Gastric sleeve surgery is an effective treatment option for obese individuals who have struggled to find success with traditional weight loss methods. Weight loss after gastric sleeve can restore your health and fitness and promote an improvement in quality of life. If you’re looking into gastric sleeve weight loss surgery, you’ll want to know how fast and how much excess weight you can expect to lose per month. Understanding the weight loss timeline associated with bariatric surgery is crucial for setting realistic goals, managing expectations, and staying motivated throughout your weight loss journey. Statistics indicate that weight loss numbers after gastric sleeve surgery seem to follow a pattern of milestones.
Introduction
Weight-loss surgery, also known as bariatric surgery, has gained significant popularity as a viable option for individuals struggling with obesity. The decision to undergo weight-loss surgery is a life-changing one, and a common question that arises is, “How quickly will I see results?” While there’s no one-size-fits-all answer, understanding the general timeline for post-surgery results can provide valuable insight into managing expectations and staying motivated on your weight-loss journey.
What is Bariatric Surgery?
Bariatric surgery is a group of procedures that help people lose weight by changing the way their digestive system works. At our surgical center in Birmingham, we focus on minimally invasive techniques. It gives you a powerful boost, but it works best when paired with daily habits that support your health.
Types of Bariatric Surgery and Expected Weight Loss
Several bariatric surgery options are available, each with its unique approach to facilitating weight loss. The type of bariatric surgery combined with patient commitment to their new lifestyle can affect the amount of weight lost.
Gastric Sleeve Surgery (Vertical Sleeve Gastrectomy)
Gastric sleeve targets excess weight by limiting the amount of food you can eat and creating hormonal changes that curb hunger. Gastric sleeve surgery is often chosen after unsuccessful traditional weight loss attempts. Over the past few years, Laparoscopic Sleeve Gastroplasty (LSG) has become the most popular weight loss surgery performed. Gastric sleeve reduces the stomach size by approximately 70 to 80%. A portion of the stomach is surgically removed and the remainder is stapled together in the shape of a small pouch. After undergoing gastric sleeve surgery, the smaller stomach limits the amount of food that the patient can eat. The procedure also removes the portion of the stomach that produces the “hunger-causing” hormone ghrelin so it suppresses the appetite.
Read also: Diet Before Bariatric Surgery
After a Vertical Sleeve Gastrectomy, known as Gastric Sleeve, 80-85% of the patient’s stomach is removed, leaving behind a long, narrow, vertical pouch that can hold about 2-3 oz of food. It is minimally invasive and has no intestinal bypass, making the VSG one of the most dominant bariatric surgeries in the United States, Canada, and Mexico.
By restricting the stomach capacity, increasing sensitivity to satiety hormones, and lowering the production of hunger hormones, gastric sleeve patients can expect to lose almost as much weight as gastric bypass patients while still having a more “normal” diet post-operatively. 12 months after gastric sleeve, patients can shed 23.4% of their baseline weight or 63% of their excess weight. 3 years patients can expect to lose at least 50% of their excess weight. More than 4 years after their surgery, patients normally lose 17.8% of their total body weight or 43.0% of their excess weight.
Gastric Sleeve Weight Loss Timeline
- Immediate Post-Surgery: In the first few weeks, you might experience a rapid drop in weight due to reduced calorie intake and fluid loss.
- Months 1-3: During this phase, weight loss tends to be more noticeable. Many individuals can lose 20% to 30% of their excess body weight during these initial months.
- Months 4-6: Weight loss may continue at a slightly slower pace. You could potentially lose an additional 10% to 20% of excess body weight during this period.
- Long-Term: As you continue to follow dietary and lifestyle recommendations, weight loss can persist, albeit at a more gradual rate. Long-term success depends on consistent adherence to your healthcare team’s guidance.
