaller stomach will cause you to feel full sooner while eating so you’ll eat less and, as a result, achieve long-term weight loss.
You can expect to lose a lot of weight very quickly after your procedure.
Most patients lose up to half of their excess weight in 6 months and almost three quarters of their excess weight within one year.Click Here to See How Much Weight You Could Lose
- Sleep apnea
- Type 2 diabetes
- Cholesterol problems
- Joint problems
You’ll also reduce your risk of future disease.
For example, a prominent cancer study found that weight loss surgery patients have a 33% lower risk of developing ANY type of cancer than people with severe obesity who do not undergo bariatric surgery. Cancer risk that is specifically related to obesity goes down even further (3).Click Here to See A Full List of Health Benefits
However, there are several side effects and challenges to be aware of.
About 1 in every 5 patients experience Gastroesophageal reflux disease (GERD) in the first 12 months. The good news is that this tends to be a shorter-term issue. After 3 years, the GERD rate drops to around 3% of patients (6).
- Indigestion (Dyspepsia)
- Developing an intolerance to some food types
- Vomiting or nausea
- Vitamin deficiency
These digestive issues can often be addressed and fixed with diet and behavior changes.
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.
The extra skin may be embarrassing. It can also cause several issues ranging from minor to severe, including:
- Hard time getting dressed
- Uncomfortable to exercise
- Skin problems, such as rashes and infections
In some cases, patients manage sagging skin with body-contouring undergarments. In more serious cases, patients have plastic surgery to remove the excess skin. Surgery to remove excess skin is often covered by insurance.
After two years, about 1 out of every 20 gastric sleeve patients have gained back some weight from their low point.
The reasons for weight regain?
- Consuming calories in liquid form, such as protein shakes, pureed foods, smoothies, etc. Your new sleeve stomach works by making you feel full sooner when you eat. Since liquids don’t make you feel as full as solid foods, you’ll eat more and gain weight if you get your calories from liquids instead of solids.
- Overeating or eating the wrong things. This can stretch out the smaller gastric sleeve stomachs over time which will allow you to eat more and gain unwanted weight.
Remember, gastric sleeve is one of the best tools for weight loss, but it is only a tool. To avoid weight regain, you’ll need to eat the right foods and make the right lifestyle choices.
If your health insurance includes coverage for bariatric surgery and you have a qualifying body mass index, then the gastric sleeve procedure will be covered after you complete a medically-supervised diet program.Click Here to Check Your Insurance
If bariatric surgery is not included in your policy, then your only option is to pay for the procedure yourself, also called “self pay”.
According to our annual surgeon cost survey, the average self-pay cost is $19,000 in the United States. However, many practices charge much lower than this, with some practices getting as low as $10,000.
Click here for an interactive map of average gastric sleeve costs by country, region, and state.
You will follow a detailed plan in the weeks leading up to surgery, including several tests, doctor visits, and a strict pre-surgery diet regimen.
Your goal will be to start practicing the right habits that you’ll need after surgery in order to be successful. The right pre-op habits will also cause you to lose weight before surgery which will help to minimize the risk of complications.
After surgery, you’ll be in the hospital for 2 or 3 days. Most patients can return to work in one to three weeks. Full recovery happens in 4 to 6 weeks.
During the first couple of years after surgery, your new smaller gastric sleeve stomach does much of the work. Even patients who “cheat” on their prescribed diet and exercise regimen see amazing results.
But after 2 years, it becomes easy to see which patients have made the permanent diet and lifestyle adjustments and those patients that have not. Those who let themselves slip can expect their smaller stomachs to stretch back out which leads to significant weight regain and the return of health problems.
If you’re serious about keeping your weight off long-term, you’ll need to stick to your surgeon’s diet and exercise plan.
Also be mindful that big changes are likely to happen to many of your relationships as they are confronted with the new “skinny” you.
Your New Diet
At a high level, your new diet will look like this:
- Healthy meals (mainly whole foods; limited processed foods)
- 60+ grams of protein per day
- No fibrous foods, starchy foods, greasy or spicy foods, whole milk products, or sugar
- Lots of water or low-calorie fluids (2+ liters per day)
- No sodas, alcohol, sugary drinks
- Don’t drink anything around meal time (30 min before and after)
- Small portion sizes cut into small pieces, chewed slowly and thoroughly
- Stop eating when you feel “80% full”
- No (or limited) snacking
- Strict vitamin and supplement regimen
Click here for all of the details about your new short and long-term diet after gastric sleeve surgery.
Your New Exercise Regimen
Most surgeons recommend 2 and a half hours per week of moderate exercise.
