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Gastric Sleeve Surgery Success Rates

Success

Gastric sleeve surgery is a weight loss procedure in which the surgeon removes about 80% of the stomach, leaving only a small tube-like portion behind. It is the most popular form of weight-loss surgery performed today.

According to the American Society for Metabolic and Bariatric Surgery, sleeve gastrectomy accounted for 59.4% of the estimated 256,000 bariatric surgeries performed in 2019.

Up to 50% of sleeve gastrectomy patients regain a small amount of weight within 24 months after surgery. However, most people who undergo sleeve gastrectomy are able to keep their excess weight off over the long term. For many people, this is the ultimate goal. Once they’re able to maintain a lower weight, they deem their surgery a success.

That being said, there are multiple ways in which doctors and patients can measure the success of sleeve gastrectomy and we’ll discuss them in this article. We’ll also look at what you can do as a patient to improve the likelihood that your procedure will be successful.

Indicators of Gastric Sleeve Success

There are several things that indicate gastric sleeve surgery has gone according to plan. These include the percentage of excess weight loss (%EWL), improvement in comorbidities, long-term weight regained, and improvement in quality of life. Let’s look at each of these.

Percent Excess Weight Loss

This measure is used to assess the outcome of all bariatric surgeries including sleeve gastrectomy. You can measure excess weight by subtracting your ideal weight from your actual weight before surgery.

As you start to lose weight, your weight loss is measured as a percentage of your excess body weight. If your excess body weight was 100 pounds and you lost 50 pounds, your %EWL would be 50%.

You may be wondering what is considered a good %EWL. A  lot depends on when your results are measured and different studies arrive at somewhat different figures.

For example, Fischer et al. carried out a literature search on 123 papers that covered 12,129 patients. They found that after 12 months, the average %EWL was 56.1%. At 24 and 36 months, the average %EWL was 64.3% and 66%, respectively.

Meanwhile, Hoyuela studied 156 patients who had a mean preoperative body mass index (BMI) of 41.5kg/m2. The average percentage of excess weight loss was 82% at one year and 60.3% at five years.

Shabbir and Dargan arrived at different figures after reviewing various studies covering 46, 133 patients. They found that the %EWL was 59% at one year and 50% at six years.

All these studies show that individuals who undergo gastric sleeve surgery can achieve and maintain substantial weight loss over several years. This alone indicates this procedure is highly successful.

The various reductions in %EWL may be due to patients’ ability to maintain the correct diet and stay active after surgery.

Improvement in Comorbidities

Obesity leads to a variety of health conditions including:

  • High blood pressure
  • Diabetes
  • Gastroesophageal reflux disease
  • High cholesterol
  • Fatty liver disease
  • Arthritis

Therefore, another measure of gastric sleeve success is whether there’s an improvement in these conditions.

Undergoing gastric sleeve surgery can lead to relief from symptoms or even remission in some cases. It can, therefore, be key in helping individuals to improve their overall health and wellbeing.

In the study by Hoyuela et al., after one year, 75% of patients recorded a complete resolution of diabetes mellitus. This was reflected in blood sugar levels that were below 120mg/dL after individuals stopped taking their diabetes medication.

The other patients showed significant improvement in their diabeteswhile one person was able to switch from insulin to anti-diabetic drugs. Meanwhile, 71.7% of hypertensive individuals saw an improvement or remission in their condition.

Also, those who had obstructive sleep apnea no longer need Continuous Positive Airway Pressure (CPAP) ventilation).

Meanwhile, Shabbir and Dargan found that 42% of individuals with diabetes and obesity in the Cleveland Clinic’s STAMPEDE trial had their HbA1C reduced to 6.0% at 12 months post-surgery. At six to eight years after surgery, 77% of them recorded remission or improvement of their condition.

These researchers also reported another study in which high blood pressure was reduced in 75% of the patients and resolved in 58%. These results show that gastric sleeve surgery alleviates obesity-related conditions, thereby lowering cardiovascular risk and related mortality.

Weight Regained in The Long Term

The third way to determine whether gastric sleeve surgery was successful is to look at the amount of weight the patient regains over time. It is common for individuals to put on a few pounds after losing a tremendous amount of weight in the initial stages. However, in a successful case, the weight gain is minimal.

Lauti et.al. found that patients recorded weight regain from about 5% two years post-op to 75% or more six years after surgery. They dtermined that putting on weight could be due to several factors including:

  • The initial size of the sleeve
  • Dilation of the sleeve
  • Increased levels of ghrelin (the hunger hormone)
  • Inadequate follow-up
  • Maladaptive behaviors

Quality of Life Improvement

Gastric sleeve success may also be measured by how it affects the patient’s quality of life.

Fezzi et al. administered two surveys to measure health-related quality of life in 78 patients undergoing laparoscopic sleeve gastrectomy prior to surgery and then 12 months after. They detected significant improvement across all criteria independent of the amount of weight lost.

Why Some Sleeve Gastrectomies Fail

As you can see, most sleeve gastrectomies result in an outcome that’s satisfactory for both the patient and their medical team. However, some people get better results than others and there are a number of reasons for this.

