Sleeve gastrectomy, also known as gastric sleeve surgery, is a weight-loss surgical procedure that reduces the size of your stomach to aid in weight reduction. It is a less invasive option compared to gastric bypass surgery, as it does not involve the reconstruction of your intestinal tract.
Determining whether gastric sleeve surgery is the right choice for you is a meticulous process that often entails multiple consultations, a diet plan, and potentially even a psychological examination. We sought the expertise of professionals to offer some insights to assist you throughout the process, both before and after the surgery.
Before Surgery
1. Alter your diet
A gastric sleeve is a significant procedure, and one for which you should prepare well in advance. Your doctor might prescribe a specific pre-operative diet for you to commence approximately two weeks prior to the surgery—though the timing could vary depending on your doctor and your individual circumstances. “It is crucial that patients adhere to a genuine liquid diet, mainly composed of protein shakes, with the aim of keeping the caloric intake at 1,200 calories per day or lower,” states Dr. Daniel J. Rosen, a bariatric surgeon based in New York City. “The liquid diet readies the body for the surgery and helps shrink the liver. The greater the weight loss, typically the more the liver shrinks, which is beneficial for bariatric surgery because the surgeon will have to lift the liver up and out of the way to access the stomach. A smaller liver can facilitate a smoother surgery, as it can be lifted more easily and is less prone to injury.”
2. Modify your grocery list
You will need to consume a considerable amount of protein after the surgery—approximately 60 to 80 grams per day, as per Dr. Rosen. “Protein assists in building and maintaining muscle mass, serves as an energy source, and can help keep your hair, skin, and nails strong post-surgery,” he explains. “Prioritizing protein and engaging in strength training when medically permitted signals to your body to preserve muscle and prioritize burning fat to meet energy requirements.” Take the time before the surgery to determine which protein powders you prefer, and then find some protein-rich foods that you can incorporate into your diet without adding excessive calories.
“It is important to have the appropriate foods and supplements at home, ready for you when you return from the surgery,” remarks Dr. Channing Chin, a bariatric surgeon from Wayne, New Jersey. “However, be cautious not to obtain more than a month's supply. Some patients undergo taste alterations after the surgery, and your favorite protein drink might no longer be your favorite.”
3. Ensure your clothing is appropriate
You are likely to experience some discomfort after the surgery. “Wear loose and comfortable apparel,” says Dr. Rosen. “Bending down to pull on tight pants or stretching your arms overhead to put on a fitted shirt might be painful—and thus, the looser the clothes, the better.” It is also advisable to have some “transition” clothing to accommodate you at different stages of your weight loss.
4. Quit smoking
Stop smoking at least two months before the surgery. “Smoking and vaping of tobacco and marijuana can reduce the oxygen in your blood,” says Dr. Chin. “This ultimately influences all aspects of the healing process and heightens the risk of leaks, infections, and pneumonia.” In fact, your doctor might decline to perform the surgery if you continue to smoke.
5. Prepare your hospital bag
Gastric sleeve surgery necessitates an overnight stay in the hospital, so pack everything you believe you might need for your comfort—including those new, loose clothes you have stocked up on.
6. Prepare your support system
It is essential to educate your friends and family to ensure you have people to assist during your recovery. You might also require both mental and physical support throughout this journey, so your doctor might encourage you to join a post-bariatric support group. “They offer encouragement and, as the name suggests, support,” says Dr. Rosen. “Some groups even provide ongoing education on relevant topics to help patients achieve and maintain weight-related goals.” He recommends asking your doctor for suggestions and seeking a group that is moderated by a medical professional.
7. Fulfil any insurance coverage requirements or arrange financing
Depending on your insurance plan and specific needs, your surgery might or might not be covered by insurance. There are typically several factors involved, including your body mass index and any related health issues. “Please consult the surgeon's insurance specialist for any specific inquiries,” says Dr. Chin. “Two patients can have the same insurance but very distinct benefits based on the employer, so do not make assumptions.”
8. Be informed
Ensure you obtain from your surgeon a detailed understanding of what your gastric sleeve surgery involves. Engaging in detailed discussions with your doctor can alleviate the fear and anxiety associated with the procedure and also contribute to achieving the best outcomes. There should be no uncertainties or lingering concerns before the surgery. You should be aware of everything you need to do and everything that will be carried out.