Gastric Bypass (Roux-en-Y Gastric Bypass)
With a Gastric Bypass or Roux-en-Y Surgery, 90% of the stomach is separated, leaving behind a tiny walnut-sized pouch that bypasses a large portion of the small bowel. The remaining part of the stomach stays in place to build digestive fluids which then reconnects with the bypassed portion of the new stomach pouch. By utilizing two weight loss methods of restriction and malabsorption, the roux-en-y surgery produces sustainable weight loss that lasts longer than the sleeve gastrectomy. Shedding weight is a result of less food consumption and fewer calories getting absorbed into the body. The rate of weight loss is fast and effective in halting obesity-related comorbidities like type 2 diabetes and cardiovascular disease. In less than a year, gastric bypass patients can lose 60 to 80% of their excess weight on average. After 3 to 5 years, RNY patients have reported 30% of their total body weight reduced. At 10 years, patients maintain a consistent loss of 28.6% of their total body weight.
Gastric Bypass Timeline
- Immediate Post-Surgery: The first few weeks will likely involve limited intake and weight loss due to the reduced stomach size and altered digestion.
- Months 1-3: Similar to the gastric sleeve, you might see substantial weight loss during the first few months, typically in the range of 20% to 30% of excess body weight. As you transition to a soft-food diet, your body begins adjusting to its modified digestive process. During this period, weight loss is noticeable due to the restricted caloric intake and the body’s reliance on stored energy.
- Months 4-6: By this stage, you’ll be transitioning to a more varied and textured diet. Weight loss continues, although at a slightly slower pace. The body’s metabolic changes and reduced food absorption contribute to ongoing progress. Weight loss may continue, but as with other procedures, the rate might slow down a bit.
- Long-Term: Continuing healthy eating habits and staying physically active are crucial for maintaining the weight loss achieved through gastric bypass surgery.
Mini Gastric Bypass
The Mini Gastric Bypass (MGB) has similar techniques to the traditional gastric bypass while only having one anastomosis, or “connection.” This is done by pulling a further down portion of the intestines upward to merge with the new stomach pouch. The lower intestines are cut and switched with the upper portion of the intestines to speed up digestion and reduce caloric intake substantially.
Duodenal Switch
Combining aspects from the gastric sleeve and gastric bypass, the DS is designed for patients who need aggressive weight loss and have exceptionally high BMIs of over 45. While the average weight loss timeline after the duodenal switch has stronger and faster results, it is important to follow strict vitamin and diet guides to avoid not losing enough weight. Within the first year, 84% of DS patients lose at least 50% of their excess body weight and up to 80%+. Over 2 years, patients usually lose 60% to 80% of their excess body weight. 84.2% of these patients maintain this weight loss 3 years after the surgery.
Read also: Bariatric Surgery Outcomes
Duodenal Switch Timeline
- Immediate Post-Surgery: Early weight loss can be significant due to the combined restriction and malabsorption effects of the surgery.
- Months 1-3: Weight loss may be substantial during this period, potentially around 30% to 40% of excess body weight.
- Months 4-6: Similar to other procedures, weight loss might continue but could slow down as your body adjusts.
- Long-Term: Given the complexity of this procedure, long-term success hinges on strict adherence to dietary guidelines and close monitoring of nutrient levels.
Adjustable Gastric Band (LAP-BAND)
The Gastric Band, or Lap-Band, is an adjustable silicone ring that creates a small (1-2 ounce or 15-30cc) pouch at the top of the stomach. This temporarily blocks food, slowing down the digestive process and making the patient feel full faster. Based on the patient, the pouch is tightened or loosened for maximum weight loss success. While it moderately restricts the patient’s food consumption, the lap-band weight loss results are almost half as effective as other procedures. There are very few benefits that the lap band offers compared to other surgeries, but it is less invasive and somewhat reversible. After the 1st year, gastric band patients are expected to lose 20% to 60% of excess body weight. By the 5th year after the surgery, 46% of excess weight loss. 10 years after surgery, patients maintain 65% of excess weight loss.
Lap-Band Timeline
- Immediate Post-Surgery: Early weight loss is generally modest in comparison to other procedures due to the gradual adjustments made to the band.
- Months 1-3: Weight loss can vary, but you might expect to lose around 10% to 15% of excess body weight during these months. This period marks continued weight loss as you adopt a more varied diet. Regular follow-up appointments with your healthcare team provide valuable insights and enable adjustments to the band’s tightness for optimal results.
