Gastric sleeve surgery for weight loss

If you struggle with weight loss and have a considerable amount to lose, your doctor may recommend bariatric (weight loss) surgery. Gastric sleeve surgery and other bariatric surgery types were developed for people who struggle with serious obesity and haven’t been successful with other weight loss options.

Overall, about 13% of the world’s adult population (more than 600 million people) are obese. Bariatric surgery is currently the most effective treatment for morbid obesity when compared with nonsurgical approaches.

Gastric sleeve surgery (sleeve gastrectomy) is a form of bariatric surgery that removes a large portion of your stomach and leaves behind a narrow section referred to as a sleeve. Gastric sleeve surgery permanently reduces the size of your stomach to help you lose weight. Your doctor likely will advise you that gastric sleeve surgery is only a tool, and that reaching and maintaining a healthy weight requires significant diet and lifestyle changes after the procedure.

Deciding to get bariatric surgery is a big commitment. Our bariatric surgery seminars provide an overview of what to expect before making an appointment with our bariatric surgery team.

Qualifying for gastric sleeve surgery

Your doctor will evaluate your overall health, weight and medical history to determine if you’re a candidate for gastric sleeve weight loss surgery.

According to the American Society for Metabolic and Bariatric Surgery, in order to qualify for bariatric surgery, you must have a body mass index (BMI) of 40 (or more or be more than 100 pounds overweight) or have a BMI of 35 or more and at least one of the following obesity-related medical conditions:

• Diabetes
• Gastrointestinal disorders
• Heart disease
• High cholesterol
• Hypertension
• Nonalcoholic fatty liver disease
• Osteoarthritis
• Sleep apnea

You also must have failed to achieve and sustain a healthy weight loss with prior weight loss efforts. Qualifying for gastric sleeve surgery also depends on your doctor’s evaluation and physical examination.

Preparing for gastric sleeve surgery

After meeting with your doctor and surgeon, you'll receive a series of medical tests and health screenings. You may also have a psychological evaluation to assess your mood, social and family support, substance use, cognitive function, psychosocial status, motivation and willingness to undertake behavioral changes, as well as a nutritional evaluation.

Most nutritional evaluations involve a clinical interview to assess your knowledge and expectations about bariatric surgery. You also may be asked about when you began having weight problems and if you have a family history of obesity. Other questions may pertain to your eating behaviors and habits, previous weight loss regiments and your physical activity.

Before your gastric sleeve surgery, you'll attend medical weight management classes to learn how the surgery will change your eating habits and life. A supervised weight management program, including a low-calorie diet, is also often recommended.

Modest weight loss before surgery has been associated with advantages, such as shortening the time of the gastric sleeve surgery and providing a protective effect in people with nonalcoholic fatty liver disease. This condition makes the liver more susceptible to bleeding during surgery. A small weight loss can help reduce the size of the liver and the risk of bleeding.

What to expect during and after gastric sleeve surgery

During gastric sleeve surgery, the surgeon removes part of the stomach, and the remaining stomach resembles a slender tube or (sleeve). After the process, you’ll have a smaller appetite, so you’ll eat less and feel fuller longer. This helps encourage slow, steady weight loss. Most people are able to lose 55% to 65% of their extra weight after gastric sleeve surgery.

Aurora surgeons usually perform gastric sleeve surgery laparoscopically with very precise instruments. This means you’ll have only a few small incisions, so you’ll spend a shorter time in the hospital and heal faster with less scarring. The process takes about two hours, and most people go home two days later.

Most people go back to work a week or two after gastric sleeve surgery. You’ll need to avoid anti-inflammatory medications like ibuprofen and steroids for a month.

Dietary recommendations after gastric sleeve surgery

Right after surgery, you’ll need to be gradually reintroduced to eating solid foods over approximately two to three months. You’ll be on a liquid diet at first, and then gradually return to eating regular foods by transitioning to pureed foods, soft foods and then solid foods at about week eight.

Liquid foods

• Broth
• Decaffeinated tea or coffee
• Milk (skim or 1%)
• Sugar-free gelatin or popsicles
• Unsweetened juice

Pureed foods

After about a week of consuming only liquids, most people can begin eating pureed foods. Puree foods such as cooked cereal, lean meats, fish and cooked vegetables in a blender or food processor until they are the consistency of a smooth paste or thick liquid. You can also blend them with water, skim milk, unsweetened juice or broth.

Soft foods

With guidance from your doctor, most people can begin eating soft foods such as rice and soft fruits and vegetables after a few weeks of eating pureed foods.

Solid foods

After about eight weeks after surgery, your team will likely recommend that you begin eating solid foods. Try new foods one at a time.

Be especially careful with carbonated drinks, popcorn, raw vegetables and fibrous meats, which can cause pain, nausea or vomiting. Over time, you might be able to try some of these foods again, with the guidance of your doctor.

General dietary guidelines

At every stage of your gastric bypass diet you’ll want to:

• Eat lean, protein-rich foods daily, such as lean beef, chicken, fish and beans
• Take vitamin and mineral supplements daily according to your health care team’s recommendations
• Take small bites
• Divide food intake into four to six meals throughout the day
• Chew well in a relaxed manner
• End meals when feeling comfortably full
• Limit consumption of calorie-dense foods and beverages such as smoothies, ice cream, milkshakes, juices, candy, cakes and cookies
• Reduce sugar intake
• Eliminate carbonated beverages
• Separate consumption of liquids and solids by drinking 15 minutes before or 30 minutes after meals
• Drink at least 64 ounces of fluid every day to prevent dehydration

Lifestyle recommendations after gastric sleeve surgery

Dietary treatment after gastric sleeve surgery covers not only nutritional recommendations but numerous aspects related to promoting a healthy lifestyle such as physical activity, limited alcohol consumption and quitting smoking. In addition, self-monitoring by regular weight checks and food diaries is recommended to prevent weight regain.

Long-term weight loss after gastric sleeve surgery requires regular and supportive management by qualified health care professionals. Adhering to follow-up results in fewer postoperative adverse events and greater excess body weight loss.

Other types of bariatric surgery

In addition to gastric sleeve weight loss surgery, there are two other kinds of bariatric surgery available through Aurora Health Care: adjustable banding surgery and Roux-en-Y gastric bypass. Your doctor and bariatric surgical team can help you determine which type is best for you. Find an Aurora bariatric surgical team for gastric sleeve surgery near you.