These include:

  • Differences in surgical practice. Each surgeon and facility uses slightly different methods. Even though the variations aren’t drastic, they can affect the results.
  • Not following the doctor’s recommendations. The first week after surgery plays a major role in weight loss, healing, and the overall success of the gastric sleeve. It is important for patients to follow the recovery plan which will include a liquid diet followed by a gradual reintroduction of solid foods and a gradual return to physical activity.
  • Returning to old eating habits. Some individuals get comfortable after they lose a significant amount of weight and they gradually start back eating in the way that led to their initial weight gain.

Binge eating, eating large quantities, and grazing are all linked to weight regain since they can make the stomach larger over time. Getting to the root cause of these eating practices can prevent them from reoccurring.

  • Not getting enough exercise. When patients don’t stick to their exercise plan, they tend to regain more of the weight they lost. Bariatric surgery needs to be accompanied by exercise for maximum results. Livhits et al. found that postoperative exercise could lead to a marked increase in weight loss.

How You Can Increase the Likelihood That Your Surgery is Successful

You can improve the results of your gastric sleeve surgery if you take the right steps before and after surgery. You should:

  • Do your research and have your surgery performed by a reputable bariatric surgeon at a trusted facility
  • Adhere to the surgeon’s recommendations as closely as possible from the moment you recover from anesthesia
  • Avoid falling back into your old eating habits
  • Seek mental health support to help you navigate the post-op changes, especially if you’re struggling with binge eating, eating large portions often, or grazing during the day.
  • Moving around and getting into an exercise routine as soon as you’re cleared to do so.

The Bottomline on Gastric Sleeve Success Rates

Sleeve gastrectomy is associated with a high success rate. Not only can it result in significant weight loss, but it can improve or resolve comorbidities, reduce mortality, and improve quality of life.

If you undergo bariatric surgery, you need to do everything you can to get the best possible results. This can be measured at regular intervals via percentage excess weight loss. However, the number on the scale isn’t the only thing you need to consider.

If you were previously diagnosed with obesity-related conditions such as hypertension, diabetes, high cholesterol, or non-alcoholic fatty liver disease, you should also pay attention to these metrics. If your gastric sleeve surgery was successful, your condition is likely to improve or even be resolved entirely.

Your ability to regain only minimal weight as time goes on is also an indicator of success.

If you follow the advice we set out above, you can help to ensure that you get the best possible results from your procedure.

To learn more about gastric sleeve surgery and how it can help you to lose stubborn weight and improve your quality of life, contact Renew Bariatrics and talk to a member of our expert team.

References

American Society for Metabolic and Bariatric Surgery. (2021, March). Estimate of Bariatric Surgery Numbers, 2011–2019. ASMBS. Retrieved March 3, 2022, from https://asmbs.org/resources/estimate-of-bariatric-surgery-numbers

Fezzi M, Kolotkin R, Nedelcu M et al. Improvement in Quality of Life After Laparoscopic Sleeve Gastrectomy. Obesity Surgery. 2011;21(8):1161-1167. doi:10.1007/s11695-011-0361-x.

Fischer, L., Hildebrandt, C., Bruckner, T., Kenngott, H., Linke, G. R., Gehrig, T., Büchler, M. W., & Müller-Stich, B. P. (2012). Excessive weight loss after sleeve gastrectomy: a systematic review. Obesity surgery, 22(5), 721–731. https://doi.org/10.1007/s11695-012-0616-1

Hoyuela C. (2017). Five-year outcomes of laparoscopic sleeve gastrectomy as a primary procedure for morbid obesity: A prospective study. World journal of gastrointestinal surgery, 9(4), 109–117. https://doi.org/10.4240/wjgs.v9.i4.109

Ibrahim, A. M., Ghaferi, A. A., Thumma, J. R., & Dimick, J. B. (2017). Variation in Outcomes at Bariatric Surgery Centers of Excellence. JAMA surgery, 152(7), 629–636. https://doi.org/10.1001/jamasurg.2017.0542

Kofman, M.D., Lent, M.R. and Swencionis, C. (2010), Maladaptive Eating Patterns, Quality of Life, and Weight Outcomes Following Gastric Bypass: Results of an Internet Survey. Obesity, 18: 1938-1943. https://doi.org/10.1038/oby.2010.27

Lauti, M., Kularatna, M., Hill, A. G., & MacCormick, A. D. (2016). Weight Regain Following Sleeve Gastrectomy-a Systematic Review. Obesity surgery, 26(6), 1326–1334. https://doi.org/10.1007/s11695-016-2152-x

Livhits, M., Mercado, C., Yermilov, I., Parikh, J. A., Dutson, E., Mehran, A., Ko, C. Y., & Gibbons, M. M. (2010). Exercise following bariatric surgery: systematic review. Obesity surgery, 20(5), 657–665. https://doi.org/10.1007/s11695-010-0096-0

Magro, D.O., Geloneze, B., Delfini, R. et al. Long-term Weight Regain after Gastric Bypass: A 5-year Prospective Study. OBES SURG 18, 648–651 (2008). https://doi.org/10.1007/s11695-007-9265-1

Shabbir, A., & Dargan, D. (2015). The success of sleeve gastrectomy in the management of metabolic syndrome and obesity. Journal of biomedical research, 29(2), 93–97. https://doi.org/10.7555/JBR.28.20140107

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This article contains scientific and health-related references. The numbers in the parentheses (1, 2, 3) are clickable links to peer-reviewed scientific papers.