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Gastric Sleeve Surgery

None of us want to go through surgery if we don't have to. But sometimes, doctors recommend weight loss surgery (also known as bariatric surgery) for very overweight teens if they've tried and failed to lose weight on normal diet and exercise plans.

There are several different types of weight loss surgeries. One type is gastric sleeve surgery, also known as sleeve gastrectomy.

What Is It?

In gastric sleeve surgery, a surgeon removes part of the stomach and makes a narrow tube or "sleeve" out of the rest. The new, banana-shaped stomach is much smaller than the original stomach. After the operation, a person will eat less, feel full sooner, and be less hungry.

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Gastric sleeve surgery isn't a "fix it and forget it" kind of surgery. To be considered for surgery, a person must be committed to changing his or her eating and exercise habits over the long term. Not everyone who wants surgery will be eligible to get it.

Doctors consider a number of things when deciding if weight loss surgery is the right choice for teens. These include whether a teen:

  • is at least 14 years old and near adult height with more than 100 pounds of extra weight to lose
  • is healthy enough to handle surgery
  • has medical problems that could improve with significant weight loss, such as sleep apnea, diabetes, or heart problems
  • has proved that he or she can stick to a healthy diet and get regular exercise
  • has family members who will provide emotional and practical support (like driving to every doctor's visit or buying healthy food)

Preparing for Gastric Sleeve Surgery

Preparing for this major operation takes months of work. Patients need to show that they are willing and able to make big changes in their eating and exercise habits before the surgery.

If you're a candidate for gastric sleeve surgery, the best place to get it is at a children's hospital with a bariatric surgery program that involves a team of specialists. Members of the team will explain what's involved, help you prepare for your surgery, and care for you after surgery. For several months before surgery, you will work with the medical team to build the skills needed for success.

Here are some of the people who work as a team to help teens prepare for gastric sleeve surgery:

Doctors and surgeons. Several months before your surgery, you'll meet with a medical doctor and surgeon. They will explain what happens during surgery, examine you, and talk about what to expect before and after surgery. Your doctors will also let you know about some of the things that can go wrong (you'll probably hear doctors call these "complications").

Psychologists. People go through lots of emotions before and after surgery. A psychologist can help you understand your feelings and help you prepare emotionally for surgery and the changes that will follow. For example, when you're out with friends after your surgery, you won't be able to eat the way you used to.

The psychologist will help you develop coping strategies as you learn to change your relationship with food. He or she also will help you with things like worry, stress, or emotional eating. It's always a good idea to take advantage of a psychologist's expertise as you prepare for gastric sleeve surgery.

Dietitians. Because patients often depend on parents or other family members for meals, a dietitian will teach you and your family healthy eating basics like good nutrition, how to get regular meals, and the right portion sizes.

Gastric sleeve surgery permanently decreases the size of the stomach. You will have to eat less than you did before. Your dietitian will explain what and how much you can eat after surgery, both immediately after the operation and for the rest of your life.

Exercise specialists. These experts help patients get more active. They'll work with you to develop an exercise program you'll like and workouts you can stick with. It's like having a personal trainer. Exercising during the months before surgery helps patients get in better shape for the operation. This will make recovery easier.

There's another reason why it's good to exercise regularly before surgery: After the operation, it will be easier to get back into working out if you've already made a habit of it. Lots of patients find that having a workout routine helps them feel better after surgery, but you will have to go slow. Talk to your doctor and exercise specialist to get their advice on how to gradually get back into your exercise routine.

The Surgery

Gastric sleeve surgery is a major operation. Doctors will give you anesthesia so you sleep through the surgery. After you're asleep, the surgeon will take out three-quarters of your stomach, leaving you with a smaller banana-shaped stomach called the gastric sleeve.  

Because it's major surgery, a gastric sleeve operation has some risks, including:

  • too much bleeding
  • leaking of stomach contents into the belly from where the surgeon cut the stomach
  • a bad reaction to anesthesia
  • blood clots
  • infection

After the operation, you'll probably stay in the hospital for a couple of nights so doctors and nurses can monitor your recovery. They will give you medicine for pain or nausea (feeling sick), help you to get up and move around, and make sure you can drink liquids without throwing up.

Life After Gastric Sleeve Surgery

People usually recover from gastric sleeve surgery in a week. But it will take several weeks before you can eat regular food again. Gastric sleeve surgery makes your stomach smaller — permanently. To ease into having a much smaller stomach, you'll need to follow a special diet that starts with liquids only. Your dietitian will give you an eating plan that gradually works up to solid foods; for example:

  • For the first 2 to 3 weeks after surgery, you'll get all your nutrition from high-protein drinks.
  • For the next 2 weeks or so, you'll eat puréed foods.
  • Finally, you'll move on to soft foods for another couple of weeks before you can eat regular food.

How quickly someone moves from one stage to the next depends on the person. Your medical team will advise you based on what's best for you.

If you rush a stage or eat something before your body's ready for it — or if you eat too much — you'll feel very uncomfortable. You may throw up. Eventually you'll be able to eat more of the foods you're used to. But for the rest of your life, you'll always have to eat much smaller portions. You'll also feel full faster.

Because you can't eat as much, the foods you choose to eat really matter. Your dietitian will help you put together a lifelong healthy diet that includes fruits and vegetables and emphasizes protein. Your dietitian also will recommend vitamin and mineral supplements so you don't miss out on key nutrients.

Your new diet will limit the amount of processed foods and snacks like chips and candy that you can eat. This is because these foods don't have a lot of nutritional value (dietitians sometimes call them "empty calories").

In addition to eating a sensible diet, exercising is a key part of staying healthy and maintaining weight loss after surgery.

People who follow the recommended diet and exercise plan often lose a large amount of weight in the months after gastric sleeve surgery. After that, weight begins to stabilize. Your team of specialists will keep seeing you for several months after surgery to monitor your diet and health, and to help you stay on track.

What Are the Downsides?

When you get gastric sleeve surgery, you're making a huge change to the way your body handles food. It can take a while to get used to your body's new normal.

Here are some of the problems you might have in the months after gastric sleeve surgery:

  • If you eat too much food or eat too fast, you might throw up, have diarrhea, or get acid reflux.
  • Food might move too fast through your digestive system, causing nausea, cramps, and diarrhea (doctors call this "dumping syndrome").
  • If you don't eat enough nutritious food and don't take your daily vitamin and mineral supplements, you might develop vitamin and mineral deficiencies. This also may happen if your body can't absorb enough nutrients.
  • After you lose lots of weight, you may have loose skin.

If you have a lot of pain or bloating in your belly or you throw up a lot, call your doctor right away. It could be a sign there's a problem that needs medical attention.

Gastric sleeve surgery is not for everyone. But it can really help people who have serious health problems or are at risk for health problems because of their weight. If you're worried about your weight or think you may benefit from weight loss surgery, talk to your doctor.

Reviewed by: Mary L. Gavin, MD
Date reviewed: October 2015

Note: All information on TeensHealth® is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.

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