Sleeve Gastrectomy | Bariatric Surgery | JAMA | JAMA Network
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JAMA Patient Page
September 1, 2020

Sleeve Gastrectomy

Author Affiliations
  • 1Department of Surgery, Northwestern University, Chicago, Illinois
  • 2American College of Surgeons, Chicago, Illinois
JAMA. 2020;324(9):908. doi:10.1001/jama.2020.14775

Sleeve gastrectomy, also known as vertical sleeve gastrectomy or gastric sleeve, is a commonly performed surgery for weight loss.

In sleeve gastrectomy, part of the stomach is removed, reducing its capacity by approximately two-thirds. Reducing the size of the stomach limits intake of food. Additionally, removing the part of the stomach that secretes hormones causes hunger to decrease.

Who Should Consider a Sleeve Gastrectomy?

Sleeve gastrectomy may be offered to patients who are obese based on their body mass index (BMI, an estimate of body fat based on weight and height). Sleeve gastrectomy is considered if a patient’s BMI is at least 40 or at least 35 and the patient also has at least 1 obesity-related health condition, such as type 2 diabetes, obstructive sleep apnea, high blood pressure, arthritis, or high cholesterol. Patients must also be healthy enough to safely undergo surgery.

Preparation for Sleeve Gastrectomy

Insurance plans and bariatric surgery programs have different requirements for evaluation before surgery. Patients should undergo evaluation by a dietitian, including a supervised weight loss program, to learn eating habits for successful weight loss after surgery. Patients should also undergo a psychological evaluation to prepare for the lifestyle changes that accompany weight loss surgery and to address harmful eating behaviors, such as binge-eating disorder. Women of reproductive age should consider a reliable form of birth control, as the likelihood of becoming pregnant increases after surgery.

Effectiveness and Risks of Sleeve Gastrectomy

After sleeve gastrectomy, patients typically lose about one-third of their body weight. For example, if a patient weighs 300 lb, they can expect to lose 100 lb after surgery. Although there is a risk of regaining weight, most patients maintain weight loss after surgery. Sleeve gastrectomy usually results in more weight loss than with the adjustable gastric band but less than with gastric bypass surgery. Sleeve gastrectomy also improves many obesity-related health conditions.

Like any surgery, sleeve gastrectomy procedure has risks. Problems can also develop months or years following sleeve gastrectomy. These include gastric stricture, in which the stomach becomes narrow and causes food to get stuck, heartburn, and vitamin or mineral deficiencies.

Life After Sleeve Gastrectomy

Patients are generally able to resume their usual activities shortly after sleeve gastrectomy. Although most patients have a reduced appetite, they are still able to enjoy food and participate normally in social gatherings (such as eating at a restaurant or attending a dinner party). Most patients report improved quality of life after sleeve gastrectomy.

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Article Information

Conflict of Interest Disclosures: None reported.

Source: Arterburn D, Telem DA, Kushner RF, Courcoulas AP. Benefits and risks of bariatric surgery in adults: a review. JAMA. Published September 1, 2020. doi:10.1001/jama.2020.12567

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