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 surgery can restore your health and fitness and promote an improvement in quality of life. If you're considering gastric sleeve weight loss surgery, understanding the expected weight loss timeline can help you manage expectations, set realistic goals, and ultimately achieve your desired weight.
How Gastric Sleeve Surgery Works
Gastric sleeve surgery, also known as sleeve gastrectomy, involves removing 70-85% of the stomach. The procedure targets excess weight by limiting the amount of food you can eat and creating hormonal changes that curb hunger.
There is a reduction in stomach volume, causing people to feel full much quicker after the surgery. Hormonal changes, such as reduced secretion of hunger hormones, cause people to feel less hungry. Increased stomach motility allows food to pass through the stomach and intestine quicker after surgery.
History and Trend of Gastric Sleeve Surgery
Initially, the gastric sleeve was the restrictive part of the biliopancreatic diversion duodenal switch operation. Then, the gastric sleeve became the first stage operation for very obese patients who underwent duodenal switch operation to reduce the perioperative risks. Some patients lost enough weight after the gastric sleeve surgery and did not undergo the planned second stage duodenal switch operation. These findings prompted bariatric surgeons to consider the gastric sleeve surgery as a standalone bariatric procedure. The first laparoscopic Gastric Sleeve was performed in 2000.
Over the past decade, the number of gastric sleeve surgeries continues to increase nearly every year. Now, more than half of all bariatric surgeries performed in the US are gastric sleeve procedures.
Read also: Comprehensive Guide to Gastric Bypass Diet
Weight Loss Expectations After Gastric Sleeve Surgery
The gastric sleeve weight loss timeline is not clear-cut and can vary significantly from person to person. Factors such as metabolism, diet, activity level, and overall health all influence how quickly you shed pounds after surgery. The amount of excess weight loss has a strong correlation with adherence to the post-surgery dietary plan, healthy lifestyle habits, and exercise regimen.
On average, people lose about 60-70% of their excess weight. Most people reach their lowest weight 12-24 months after surgery. The Gastric Sleeve success rate is approximately 80-90%.
Month 1
Expect to lose about 10-20 pounds. This varies based on starting weight, adherence to dietary guidelines, and activity levels. Initial weight loss is rapid, primarily due to a liquid diet and reduced calorie intake. Focus on recovery. Patients may also experience weight loss stalls at the 3-week mark which is normal due to changes in muscle mass, hormonal shifts, or water retention. Transition from a clear liquid diet to a full liquid diet, then to pureed foods.
Months 2-3
Average weight loss is around 8-12 pounds per month. Patients often notice significant changes in their energy levels and physical appearance. Gradual introduction of soft foods. Continue focusing on protein intake and staying hydrated. Start incorporating light exercise, such as walking or low-impact activities, as approved by your surgeon.
Months 4-6
Approximately 5-10 pounds per month. The pace may slow compared to the initial months but remains consistent. Solid foods are reintroduced. Emphasis on balanced, nutrient-dense meals. Portion control becomes crucial. Increase activity intensity. Incorporate strength training to support muscle mass.
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Months 7-9
Around 3-8 pounds per month. Many patients hit significant weight loss milestones during this period. Well-balanced, solid food diet. Focus on long-term eating habits and maintaining portion sizes. Regular, varied exercise routine. Cardio, strength training, and flexibility exercises are recommended.
Months 10-12
2-5 pounds per month. Around this time, patients often reach or approach their target weight. Maintain healthy eating habits established throughout the year. Pay attention to any dietary issues and adjust as necessary. Consistent and challenging exercise regimen. Consider working with a fitness professional to optimize results.
Year 1 and Beyond
Continue monitoring weight and make adjustments as needed. Most patients achieve 60-70% excess weight loss within the first year. Lifelong commitment to healthy eating. Avoid old habits that could lead to weight regain. Stay active. Incorporate enjoyable physical activities to maintain weight and improve overall well-being.
Factors Influencing Gastric Sleeve Weight Loss
Several factors can affect your weight loss results after gastric sleeve surgery. These include your starting weight, post-op diet, lifestyle, age, race, health-related issues, and the surgeon's skills. The beginning months are crucial for setting the stage for long-term success, as the body adjusts to new eating habits and changes.
- Starting Weight: Higher starting weights often result in more significant initial weight loss.
- Diet Adherence: Following dietary guidelines is critical for successful weight loss.
- Exercise: Regular physical activity accelerates weight loss and improves overall health.
- Metabolism: Individual metabolic rates can affect the pace of weight loss.
- Support System: Emotional and psychological support from healthcare professionals, family, and friends is vital.
