What Is Gastric Sleeve Surgery And How Does It Work?
Gastric sleeve surgery is a procedure where approximately 75% to 85% of the stomach is surgically removed, leaving behind a thin, banana-shaped tube. This process primarily ensures that the patient feels full with much less food by dramatically reducing the stomach volume. The secondary and more significant effect is the reduction of the level of ghrelin, known as the hunger hormone, which is produced in high amounts in the removed part of the stomach. The decrease in the ghrelin hormone helps patients feel less hungry in the post-operative period, thus leading to sustainable weight loss, meaning the surgery works through a dual mechanism of action.
How Much Weight Loss Should Be Expected On Average With Gastric Sleeve?
Patients undergoing gastric sleeve surgery are generally expected to lose 60% to 70% of their excess weight within a year and a half. This is only an average expectation, contingent upon the patient’s pre-operative body mass index (BMI), metabolic rate, and especially their adherence to the new post-operative nutrition and exercise program. A significant portion of patients experience the most rapid weight loss within the first 6 to 12 months. The average results are quite impressive and enable most patients to recover from obesity-related co-morbidities (such as diabetes and hypertension).
When Is The Period Of Highest Excessive Weight Loss?
The period of highest excessive weight loss is generally the first 6 months following the surgery. In this early phase, the combination of reduced calorie intake due to the smaller stomach volume and appetite suppression resulting from the decrease in the ghrelin hormone takes effect. As the body rapidly tries to adapt, it uses stored fat for energy, leading to a quick reduction. The most aggressive loss is seen in the first 3 months, after which the rate slows down, and weight loss generally stabilizes between the 12th and 18th months. It is critically important for the patient to go through this period under the supervision of a doctor and dietitian.
What Are The Main Factors Affecting The Rate Of Weight Loss?
The main factors influencing the rate of weight loss are adherence to lifestyle changes, pre-operative weight (BMI), and the patient’s metabolic health. Surgery is only a tool; permanent success requires the patient to adhere to the strict nutritional rules set by the dietitian, engage in regular physical activity, and prioritize water consumption. Patients with a higher pre-operative BMI generally lose more weight numerically, while younger patients may achieve better results due to a faster metabolism. Furthermore, sleep schedule and stress management are important, yet often overlooked, factors affecting weight loss.
How Does Pre-Operative Body Mass Index (BMI) Affect Weight Loss?
The pre-operative Body Mass Index (BMI) affects the amount of weight loss numerically in direct proportion. The higher the starting BMI, the greater the total amount of weight the patient will lose. For example, a patient with a BMI of 60 will lose much more absolute weight than a patient with a BMI of 40. However, when looking at the percentage of weight loss, success rates can be similar. For patients with a high BMI, the goal is often to approach a healthy weight and regress co-morbidities rather than reaching their ideal weight.
What Percentage Of Excess Weight Can Be Lost After Surgery?
After gastric sleeve surgery, patients are generally targeted to lose 60% to 80% of their Excess Weight. Excess weight refers to the difference between the patient’s current weight and their healthy/ideal weight. For example, if a patient’s ideal weight is 60 kg and they currently weigh 120 kg, their excess weight is 60 kg. Post-surgery, they are expected to lose 70% of this 60 kg, which is 42 kg. Achieving this goal means significant improvements in the patient’s health status and a substantial increase in their quality of life. Therefore, surgical success is evaluated by the percentage of excess weight lost, rather than the absolute weight lost.
For How Many Months Does Weight Loss Continue After Gastric Sleeve Surgery?
The weight loss process after gastric sleeve surgery generally continues for 12 to 18 months. The first 6 months are called the “honeymoon period,” where the fastest and most dramatic loss occurs. After the 6th month, the rate of weight loss slows down, and patients usually enter a plateau period around the 12th month. In some patients, especially those who adhere strictly to the weight loss regimen, weight loss may continue at small rates up to the 24th month. The key is maintaining the weight reached at the end of this process and not reverting to old habits.
How Much Do Diet And Exercise Affect Weight Loss Success?
Diet and exercise are the most critical factors determining the long-term success of gastric sleeve surgery. The surgery is merely a tool; the desired outcome cannot be achieved without 100% adherence. Non-compliance with nutritional rules, especially the excessive consumption of high-calorie liquid and soft foods, can lead to the stretching of the stomach and weight gain. Regular exercise, on the other hand, both accelerates metabolism to support fat burning and preserves muscle mass, contributing to a more aesthetic body shape. In short, diet and exercise are the key to transforming the opportunity provided by the surgery into permanent success.
What Is The Role Of Hormonal Changes In Weight Loss Success?
