Grace from Katy, Texas sent us this question: “How much weight do I lose after sleeve gastrectomy? I am concerned of losing too much. Can you not take too much of the stomach out? Thank you.”

Dear Grace,

Gastric sleeve surgery or sleeve gastrectomy is currently the most commonly performed weight loss surgery in Houston. Sleeve gastrectomy is both safe and effective. Properly performed sleeve gastrectomy results in a well contoured, “banana” shaped, stomach with no narrowing or twisting of gastric sleeve lumen. The art of gastric sleeve surgery is to resect just enough to achieve the best metabolic response leading to the most optimal weight loss outcome. If too much of the stomach is taken out, functional narrowing or stricture formation develop. In this case, patients develop acid reflux, nausea, vomiting, and may experience excessive weight loss. On the other hand, if too little of the stomach is resected patients will achieve suboptimal weight loss.

Weight loss stabilizes around one year after sleeve gastrectomy. Bariatric patients do not lose weight indefinitely because they reach an equilibrium point between energy consumption and energy expenditure. This equilibrium point depends on many factors that are not fully understood. Consequently, we cannot predict how much weight does a patient exactly lose after sleeve gastrectomy. Studies show that on average sleeve gastrectomy patients lose 70% of their excess weight. Some lose more and some lose less. No one, however, loses too much weight to the point of becoming malnourished.