Sleeve Gastrectomy

How to know if Gastric Sleeve surgery is right for you

Do you find yourself trapped in a cycle of losing and regaining weight, regardless of what diet you have tried? We understand. Looking into weight loss (bariatric surgery) can be overwhelming, leaving you with many questions.

To get the best results, you need to arm yourself with knowledge, commitment and support for long-term success. The most significant benefit of weight-loss surgery is you’ll be a healthier you!

“For many obese individuals, surgery provides the most effective long-term solution for weight loss when other methods have failed,” says Vishal Kothari, MD, bariatric surgeon at the Bariatrics Center at Nebraska Medical Center. “Increasing evidence shows that it can help reduce a person’s risk for a number of serious diseases like diabetes, heart disease, arthritis and cancer. Patients are more mobile, feel better about themselves, have less depression and have better family, social and work lives.”

What is Gastric Sleeve surgery and how does it promote weight loss?

Gastric sleeve is a newer procedure than gastric bypass. It is a nonreversible procedure in which a portion of your stomach is removed from the body. Studies have shown that a person loses half their excess body weight on average. This means if you are 100 pounds overweight, we anticipate you losing at least 50 pounds after surgery. During surgery, the stomach is divided. About 80% is completely removed, leaving your stomach size about 20% of what it once was. There is no rerouting of the bowel.

Sleeve gastrectomy works in two ways:

  • Restriction – About 80% of your stomach is removed at the time of surgery, leaving you with a tube- or banana-shaped stomach. This limits the amount of food you can eat and the amount of calories consumed.
  • Hormonal changes – The procedure causes changes in the hormones that control hunger. Most patients will experience a time during which they do not feel hungry. This is an added benefit as you make the necessary diet and behavior changes. Hormonal changes are not permanent, and after a time, hunger cravings will usually return.

What are the advantages and disadvantages?

Advantages of the sleeve gastrectomy:

  • You, on average, will drop half your excess body weight loss.
  • Changes in gut hormones that decrease hunger and help you feel fuller faster.
  • It is less technically complex than the gastric bypass and therefore has less risk of post-surgery complications and shorter operating time when compared to gastric bypass surgery.
  • Does not re-route the bowel.
  • Generally safer if pregnancy is a future goal.
  • Less risk of long-term vitamin and nutritional deficiencies.

Disadvantages of the sleeve gastrectomy:

  • This surgery cannot be reversed.
  • Potential for an increase in gastric reflux.
  • Possible post-surgery complications, as discussed with your surgeon.

How do I know if I qualify?

According to the guidelines provided by the American Society for Metabolic and Bariatric Surgery, you may be a candidate if you:

  1. Have a BMI that is equal to or greater than 40. For example, an adult who is 5’11” tall and weighs 290 pounds would have a BMI over 40.
  2. Have a BMI that is equal to or greater than 35 and at least one obesity-related co-morbidity, such as: Type II diabetes (T2DM), hypertension, sleep apnea and other respiratory disorders, non-alcoholic fatty liver disease, osteoarthritis, lipid abnormalities, gastrointestinal disorders or heart disease.
  3. Have been unable to maintain a healthy weight loss for a sustained period using other reliable methods.

Calculate your BMI

Read more about who is a candidate for bariatric surgery.

What can I expect before surgery and during recovery?

Before surgery

You will have a special diet before and after surgery. In the pre-surgical classes, you’ll learn how your life will change after surgery and about new eating habits to make your surgery successful. You’ll get advice on exercise and other lifestyle changes you must make. It’s essential that you follow this advice to the letter.

After surgery/recovery

In general, recovery time and pain levels vary from person to person. After surgery, we provide follow-up and a support group to help you stay on track. Studies show this type of support directly affects a patient’s success. Those committed to the journey who remain excited about their goals will succeed!

You must adhere to a new diet, ensure you get enough vitamins and follow your doctor’s recommendations.

We want to help you lose the weight and avoid regaining it. After your surgery, we’ll want you to come in somewhat frequently. Assuming things are fine, after about two years we’ll ask you to come in once a year. It’s not uncommon for patients to regain at least a little of the weight. That’s why we want to help you remain energized to make eating healthy and keeping the weight off a habit, not just an exercise in willpower. To help get you over the rough spots of the journey, we can enlist the help of a dietitian, exercise therapist, psychologist or endocrinologist. If necessary, we can prescribe medication that boosts weight loss as well.

What is the cost? Will insurance cover it?

There are many variables when considering the cost of weight-loss surgery. Part of the conversation should be counting the long-term health costs to your body and your budget of ignoring the problems weight brings.

We suggest contacting your insurance company directly to determine what coverage your insurance plan allows. See a list of insurance plans Nebraska Medicine accepts. If you need to pay out of your pocket, we can set up a payment plan to fit your budget.

How do I maintain a healthy weight after surgery?

Remember, weight-loss surgery is only a tool in a lifetime of getting and staying healthy. It takes changing unhealthy habits to keep the weight off. It’s not the easy way out! It takes dedication, perseverance and daily work. You will need to keep learning, reinforcing good habits, and celebrating your small victories. With ongoing support and commitment, weight maintenance can be a reality. Gastric sleeve surgery may be a great option for you, but it is only the beginning of your journey.

“I can tell you from personal experience that bariatric surgery is a great tool for weight-loss,” says Corrigan McBride, MD, a bariatric surgeon and former bariatric surgery patient. “But there’s nothing magic about these surgeries. Yes, problems can be corrected. But when it comes to weight loss, you still have to count calories. You still have to burn calories. You still have to exercise.”

Success depends on your effort after surgery; we are here to help.

I want to take the next step. Now what?

You are already taking the first step; doing your homework and researching options. It’s important to look at all the factors involved in your decision. Doing your research, thinking through questions and meeting with a specialist are great starting points in making an educated decision.

  • Watch our bariatric surgeons and their team explain the procedures and how they can help. You’ll learn more about weight-loss surgery and the benefits of a medical weight-loss program.
  • Consider your health goals, and what it would mean to those around you if you lost the weight.
  • Think about your financial situation. Could you afford to pay for — or make payments on — the surgery if insurance doesn’t cover it?
  • Take notes as you research, jot down questions and take them with you when you meet with a gastric sleeve specialist.

While gastric-sleeve surgery is effective, other nonsurgical options are available. Get to know what we offer and set up a time to meet with a weight-loss expert to discuss all of your options. Whatever your circumstances, we can help you sort through which type of weight-loss surgery is the best option for your life and goals.

Is it time to schedule an appointment to discuss bariatric surgery? We look forward to meeting and helping you on your weight-loss journey.

To make an appointment or for a consultation at the Bariatrics Center, please call 402.559.9500.

Have questions? We're here to help.

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