- Months 4-6: As the band is adjusted and you adapt to the new dietary changes, weight loss might continue.
- Month 6+: As you become accustomed to your adjusted lifestyle, weight loss stabilizes. Consistency in adhering to dietary recommendations and regular exercise routines remain pivotal for sustained progress.
- Long-Term: Regular band adjustments, adherence to dietary guidelines, and consistent follow-up with your healthcare team are essential for achieving and maintaining weight loss.
Gastric Balloon
If a bariatric patient wants to avoid an invasive procedure or needs to lose weight extensively before another surgery, they can opt for a non-surgical Intragastric Balloon. The gastric balloon weight loss system is inserted through the esophagus into the stomach, making it uncomfortable to overeat. Based on the gastric balloon system, such as Spatz and Orbera, it is then deflated and removed endoscopically after 6 to 12 months. While the balloon can have positive side effects, it sheds fewer pounds compared to nearly all other procedures and unfortunately, patients can easily go back to bad habits afterward. Unless the patient is satisfied with their weight loss, we recommend revising to vertical sleeve gastrectomy or RNY gastric bypass surgery. Within 6 months, 30-47% excess weight loss is expected with Orbera when it is removed. By 6 months with Spatz, 26.4% excess weight loss. After 12 months, 48.8% excess weight loss with Spatz when it is removed.
General Weight Loss Expectations After Gastric Sleeve
Your weight loss at each stage of the journey will depend on several factors, including your starting weight, post-surgery diet, age, lifestyle, and existing health issues. On average, most patients can expect to lose 8 to 16 pounds per month.
The First Month
Following gastric sleeve surgery, the first month often sees rapid weight loss; such swift progress might not continue. In the first 30 days, most people meet or exceed the average monthly weight loss after gastric sleeve. Most patients start a full liquid diet for 2 weeks before the surgery and then a clear liquid diet from 2 days before to a few weeks after the surgery. Patients must be determined to persevere through this period because although it is the time of the most weight loss, it is also one of the toughest periods. During this first month, patients will normally lose between 10% and 15% of their excess body weight. The post-surgical diet of mostly liquids and pureed foods facilitates rapid changes.
Months 3-6
By this point, you’ll have gradually transitioned from a liquid diet to solid foods. Also, your body will be healed enough that you should be engaging in physical activities. By six months, patients should have lost a significant amount of weight. By the 6-month mark, patients should have reduced their excess weight by 30-40%. With that said, it’s not uncommon for our Tijuana patients who have undergone gastric sleeve surgery to lose 25 pounds or more after six months.
Read also: Is Bariatric Surgery Right for You?
6-12 Months
Half a year after surgery, your weight loss continues but at a slower pace. After six months, weight loss slows to 1-2 pounds monthly for patients, leveling out from that point onward. Patients should expect to lose a significant amount of weight by 12 months after surgery.
12-18 Months
At the 12-month point, you should be getting close to your goal weight if you’ve not reached it already. Most people lose an average of 65-75% of their excess weight by this stage. At the 12-month point, patients should be close to their goal weight if they have not reached it already. Patients who have had gastric sleeve surgery normally lose between 50% and 60% of their excess body weight in 12-18 months. If patients follow their dietary restrictions and exercise programs diligently they may lose more.
18+ Months
Expect your weight loss to level off a year and a half after your gastric sleeve surgery. At the 18-month point, weight loss normally transitions to a maintenance phase and plateaus. To achieve more weight loss, the patient needs to incorporate something into their routine to jump-start and facilitate ongoing weight loss.
Factors Influencing Weight Loss Speed and Extent
Several other factors impact the speed and extent of results after weight-loss surgery:
- Starting Weight: Individuals with a higher starting weight tend to experience more rapid weight loss in the initial stages after weight-loss surgery. This is often due to the body’s initial adjustment and response to the changes brought about by the surgery. As the excess weight is significant, the body may tap into its fat stores more aggressively. This is only the start of your journey.