The role of hormonal changes in weight loss success is immense and forms the basis of the surgery’s effect. Since a large part of the stomach is removed during the operation, the levels of ghrelin, the hormone that stimulates appetite, drop rapidly. This leads to patients experiencing natural appetite suppression in the post-operative period. Furthermore, the levels of hormones like GLP-1, which are secreted from the intestines and increase the feeling of satiety, rise. This hormonal readjustment, combined with surgical restriction, allows the patient to effortlessly reduce their calorie intake and facilitates the weight loss process.
Is A Plateau Period Experienced During The Post-Surgery Weight Loss Process?
Yes, experiencing a plateau period (stalling) during the weight loss process after gastric sleeve surgery is very common and normal. Usually around the 3rd month or the 6th month, the body develops a defense mechanism against rapid weight loss by slowing down its metabolic rate. This period does not mean that weight loss stops entirely, but rather a process where the rate significantly decreases. To overcome the plateau period, strategies such as making minor adjustments to the diet under dietitian control, increasing protein intake, and especially intensifying physical activity should be followed.
Is There A Risk Of Regaining The Lost Weight And How Is This Prevented?
Yes, the risk of regaining the lost weight begins within the first 5 years after the surgery, and the risk increases over time. By the 5th post-operative year, a small percentage of patients may experience weight regain of 5-10%. The main reasons for this risk are deviations from nutritional rules, excessive consumption of high-calorie liquid foods, and the stomach tissue slightly stretching over time. The way to prevent weight regain is to view the surgery as just the beginning, commit to lifelong regular follow-ups, seek psychological support, and never abandon the established diet and exercise routine.
How Does The Age Factor Affect The Speed And Amount Of Weight Loss?
The age factor indirectly affects the speed and amount of weight loss. Generally, younger patients start the weight loss process faster and show more aggressive weight loss in the first months due to their higher metabolic rates. As age advances (especially over 55), the rate of weight loss may be slightly lower because the metabolism slows down. However, older patients are often observed to be more disciplined and compliant with lifestyle changes, which can increase long-term weight maintenance success. The most important determinant for success is individual adherence rather than age.
In How Many Months Is It Possible To Reach Ideal Weight After Gastric Sleeve?
Reaching the ideal weight after gastric sleeve surgery varies depending on the patient’s starting BMI and how far they are from their ideal weight. Generally, most patients achieve maximum weight loss between 12 and 24 months, and this weight is often in a range close to their ideal weight. Patients with a starting BMI in the 40-45 range may reach this goal faster, while patients with a BMI over 50 may need close to 2 years to approach their ideal weight. It must be remembered that the primary goal of the surgery is to eliminate health problems caused by obesity, rather than strictly reaching the ideal weight.
Do Chronic Diseases Like Diabetes Affect Weight Loss Success?
Chronic diseases like diabetes, especially if insulin resistance is high, can slow down the speed and amount of weight loss success initially. Patients with insulin resistance struggle to burn fat for energy. However, gastric sleeve surgery has a direct and positive effect on diabetes through weight loss and changes in ghrelin and GLP-1 hormones. Regression or complete resolution of diabetes is expected after surgery, which aids in the normalization of metabolism and positively supports long-term weight loss success.
What Are The Situations Requiring Revision Surgery And Their Costs?
Revision surgery is generally required in situations where the initial surgery was aesthetically or metabolically insufficient, or when weight regain has occurred. Insufficient weight loss or excessive weight regain 3-5 years after the surgery are the primary indications. Revision surgeries are usually more complex and therefore more costly than the initial operation. Different procedures such as converting from a sleeve to a mini bypass or from a sleeve to a Roux-en-Y gastric bypass may be applied. The costs of these surgeries vary depending on the complexity of the procedure, the length of hospital stay, and the techniques used.
What Should The Post-Surgery Nutrition Plan Be Like In The First Months?
The post-surgery nutrition plan should proceed in a strict four-stage protocol in the first months. The first few weeks involve consuming only clear liquids. This is followed by a transition to pureed foods (approximately weeks 2-4). From the 4th week onwards, soft solid foods are introduced, and finally, after the 8th week, the patient transitions to normal solid foods. This staged transition is vital for adapting to the new stomach volume, protecting the suture lines, and preventing potential complications. Every stage must be meticulously managed under dietitian supervision, prioritizing protein intake.
Are Additional Treatments Needed For Loose Skin Accompanying Weight Loss?
Yes, with rapid and high amounts of weight loss, significant skin laxity and sagging can occur, especially in the abdomen, arms, and legs. Although skin elasticity and the patient’s age influence this condition, additional treatments are generally required for this issue. Body contouring surgeries (tummy tuck, arm lift, etc.) can be planned 18-24 months after the surgery, once weight stabilization is achieved. These surgical procedures are an important step to correct the body contour and increase the patient’s satisfaction with the achieved results, but they require a separate cost and recovery period.
Does Pre-Operative Psychological Preparation Support The Weight Loss Process?
