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Post-Surgery Weight Regain: Sleeve Gastrectomy

sharma-obesity-verticalsleevegastrectomyContinuing in my discussion of factors that can promote weight regain after bariatric surgery, discussed in our systematic review published in Obesity Surgery, I now turn to the technical or anatomical issues specific to sleeve gastrectomy.

As sleeve gastrectomies have only been performed as a stand-alone procedure for about 5 years, data on weight recidivism is rather limited.

However, there are studies and case reports to suggest that the remnant stomach or sleeve may expand over time and that the size of the gastric sleeve is related to weight loss and possibly weight regain.

How and why the sleeve expands and how exactly such expansion affects satiety and the mode of action of this type of surgery remains unclear and will require further study.

However, weight recidivism after sleeve gastrectomy should prompt appropriate investigations to rule out sleeve dilation (upper gastrointestinal endoscopy, radiographic upper gastrointestinal series) and a large remnant sleeve may require surgical correction or conversion of this procedure to a Roux-en-Y gastric bypass.

Edmonton, AB
Karmali S, Brar B, Shi X, Sharma AM, de Gara C, & Birch DW (2013). Weight Recidivism Post-Bariatric Surgery: A Systematic Review. Obesity surgery PMID: 23996349 


  1. After two years with the sleeve, I find I can eat a fairly “normal” amount of food. While it’s not nearly as much as my husband eats, it’s not so little as to draw the notice of anyone who doesn’t know that I had surgery. The first few months after surgery, I could literally eat only a few tablespoonfuls of food at one time. I find I have to eat very carefully and maintain a rigorous exercise schedule to keep the weight off.

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  2. I am curious as to any advice. It has been 2 years since my gastric sleeve. I lost a total of 50 lbs before the surgery on my own (using the specialists advice of 3 cups of food, in total, per day). After the surgery I lost a total of 40 lbs. I too could only eat a table spoon of food at a time. Now I can maybe consume a half a cup to 3/4 cup of food in one sitting. I still throw up alot, and there are so many foods I cannot eat, like rice or quinoia. I had a recent reconstruction surgery (unrelated to the sleeve). After which I had a severe allergic reaction to a pain killer. The Doctors put me on quite a bit of steroids to combat the reaction. After that, with in a week to two weeks I gained 30 lbs. I have been working very diligently to lose the weight, adding more excersize and adding more power foods like kale, ginger etc. I cannot lose any weight. I just entered menopause as well and am struggling greatly. I do not consume anymore than 775 to, at most, 900 calories per day. Does anyone have any advice as to what my next step is?

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  3. I had a VSG in 2009 and have been vigilent with my diet – almost to the point of anorexia – and I still have weight gain. I was 50 when I had the surgery and have gone through menopause and from the 45 pounds I lost, I have regained 11 and am struggling to not gain more. I cannot seem to lose. Protein is my mainstay and I drink cold pressed green juices for my veggies. I have had trainers tell me I have set my metabolism so low that when I do eat, it sticks. I don’t think I can eat less every day (about 500 calories) and I walk about 3 – 5 miles a day, and pilates 3 times a week. Is there any good news for me? When it is recommended I eat 1200 calories a day, I cringe – and I have tried, but I rarely can reach it.
    Your thoughts please. If it is to eat 1200 to reset my metabolish, I can try (yes hypothyroid, 5’0″ and 131lbs at present. When I say, I might as well enjoy my food if I am going to gain weight, I put on a few pounds overnight that takes weeks to get off…but most of it has not come off.

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