Gastric Sleeve

There are many factors to consider for eligibility but we generally offer the sleeve gastrectomy procedure to those with a minimum body mass index (BMI) of 35. If you are of Asian ethnicity and/or you are a Type 2 diabetic we would consider surgery at a lower BMI. We will explain the eligibility criteria in more detail at your face-to-face consultation.

At Healthier Weight, we specialise in bariatrics. We offer gastric sleeve surgery for individuals seeking a dedicated and personalised approach to their weight loss journey. Our criteria for eligibility focus primarily on a BMI of 35 or higher, with no upper BMI limit, as we specialise exclusively in weight loss procedures. We understand that obesity affects individuals differently, and our team of experienced surgeons, dieticians, and support staff are dedicated to evaluating your unique circumstances. We prioritise your individual goals, health conditions, readiness for the procedure, and long-term commitment to ensure the best outcomes.

The eligibility criteria that apply in private healthcare are a little different to those that apply in the NHS. The reason is that the NHS eligibility criteria that are set by NICE (the National Institute for Health and Clinical Excellence) have to balance the public health benefit with what the state can afford.

In the private sector, we are not faced with the same price restraints as patients are paying for their procedures. This means that we can make decisions based purely on the available scientific data. For that reason, we will generally consider patients with lower BMI than would be the case for the NHS.

The NICE guidelines state that patients will be eligible for bariatric surgery if they have a BMI above 40 or above 35 with at least one major co-morbidity. In addition, patients will need to follow and ‘pass’ a 6 – 12 month weight loss programme before they will be considered eligible for surgery. There will then usually be a waiting list.

The reality is that very few NHS Trusts apply these criteria and you may have read in the press that Trusts are applying their own, much tighter, selection criteria. This is because they do not have the resources needed to apply the NICE guidelines. Some Trusts are limiting surgery to patients with a BMI over 50, to diabetics and/or to patients who don’t smoke.

At Healthier Weight, we generally consider sleeve surgery for patients with a BMI of 35 and above. You will need to have tried and failed with diet plans as a way to manage your weight and your weight will need to be harming your everyday life.

As with all surgical operations, there are associated risks and a gastric sleeve is a more invasive procedure than a gastric band which is why it is important to choose a specialist bariatric surgeon with considerable gastric sleeve experience. In the hands of a highly experienced Healthier Weight surgeon, the gastric sleeve is still a safe and effective procedure. Read more about our sleeve centres and surgeons here.

The gastric sleeve (laparoscopic sleeve gastrectomy) is the world’s fastest-growing weight loss procedure, surpassing gastric band and bypass surgeries in NHS popularity. This simple concept involves laparoscopic access, cutting and removing about 80% of the stomach.

Post-surgery, food follows the same path, but with a significantly smaller stomach. The sleeve facilitates weight loss by reducing stomach capacity and altering gut hormones (ghrelin and GLP-1), suppressing appetite. Notably, excess body weight loss is rapid, and it’s crucial to understand that weight loss isn’t directly tied to the remaining stomach size; gut hormone changes drive effective weight loss in both ‘tight’ and ‘loose’ sleeves.

The gastric sleeve’s effectiveness lies in a combination of factors – a smaller stomach and hormonal changes. Specifically, the reduction in ghrelin, a hormone affecting appetite, contributes to the success of sleeve surgery. Around 90% of patients find success due to these changes, often experiencing an immediate shift in their taste for food.

Like all weight loss surgeries, long-term success depends on adopting the right diet and habits post-surgery. Ongoing aftercare and support are vital for sustaining benefits over time, making them as crucial for sleeve patients as for those undergoing other weight loss procedures.

Gastric sleeve surgery, like any bariatric procedure, carries operative and long-term risks. In skilled hands, it’s notably safe, with a low early complication rate (3-5%) and a minimal mortality rate (0.1-0.5%). This is attributed to its technical simplicity, avoiding bowel cutting or joining, differentiating it from procedures like the gastric bypass.

Gastric sleeve risks include:

• Haemorrhage (bleeding)
• Leaks from staple lines leading to infection
• Adverse reactions to anaesthesia and/or medication
• Blood clots (Deep vein thrombosis in the legs / Pulmonary embolus on the lungs)
• Longer term, potential nutritional deficiency
• Marginal ulcer
• Narrowing of the stomach
• Gastroesophageal Reflux

Read more about the common complications of gastric sleeve surgery

Gastric sleeve is a powerful choice for rapid weight loss, with studies indicating an average excess weight loss of 60-70%* over 2 years. Our patient success stories also showcase what spectacular results you can achieve with a gastric sleeve.

To sustain long-term benefits, adopting a healthy diet and regular exercise is crucial. Additional benefits include a reduced risk of weight-related medical conditions like type 2 diabetes and heart disease.

Typically, we expect gastric sleeve patients to lose 60-70% of their excess weight over a 2-year period, and most of this weight is lost in the first year after surgery*. You will see from our case studies that some people lose all their excess weight. 

Weight loss results will differ from person to person and your results, especially in the long term, will depend on how well you are able to adapt your lifestyle and eating habits. Our bariatric aftercare team is vital to helping you learn and embed the skills needed to maximise and maintain your weight loss (see before and after photos and stories from gastric sleeve patients here).

Weight loss example

• A 5ft 6in person weighing 17st (240lbs / 109kgs) has an ideal weight of about 11st (154lbs / 70kgs)
• They are carrying excess weight therefore of 86lbs (240lbs actual weight minus 154lbs ideal weight)
• 70% of 86lbs is around 60lbs
• So, this person could expect to lose (on average) about 60lbs (27kgs).

Scientific evidence suggests that most gastric sleeve patients who comply with the follow-up requirements, including nutritional recommendations, do very well, and see great long-term results*. Moreover, compared with obese individuals who have not had surgery, gastric sleeve patients have a much lower risk of premature death and disability.

*JAMA. 2012 Jan 4;307(1):56-65. doi: 10.1001/jama.2011.1914. Bariatric surgery and long-term cardiovascular events

Due to the considerable amount of weight that gastric sleeve patients typically lose, it’s possible that you will experience some excess, loose or saggy skin. This most commonly occurs in the abdominal apron, or trunk area. The amount of excess skin you’ll be left with following a gastric sleeve operation varies and will depend upon your age and weight before the procedure. Generally, the heavier and older you are, the more likely you are to have excess skin. Younger patients tend not to have as much lax skin due to greater natural skin elasticity. 

Most sleeve patients will stay in a hospital for 1 night before going home. You should start to feel much more comfortable around 2 weeks after surgery, but it typically takes around 6 to 8 weeks for your stomach to heal completely. Read more about the recovery time.

Your diet will change following the weeks out of surgery, however, after week 5 you can eat most foods, provided they don’t cause you discomfort. However, because you will be consuming less food in general, it is important that you include foods that are rich in protein, but low in fat and sugar. We encourage you to eat vegetables, fruit, whole grains, lean meat and fish. You will be provided with detailed nutritional information following your gastric sleeve operation.

Typically lasting 45 to 60 minutes, gastric sleeve surgery involves making 4 to 5 small horizontal incisions (about 5mm long) in the stomach for instrument passage. After a brief hospital stay of 1-2 nights, you’ll be discharged and advised to rest for at least 7 days to aid recovery. Improved comfort is expected around 2 weeks post-surgery.