After Surgery
1. Adhere to the diet prescribed by your doctor
If you attempt to consume solid foods too soon or eat foods high in sugars and fats, you could potentially harm yourself or damage your stomach. “By not adhering to the post-operative eating guidelines, several issues can arise. In the short term, certain food types, such as starches, can get stuck and cause vomiting, resulting in incisional pain and, in extreme cases, a leak,” says Dr. Chin. “It can also slow down weight loss and, in the long term, lead to weight gain.”
Discover new recipes to prevent food from becoming monotonous after the surgery. It is vital to stick to your diet plan. “After approximately six weeks post-operation—and if the patient tolerates the soft diet well—they will most likely start advancing the diet to that of a modified regular diet that will emphasize lean protein, fruits, vegetables, and high-fiber whole grains,” Dr. Rosen states. “The protein and water requirements will remain essential, and patients need to avoid bread and rice until 8 to 10 weeks after the surgery, as they are high-risk foods that may get stuck and are likely to cause discomfort.” Being proactive to prevent food from becoming stale or boring will assist you in avoiding turning to foods you should not consume.
2. Monitor your calorie intake
The dietary guidelines of the University of California suggest a daily caloric intake of less than 400 calories a day for the first two weeks post-op, and then gradually increase to your final daily intake of 900 to 1,000 calories at six months post-op. Ensure you are not ingesting foods that are high in calories, sugar, or fat. Always make sure to consult your doctor regarding the number of calories you require each day. They will be familiar with you and your body and will provide you with a specific target tailored to your specific needs.
3. But avoid consuming calories through beverages
Only consume low-calorie beverages like water, sugar-free juices, and unsweetened ice tea. You will need to limit your overall calorie intake as part of the weight-loss program—and instead of obtaining calories from drinks that offer only empty calories, use your calories to consume protein. “It is extremely important that you chew your protein rather than drinking it. Your body needs to go through the act of eating, which also helps suppress appetite,” says Dr. Chin. “That is why liquid diets are not effective in the long term.”
4. Do not return to work until you are fully prepared
Your recovery period will vary, but it typically takes at least two weeks before individuals are ready to resume work after the surgery. “It is not uncommon to have lower energy levels post-surgery and for you to require a few days or weeks to adjust to a full workday once cleared,” says Dr. Rosen. You should also undertake only light duties when you initially return to work. Walking around is beneficial exercise, but avoid any heavy lifting.
5. Engage in exercise when possible
It might take some time before you can exercise to the fullest extent, but it is still important to strengthen your muscles and return to walking as soon as feasible. “In the first month, low-impact exercises are recommended—stationary bike, walking, resistance and weight training with no more than 10 or 15 pounds,” says Dr. Chin. “After a month, there will be no activity restrictions. A diverse range of exercises is important to prevent you from getting bored with any one activity.” Just do not push yourself too hard too soon, as doing so can increase the risk of developing a hernia.
6. Never miss your follow-up appointments
Make sure to schedule follow-up appointments with your doctor to confirm that you are recovering well. Doing so will also keep you on the correct path regarding diet, exercise, and your weight-loss goals.
7. Take multivitamins regularly
After the surgery, it can be challenging to obtain all the necessary nutrition from food alone. “Although the absorption of nutrients might not be affected, you will be reducing your overall food intake,” says Dr. Chin. “Therefore, it is important to comply with taking vitamins to ensure your body receives the appropriate nutrients and functions optimally.” Your doctor will be able to specify which particular vitamins you need. This should become a lifelong habit for you, so start early.
8. Know when to seek assistance
During the initial recovery phase, it can be difficult to move and complete tasks. Ensure you get sufficient rest and have a reliable support network to assist you in easing back into normal life. (This is once again where a support group can be beneficial.)
9. Follow your prescribed medication
Do not attempt to stop taking your medication prematurely. “Many surgeons prescribe medications for heartburn after the surgery while the stomach heals from the operation. It allows for a lower-acid environment and keeps the stomach in a less active state,” says Dr. Rosen. While he typically discontinues the medication after three months, he states, “if some heartburn returns, you may need to restart the heartburn medication as needed.”