Absolutely yes, pre-operative psychological preparation and support are among the most important factors that positively support the weight loss process. Obesity is often associated with emotional eating, stress management issues, and unhealthy eating habits. Although surgery provides a physical restriction, eating disorders and behavioral factors may persist. Consultations with a psychologist or psychiatrist help the patient modify their eating behaviors, adapt to the new post-surgery lifestyle, and cope with potential emotional difficulties, thereby increasing the chances of long-term success.
Which Vitamin Supplements Should Be Used After Gastric Sleeve Surgery?
Due to the reduced surface area for nutrient absorption in the stomach after gastric sleeve surgery, lifelong vitamin and mineral supplementation is mandatory. The most critical supplements are generally Vitamin B12, Vitamin D, Iron, Calcium, and Folic Acid. The dosage and type of these supplements must be determined based on the patient’s regular blood test results. Neglecting these supplements can lead to serious health problems like severe anemia, bone weakening, and nervous system damage, making this a vital part of the post-operative lifestyle that must never be ignored.
Do Smoking And Alcohol Consumption Negatively Affect Weight Loss Results?
Yes, smoking and alcohol consumption severely negatively affect weight loss results and overall surgical success. Smoking increases the risk of stomach ulcers and bleeding and slows down the healing process. Alcohol, on the other hand, not only hinders weight loss because it is high in calories but also leads to very rapid absorption in the new stomach volume, reducing alcohol tolerance and putting extra strain on the liver. Completely quitting these habits before the surgery and strictly avoiding them afterward is essential for both health preservation and the continuation of surgical success.
What Should Be Done To Minimize Muscle Loss During The Weight Loss Process?
The most important steps to be taken to minimize muscle loss during the weight loss process are adequate and high-quality protein intake and regular resistance (weight) exercises. The post-operative diet must aim to meet the daily protein goal despite small portion sizes. Protein is the fundamental building block for muscle repair and preservation. Furthermore, resistance exercises (with body weight or light weights) performed at least 2-3 times a week, which should be started after doctor approval, prevent a drop in metabolic rate by preserving muscle mass and improve body composition.
Is There A Difference In Weight Loss Between Different Types Of Bariatric Surgery?
Yes, there are differences in the amount of weight loss among different types of bariatric surgery. Gastric sleeve (Sleeve Gastrectomy) generally targets a loss of 60-70% of excess weight, while surgeries involving malabsorption like Gastric Bypass can achieve higher rates, often reaching 70-80% of excess weight loss. Each surgery has its unique risks and benefits. The most suitable method is decided upon considering the patient’s BMI, co-morbidities (especially diabetes), and eating habits. The correct decision is made through a detailed evaluation by an experienced team.
How Does Weight Loss Success Improve The Patient’s Quality Of Life?
Successful weight loss dramatically improves the patient’s quality of life. Physically, patients experience less fatigue, higher energy levels, and increased mobility. Co-morbidities associated with obesity, such as sleep apnea, joint pain, diabetes, and hypertension, regress or disappear entirely. Psychologically and socially, patients’ self-confidence increases, their desire to participate in social activities rises, and rates of depression decrease. This improvement is the greatest long-term benefit provided by the surgery.
When Should Pregnancy Planning Be Done After Gastric Sleeve Surgery?
Pregnancy planning after gastric sleeve surgery should coincide with the period when the body has achieved maximum weight loss and nutrient balance has stabilized. Doctors generally strongly advise waiting at least 12 to 18 months after the surgery. This waiting period is critically important for preparing the mother’s body against rapidly changing nutritional needs and potential vitamin-mineral deficiencies. Early pregnancy can negatively affect both the mother’s health (nutrient deficiencies) and the baby’s development.
What Temporary Side Effects Can Rapid Weight Loss Cause In The Body?
Rapid weight loss can cause some ** temporary side effects** in the body. The most common of these are hair loss, dry skin, feeling overly cold, and fatigue. Hair loss, which is the body’s reaction to stress and nutrient restriction, usually begins around 3 to 6 months and is temporary, managed with vitamin supplements. The feeling of coldness is due to the decrease in body fat percentage. All these side effects tend to resolve spontaneously as the rate of weight loss slows down and the body adapts to the new state.
How Is Appetite Control Achieved After Surgery And Is Constant Hunger Felt?
Appetite control after surgery is achieved naturally, largely thanks to the removal of the ghrelin-producing part of the stomach. Most patients do not experience significant hunger in the first months following the surgery. To maintain appetite control in the long term, the patient needs to learn to manage emotional eating triggers, separate liquid and solid foods, and continue adequate protein intake. A constant feeling of hunger is usually caused by non-adherence to post-operative rules or psychological factors, in which case seeking support is important.
What Are The Benefits Of Participating In Support Groups During The Weight Loss Process?