In addition to improving your physical fitness which will improve your quality of life, patients who exercise 2.5 hours each week lose about 6% more body weight than patients who don’t. For every 17 pounds that you lose, that’s an additional pound that will come off (11, 12).
Patients who seek the help and support from other patients do much better than those who “go it alone.” In fact, patients who regularly attend weight loss surgery support group meetings experience about 12% more weight loss than those who don’t (13).
Talk with your surgeon about available support groups in your area.
Real Patient Experiences After Gastric Sleeve
The links below will take you to stories submitted by real patients about what life is like at various time frames after gastric sleeve surgery.
- 5 Months Post-Op (Murray from Canada)
- 16 Months Post-Op (Molly from Florida)
- 3 Years Post-Op (Mary from Australia)
- 4 Years Post-Op (Essjay from the UK)
Gastric sleeve is the most popular type of weight loss surgery, but there are other good options as well. Each carries its own set of Positives and Negatives.
If you’re unfamiliar with the other types of surgery, click the button below for an overview.Summary of All Weight Loss Procedures
For a complete comparison of all procedures, click here.
Gastric Sleeve Surgery Positives
Gastric sleeve has earned its place as the most popular procedure for several reasons:
- Weight loss is as good or better than gastric bypass. It is much better than after Lap-Band surgery and gastric balloon.
- Health Improvement is better than every procedure other than duodenal switch.
- Reduced hunger – only gastric sleeve and duodenal switch make you feel less hungry.
- Short-term risks associated with gastric sleeve surgery are similar to gastric bypass and lower than duodenal switch.
- Long-term risks associated with gastric sleeve surgery are lower than gastric bypass, duodenal switch, and Lap-Band surgery.
- No external device – There is no external device left inside the body after gastric sleeve surgery as there is with Lap-Band, gastric balloon, and AspireAssist, so there is no risk of device-related complications. While the risk of device-related complications is relatively low for gastric balloon and AspireAssist, it is a concern and should be considered for Lap-Band.
- Compared to gastric bypass and duodenal switch (DS):
- Comparable improvement in obesity-related health problems
- Quicker recovery than bypass or DS
- Complication rates are lower than bypass or DS
- Risk of vitamin deficiency is lower than bypass or DS
- Little to no risk of dumping syndrome (unlike gastric bypass)
- Side effects like nausea, vomiting, or diarrhea should be less likely than bypass or DS. If present, they are usually less severe than after gastric bypass.
- Less expensive overall than bypass or DS. Similar cost if you have insurance that covers weight loss surgery.
- If you are on anticoagulation medication (blood thinners), gastric sleeve surgery is probably a better choice than gastric bypass to reduce the risk of marginal ulcers.
- Compared to Lap-Band surgery:
- Risk of long-term gastroesophageal reflux disease (GERD) is lower with gastric sleeve
- Risk of esophageal dilation, pouch dilation, and food trapping is much lower with gastric sleeve
- No risk of external-device-related issues like Lap-Band erosion, band slippage, or port problems with Lap-Band surgery
- Much lower risk of long-term complications than Lap-Band surgery
- Fewer follow up doctor visits required than after Lap-Band surgery
- More expensive overall than Lap-Band surgery. Similar cost if you have insurance that covers weight loss surgery.
- No dumping syndrome – Dumping syndrome (extremely uncomfortable digestive problems) is experienced by up to 7 out of 10 gastric bypass patients, although many patients report this being a “good thing” since it helps them keep their diet on track. Dumping syndrome is uncommon after gastric sleeve surgery.
- Cost With Insurance – The cost of gastric sleeve for patients with insurance is ~ $3,500 (as a result of deductibles, copays, coinsurance, etc), which tied for the lowest with gastric bypass, duodenal switch, and Lap-Band surgery (gastric balloon and AspireAssist is usually not covered by insurance).
Gastric Sleeve Surgery Negatives
The gastric sleeve also has negatives compared to some of the other bariatric surgery types:
- Not reversible – Unlike Lap-Band, gastric balloon, and AspireAssist, gastric sleeve surgery is irreversible. You cannot change back your smaller stomach. This is not necessarily a “negative”, but it is worth noting.
- Weight loss (on average) is usually less than after duodenal switch.
- Health Improvement is generally not as good as gastric bypass or duodenal switch.
- Short-term risk is higher than Lap-Band, gastric balloon, and AspireAssist.
Gastric Sleeve: Test Your Knowledge
Well-educated patients are more likely to be successful over the long-term. Test your knowledge to ensure that you’re ready to take the next step!
Click the form field below to ask our experts a question or to share you experiences.
Scroll down to review questions and experiences from others.
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