Weight Loss & Metabolic Health
What Is Sleeve Gastrectomy?
Last reviewed: May 2026 · Haute MD Editorial Team
Sleeve gastrectomy is a bariatric procedure that removes approximately 80% of the stomach, leaving a narrow, banana-shaped tube. It produces 25–30% total body weight loss long-term and is now the most commonly performed bariatric procedure worldwide because it is technically simpler than gastric bypass, has lower long-term GI complications, and produces substantial metabolic improvement.
How sleeve gastrectomy works
Removing the majority of the stomach restricts how much food can be eaten in a single meal and also dramatically reduces production of ghrelin, the primary hunger hormone, which is made largely in the fundus of the stomach. The procedure preserves normal anatomy of the small intestine, so nutrient absorption is largely unchanged — making nutritional deficiencies less common than after gastric bypass. The metabolic effect, while real, is somewhat less than with bypass.
Outcomes and comparison to bypass
Average total body weight loss is 25–30% at 1–2 years, with most patients maintaining 20–25% at 10 years. Type 2 diabetes remission rates are 40–60% at 5 years — strong, though slightly lower than with bypass. The sleeve is favored for patients with adhesions from prior abdominal surgery, those at higher surgical risk, and those who prefer a less anatomically altering procedure. Reflux can worsen after sleeve gastrectomy and may require conversion to bypass in some patients.
Risks and follow-up
Early risks include bleeding, staple-line leak (1–2%), infection, and blood clots. Long-term, reflux/GERD is the most common complication and is sometimes severe. Nutritional deficiencies (B12, iron, vitamin D) still occur and require monitoring and supplementation, though less aggressively than after bypass. Pregnancy should be delayed 18–24 months. Long-term follow-up with the bariatric team is essential.
Frequently Asked Questions
Is sleeve gastrectomy reversible?
No — removed stomach tissue cannot be restored. It can be converted to a gastric bypass if needed (commonly for severe reflux or weight regain).
How much weight will I lose?
Most patients lose 55–70% of excess body weight in the first 18 months (about 25–30% of total body weight).
Will I have reflux after a sleeve?
Some patients develop or worsen reflux. Severe cases occasionally require conversion to gastric bypass. Pre-op evaluation helps identify patients at higher risk.
Do I still need vitamins after sleeve?
Yes — long-term supplementation with multivitamin, B12, iron, calcium, and vitamin D is recommended, though deficiencies are less common than after gastric bypass.
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