The benefits of participating in support groups during the weight loss process are invaluable. These groups provide a safe environment where patients share their experiences, learn coping strategies for emotional difficulties, and stay motivated. Lifestyle changes after surgery can be challenging; support groups reduce the feeling of isolation, provide moral support, and strengthen long-term adherence by connecting people who are going through similar processes. This social support is very effective in reducing the risk of weight regain, especially where psychological factors are at play.
What Should Be Done If The Target Weight Is Not Reached After Surgery?
If the target weight (usually 70% of excess weight) is not reached after surgery, the patient’s lifestyle should first be examined in detail. Failure is often due to behavioral issues such as deviation from nutritional rules, insufficient exercise, or emotional eating. In this case, nutrition and behavioral therapy should be intensified in collaboration with a dietitian and psychologist. If failure persists despite all lifestyle changes and no medical reason is found, revision surgery may be considered as an option, but this should be a last resort.
What Steps Should Be Taken For Lifestyle Changes To Be Permanent?
The steps that must be taken for lifestyle changes to be permanent are discipline, routine establishment, and a support system. Patients should adopt new nutritional habits (small portions, slow eating, separating liquid and solid) not as a constraint, but as a way of life. Incorporating regular exercise into the weekly routine, consistently taking supplements to prevent possible nutrient deficiencies, and adhering to long-term follow-up appointments are crucial. Furthermore, developing alternative coping mechanisms instead of emotional eating is the most important step guaranteeing permanent success.
What Is The Long-Term Weight Maintenance Success Of The Surgery?
The long-term weight maintenance success of gastric sleeve surgery is quite good, but this success depends on patient adherence. Most patients maintain a loss of 50% to 60% of their excess weight by the 5th year post-surgery. However, a small portion of patients, particularly those who abandon their diet and exercise routines, may experience weight regain 10 years after the surgery. While the effect of the surgery diminishes over time, the patient’s ability to maintain the new healthy habits becomes the true determinant of long-term weight maintenance success.
Is Hair Loss Experienced During The Weight Loss Process And How Is This Condition Managed?
Yes, hair loss (telogen effluvium) is a common side effect after gastric sleeve surgery due to rapid weight loss and the body being under stress. It usually starts around 3 to 6 months post-surgery and lasts for a few months. To manage this condition, the regular and adequate intake of protein and essential nutrient supplements like zinc, B vitamins, and iron is critical. Hair loss is typically temporary, and hair begins to regrow as weight loss slows down and the body adapts. Patience and not neglecting supplements are the most important management strategies.
How Much Weight Needs To Be Lost Before Gastric Sleeve Surgery?
Pre-operative weight loss is generally a mandatory step, and doctors set a specific target based on the patient’s BMI. This preliminary weight loss ensures the surgery is safer, helps shrink the liver to open up the surgical field, and reduces the risk of complications. Generally, patients are asked to lose 5% to 10% of their total body weight within a few weeks before the surgery. This process also serves as an indicator of how well the patient can adhere to post-operative discipline.
How Do Diseases Like Diabetes And Hypertension Improve With Weight Loss?
Diseases associated with obesity, such as diabetes and hypertension, improve rapidly and dramatically after gastric sleeve surgery. Thanks to weight loss and hormonal changes, insulin sensitivity rapidly increases, and blood sugar levels improve; most patients can discontinue the need for insulin or diabetes medication shortly after the surgery. Similarly, blood pressure drops as body fat decreases and pressure on blood vessels is relieved. This improvement is the most important evidence that the surgery is not just aesthetic but a metabolic treatment.
When Should Sports And Physical Activity Be Started After Surgery?
The process of starting sports and physical activity after surgery should be gradual and doctor-approved. Generally, light walking is encouraged in the first few weeks after the surgery. However, patients are usually advised to wait 6 to 8 weeks before starting intense exercises and weight lifting that strain the abdominal muscles. This period is necessary for the surgical incisions and internal stitches to heal completely. The program, prepared with the assistance of a doctor and physiotherapist, should include cardio first, followed by light resistance exercises, thereby supporting weight loss and preventing muscle loss.
How Is Weight Loss Follow-Up Done In Turkey For Patients Coming From Abroad?
Weight loss follow-up for patients coming from abroad in Turkey is typically done through remote consultation and regular reporting. After returning to their home country, patients stay in touch with their assigned dietitian and coordinator through video conferences, phone calls, and email. Blood test results are regularly requested, and vitamin supplement dosages are adjusted based on these results. This system ensures that the patient continues to receive comprehensive and disciplined follow-up for at least 5 years, even when far from face-to-face check-ups, thereby increasing the chance of long-term success.
Gastric sleeve surgery is a major decision that reshapes your life, and the support you receive during this process is critical. If you are looking for a high-quality, reliable, and internationally standardized health experience on your bariatric surgery journey, you can contact Cure Holiday for personalized process management, accommodation, and treatment follow-up.