Improvement of Obesity-Related Health Problems
Large clinical trials and studies have proven gastric sleeve surgery lead to resolution or improvement of many obesity-related health problems such as:
Read also: Guide to Pureed Foods Post-Surgery
- Type 2 diabetes: Most studies indicated that 60-80% of patients with type 2 diabetes could achieve disease remission or improvement after gastric sleeve surgery
- Hypertension
- Fatty liver disease
- High cholesterol
- Sleep apnea
- Decreased cancer risk
- PCOS
- Asthma
- Migraine
- Joint pain
- Depression and other psychosocial problems
- Infertility
- Low testosterone: Gastric sleeve can naturally lead to increased testosterone level
- Urinary incontinence
- Gout
Eligibility and Insurance Coverage
Most insurance companies cover bariatric surgery, when you meet the following criteria:
- BMI greater than 40, or
- BMI of 35-39.9 with one of the obesity related health problems such as:
- Hypertension
- Type 2 diabetes
- Sleep Apnea
- Fatty liver disease, or
- Hyperlipidemia
For patients with BMI of 30-34.9, insurance will not cover bariatric surgery procedures. However, there are self-pay options for those individuals who have struggled with obesity for a long time, especially those with obesity related health problems.
Recovery After Surgery
The surgery takes approximately 40-70 minutes. Discharge from hospital typically occurs after 1-2 nights. All patients are encouraged to walk as early as 3-4 hours after surgery. In general, the pain is easily manageable after surgery. Most patients take less than the recommended pain medication. Most patients go back to work and/or school after 2-4 weeks. Fatigue is common the first 2 weeks due to low calorie intake from liquid diet. However, the majority of patients do not feel hungry during this stage of the diet. The energy level improves quickly after the introduction of the soft diet, which is approximately 3 weeks after surgery. Patients can begin exercising 4 weeks after surgery.
Complications and Risks
Over the past decade, with the improvement of surgical techniques and surgeons’ experience, the gastric sleeve has become an overall safe bariatric surgical procedure. However, complications can still occur during and after surgery. Below are the main complications and risks of the gastric sleeve surgery:
- Leakage from the staple line - this is a rate complication of the gastric sleeve surgery. The stable line opens after surgery. Most leaks can be treated with endoscopic procedure.
- Stricture/stenosis - another rare complication with narrowing of the stomach after sleeve gastrectomy. Most stricture/stenosis can be treated with endoscopic dilation.
- Bleeding
- Blood Clot
- Heart Burn - This is a very controversial topic in bariatric surgery and the data from different centers is inconsistent. In our experience, most patients with heartburn before surgery see improvement of symptoms after surgery due to weight loss. Some patients may develop new heartburn, which is treatable with over-the-counter anti-acid medications, in most cases.
- Nutrient or vitamin deficiency
- Weight Regain - After 1-2 years, slight weight regain is common among all bariatric procedures and about 10-20% of patients can have significant weight regain after gastric sleeve surgery. After 5 years of follow up, many centers collected data to show that the majority of patients can maintain their weight loss after the Gastric Sleeve Surgery.
- Excess skin, in some cases, insurance will cover excess skin removal
Diet After Gastric Sleeve Surgery
- Day 1: Clear liquid diet. Some surgeons allow patients to drink water a few hours after surgery
- Days 2-21: Full liquid diet including protein shakes, yogurt, broth, milk, and juice
- Weeks 4-6: Soft food diet
- Patients can begin introducing regular food 6 weeks after surgery. They are encouraged to eat a small amount of food each time and have meals that are more frequent.
- All patients must take multi-vitamin and B complex after surgery
Comparison of Gastric Sleeve to other Types of Bariatric Procedures
Laparoscopic gastric banding (Lap-band) was once very popular. However, due to its high rate of long term complications and inferior weight loss, the number of Lap-band surgeries went down every year in the US and worldwide. Most of the US large academic Bariatric Surgery Centers rarely perform the Lap-band procedure at this time.
Laparoscopic Roux-en-Y Gastric Bypass Surgery is the gold standard of bariatric surgery. However, Gastric Sleeve has replaced the Gastric Bypass Surgery as the most popular bariatric surgery in recent years due to its technical simplicity and fewer long-term complication rates.
Advantage of Gastric Sleeve versus Gastric Bypass Surgery
Technically, the Gastric Sleeve is a much simpler surgery. The operating time for gastric sleeve is usually 40-70 minutes, while gastric bypass surgery takes approximately 2-3 hours to complete.
There is a much lower chance for nutrient or vitamin deficiency with the Gastric Sleeve procedure. In addition, there is no mal-absorption for Gastric Sleeve patients.
Some long-term complications could occur with the Gastric Bypass patients including bowel obstruction, marginal ulcer, and internal hernias.
Maintaining Long-Term Results
Maintaining the results of gastric sleeve surgery is a lifelong commitment. You need to be willing to change your lifestyle, particularly in diet and exercise. Regular physical activity not only helps burn calories but also allows your body to boost metabolism as well as improves cardiovascular health. It is important to remain in steady contact with your physician and the bariatric team to monitor your progress. Also, be honest about where you are mentally and physically.