Gastric Sleeve Surgery (Stomach Reduction Surgery) is one of the most popular and effective weight loss procedures, particularly for individuals who are overweight or obese and unable to lose weight through other methods.
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Who is this procedure suitable for?
This surgery is suitable for individuals with a BMI over 40 (37.5 for Thais) or a BMI over 35 (32.5 for Thais) along with comorbid conditions, such as diabetes or heart disease, and who have been unable to lose weight through other methods, based on the following criteria:
- BMI higher than 40 (37.5): Individuals with a BMI above 40 are considered to have severe obesity and may be suitable candidates for weight loss surgery.
- BMI between 35-39.9 (32.5) with comorbidities: Individuals with a BMI between 35-39.9 who also have obesity-related comorbidities, such as type 2 diabetes, high blood pressure, sleep apnea, or heart disease, may be considered for surgery to reduce their risk and alleviate symptoms (including high cholesterol, fatty liver, or polycystic ovary syndrome).
- Failure to lose weight through other methods: Patients who have tried to lose weight through diet and exercise without success or who have regained the lost weight.
- Mental preparedness and understanding of the surgery: Patients must understand the risks and outcomes of the surgery, as well as the need for lifestyle and eating habit changes after the procedure.
- No medical contraindications for surgery: Patients must be physically fit for surgery and free of any contraindications, such as uncontrolled mental health conditions or other health risks that could make surgery unsafe.
How Gastric Sleeve Surgery Works During Gastric Sleeve surgery, approximately 75-80% of the stomach is removed, leaving a smaller, sleeve-shaped stomach. This reduction in size helps patients feel full faster and eat less at each meal. The surgery also reduces hunger hormone levels, leading to decreased appetite. The surgeon makes 4-5 small incisions for the procedure, allowing for quicker recovery and less pain due to the smaller incisions.
Patients typically begin to see results as early as the first week, with significant weight loss occurring within 1-1.5 years post-surgery. The most rapid weight loss tends to happen within the first six months. The long-term success of the procedure depends on post-surgery self-care, including nutritious eating, regular exercise, and follow-up care with the doctor.
Surgical Procedure Steps
- Preparation: Prior to surgery, the patient undergoes a thorough physical examination to ensure they are a suitable candidate. The doctor may provide pre-operative dietary guidelines, such as consuming low-calorie foods to prepare the stomach.
- Surgery: The procedure is typically performed laparoscopically (Laparoscopic Surgery), where the surgeon removes part of the stomach and sutures the remaining portion into a sleeve shape.
- Surgical Duration: The surgery generally takes 1-2 hours, and patients usually require a 2-3 day hospital stay for recovery.
Benefits of Gastric Sleeve Surgery - Effective Weight Loss: Patients typically lose about 60-70% of their excess weight within the first 1-2 years post-surgery.
- Reduced Hunger: Due to a reduction in the hunger hormone (Ghrelin), patients often feel less hungry.
- Minimal Impact on Nutrient Absorption: Since the surgery does not alter the digestive tract, nutrient absorption is less affected compared to other procedures (e.g., Gastric Bypass).
Risks or Disadvantages - Nutrient Deficiencies: Although this surgery has less impact on nutrient absorption, patients must still be cautious of potential deficiencies in vitamins and minerals.
- Irreversible Procedure: The removed portion of the stomach cannot be restored, making this surgery permanent.
- Other Side Effects: These may include leakage from the stomach incision, infection, or vomiting if the patient eats too quickly or too much.
Post-Surgery Care After surgery, patients must strictly follow dietary guidelines, such as:
- Liquid Diet Initially: Patients start with a liquid diet for the first 1-2 weeks.
- Gradual Return to Normal Eating: Gradually reintroduce solid foods after the recovery period.
- Exercise and Lifestyle Changes: Regular exercise and proper nutrition are essential for maintaining long-term weight loss
Although the surgery promotes weight loss, patients must manage factors that could lead to regaining weight:
- Eating Habits: After the surgery, patients may still be tempted to consume high-calorie, fatty, or sugary foods, which can lead to weight regain despite eating smaller portions. Choosing nutritious foods is crucial for maintaining weight loss.
- Lifestyle Adjustments: Lifestyle changes, such as regular exercise, healthy eating, and mental health care, are important for sustaining weight loss. Regular physical activity helps burn calories and maintain muscle, both key factors in weight management.
- Long-term Care: Patients should have regular follow-ups with their doctor and receive guidance from a dietitian or specialist team. Ongoing support from medical professionals is a key factor in preventing weight regain.
- Psychological Factors: Patients dealing with stress, anxiety, or emotional issues may turn to food for comfort (emotional eating), which can lead to weight regain. Proper management of psychological factors, such as consulting a psychologist or specialist, can help reduce this risk.
- Stomach Adaptation: Over time, the stomach can expand slightly, especially if patients overeat frequently, allowing them to consume larger quantities of food and potentially regain weight.
- Lack of Post-Surgery Support: Without consistent post-surgery care and follow-up, patients may have a higher risk of weight regain.
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