- Adherence to Guidelines: Adhering to the guidelines provided by the healthcare team, including dietary recommendations and exercise routines, is crucial for achieving the best outcomes after weight-loss surgery. Following these guidelines helps promote a balanced and healthy lifestyle, supports weight loss, and reduces the risk of complications.
- Metabolism: Weight-loss surgery can influence metabolism, and changes in metabolic rate can affect the rate of weight loss. Some individuals experience a temporary slowdown in metabolism after surgery, which might lead to a plateau in weight loss. However, this can often be managed with appropriate adjustments in diet and exercise.
- Physical Activity: Regular physical activity is essential for accelerating weight loss and maintaining muscle mass. Engaging in exercise helps burn calories, increase metabolic rate, and improve overall fitness. It’s also important for preventing muscle loss that can occur during rapid weight loss.
- Nutrition and Diet: Adapting to a new post-surgery diet is essential for successful weight loss and overall health. Proper nutrition ensures that you’re getting the necessary nutrients while managing portion sizes and avoiding foods that could lead to discomfort or complications.
- Psychological Factors: Mental and emotional well-being can affect weight loss outcomes. Addressing psychological factors like stress, emotional eating, and developing a healthy relationship with food is important for long-term success.
- Support System: Having a strong support system, including friends, family, and support groups, can contribute to better adherence to post-surgery guidelines and provide emotional support throughout the weight loss journey.
- Medical Conditions: Certain medical conditions or medications can impact weight loss after surgery. Discussing these factors with your healthcare team is crucial for managing expectations and optimizing results.
- Age: Age can also play a role in weight loss results. Generally, younger individuals tend to experience more rapid weight loss compared to older individuals, but age is just one of many factors at play.
Calculating Excess Body Weight and Expected Weight Loss
To calculate your potential excess weight, start with your current weight. Then, subtract your ideal weight. The difference is your excess weight. Patients can typically expect to lose about 70 percent of their excess weight. As for the timeline in which these changes will occur, noticeable weight loss occurs about six months to a year post-surgery. After the first six months, patients can expect to lose one to two pounds per week.
Example Calculation
Patient A, a woman, currently weighs 250 pounds and is 5’4” tall. According to the BMI calculation using her height, her ideal weight is somewhere between 108 and 145. So for this example, we will choose a goal weight of 127 which is in the middle. Subtracting 127 from 250 reveals her excess weight, indicating her progressive goal of losing 123 pounds. Going a step further, most patients lose 10-15% percent of their excess body weight the first month post gastric sleeve. At the end of the initial month after surgery, her weight would drop by 12-18 pounds, reaching 238-232 pounds.
The Importance of Lifestyle Changes and Realistic Expectations
It is normal for patients to feel eager to lose weight after bariatric surgery, but it’s important to have realistic expectations and understand that weight loss can take time. Bariatric surgery is not a quick fix or a way to instantly lose weight. Weight loss surgery is a tool: it gives you a powerful boost, but it works best when paired with daily habits that support your health. Stick to Your Eating Plan: Follow the guidelines your care team gives you. Take Care of Your Mental Health: Major lifestyle changes can bring up a mix of emotions.
Weight-loss surgery is a powerful tool for achieving significant weight loss and improving overall health. With bariatric surgery, lifestyle changes have to be made for effective and long-lasting weight loss success. The most significant adjustments for bariatric patients are the new dietary and medical arrangements. For the first three months, patients will be transitioning from a liquids-only diet to solid foods while readjusting to their new, lower appetites and food consumption. Patients will also have to take vitamin supplements and avoid certain medications based on their needs and doctor’s orders.
It is crucial that patients use the time, immediately after surgery to radically change their relationship with food. The implementation of eating healthy, portion controlled meals and becoming more active, will help prevent old habits from coming back. Remember bariatric surgery is a tool to be used.
Maintaining Weight Loss and Avoiding Complications
Sticking to a healthy lifestyle is essential for maintaining weight loss results after surgery. If you don’t take the correct precautions, you can easily stretch your stomach sleeve and regain unwanted weight. While vomiting and constipation can be common, it is essential to eat the recommended levels of food and stay properly hydrated. Patients should notify their specialists of any infected incisions and persistent vomiting.