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How does a sleeve gastrectomy work?



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Sleeve gastrectomy surgery reduces the size of the stomach by stapling along its length to form a long tube that looks similar to a banana. The majority of the stomach is then removed and discarded. The new banana shaped stomach is long and thin hence is often referred to as a ‘sleeve’.



Sleeve gastrectomy surgery reduces the size of the stomach by stapling along its length to form a long tube that looks similar to a banana. The majority of the stomach is then removed and discarded. The new banana shaped stomach is long and thin hence is often referred to as a ‘sleeve’.

About 80-90% of the stomach is removed making it much smaller, hence it holds much less food than it did previously. This smaller stomach helps you feel satisfied after eating a small amount of food. In addition, the part of the stomach that is removed is the part that secretes much of the hormone called ghrelin, which is involved in stimulating appetite. It is thought that producing less ghrelin further helps to reduce hunger after surgery. Although ghrelin levels start to rise again after surgery, they don’t seem to return to their previous levels and so hunger is more easily satisfied.

Unlike the adjustable gastric band the sleeve gastrectomy is not reversible. The stomach may stretch, or adapt to fit a little more food, but it cannot grow back. A sleeve gastrectomy therefore is a commitment for life.

As you will be eating less after sleeve gastrectomy, making the most of your food choices is important to help you obtain all the nutrients required for good health.

Following a sleeve gastrectomy most people will lose most of their excess weight in the first year. After this time weight loss often stabilises, so make the most of this period by making good food choices and regular physical activity a habit for life. After the first year, your ongoing success will depend on your efforts to change your lifestyle and maintain these habits in the long term.

Whilst the size of the stomach changes after surgery, the type of foods that can be eaten does not. Choosing high-energy (calorie or kilojoule) foods regularly will hinder your progress. As with other types of weight loss surgery, snacking or grazing, lack of physical activity and poor food choices can lead to weight regain. Positive, lifelong changes to eating and physical activity will ensure your long-term success.

Poor food choices can also cause dumping syndrome. Dumping syndrome had been thought to occur only following gastric bypass surgery, however it has been seen following sleeve gastrectomy surgery. Avoiding fatty or sugary foods will help prevent dumping syndrome. We will discuss dumping syndrome in a coming edition of the newsletter, but for now you can see a simple explanation here. Avoiding fatty or sugary foods will help prevent dumping syndrome.

A 2011 study found that those who had regular follow up after sleeve gastrectomy achieved better weight loss, health improvement, quality of life and food tolerance, than those who did not. Your support team is there to guide you to acheive the best results following surgery, so make the most of the team and keep in touch! They have all sorts of hints and tips to help you achieve success on your weight loss journey.

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Great comments Sally,

I think the other item I would add is that drinking also makes a difference. I don't drink anything but Water, Powerade Zero, or other zero calorie drinks. I can manage an ounce or so of milk in coffee but its got to be a good amount of coffee and drank over a 10-15 min period or so.

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    • Theweightisover2024🙌💪

      Question for anyone, how did you get your mind right before surgery? Like as far as eating better foods and just doing better in general? I'm having a really hard time with this. Any help is appreciated 🙏❤️
      · 2 replies
      1. NickelChip

        I had about 6 months between deciding to do surgery and getting scheduled. I came across the book The Pound of Cure by Dr. Matthew Weiner, a bariatric surgeon in Arizona, and started to implement some of the changes he recommended (and lost 13 lbs in the process without ever feeling deprived). The book is very simple, and the focus is on whole, plant based foods, but within reason. It's not an all or nothing approach, or going vegan or something, but focuses on improvement and aiming for getting it right 80-90% of the time. His suggestions are divided into 12 sections that you can tackle over time, perhaps one per month for a year if a person is just trying to improve nutrition and build good habits. They range from things like cutting out artificial sweetener or eating more beans to eating a pound of vegetables per day. I found it really effective pre-surgery and it's an eating style I will be working to get back to as I am further out from surgery and have more capacity. Small changes you can sustain will do the most for building good habits for life.

      2. Theweightisover2024🙌💪

        That sounds awesome. I'll have to check that out thanks!

    • BeanitoDiego

      I've hit a stall 9 months out. I'm not worried, though. My fitness levels continue to improve and I have nearly accomplished my pre-surgery goal of learning to scuba dive! One dive left to complete to get my PADI card 🐠
      I was able to go for a 10K/6mile hike in the mountains two days ago just for the fun of it. In the before days, I might have attempted this, but it would have taken me 7 or 8 hours to complete and I would have been exhausted and in pain for the next two days. Taking my time with breaks for snacks and water, I was finished with my wee jaunt in only 4 hours 😎 and really got to enjoy photographing some insects, fungi, and turtles.
      Just for fun last week, I ran two 5Ks in two days, something I would have never done in the past! Next goal is a 10K before the end of this month.
      · 0 replies
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    • Teriesa

      Hi everyone, I wrote back in May about having no strength. I still get totally exhausted just walking from room to room, it’s so bad I’m using a walker with wheels of all things. I had the gastric sleeve Jan. 24th. I’m doing exactly what the programs says, except protein shakes. I have different meats and protein bars daily, including vitamins daily. I do drink my fluids as well.  I go in for IV hydration 4 days a week and feel ok just til evening.  So far as of Jan 1st I’ve dropped 76 lbs. I just want to enjoy the weight lose. Any suggestions or has anyone else gone thru this??  Doctor says just increase calorie intake, still the same. 
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    • Clueless_girl

      Losing my hair in clumps and still dealing with "stomach" issues from gallbladder removal surgery. On the positive side I'm doing better about meeting protein and water goals and taking my vitamins, so yay? 🤷‍♀️
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