How much weight can be lost with the gastric sleeve surgery?

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Your weight falls into class III obesity, with uncontrolled diabetes and hypertension. In such cases, the risk of not opting for surgery, continued progression of diabetes, cardiovascular disease, and kidney damage, can outweigh the risks of surgery itself, especially if medications and lifestyle changes have not been effective.

Metabolic surgery can help to improve both blood sugar and hypertension, depending on the type of surgical procedure. With around 60-70 % inducing remission for diabetes and hypertension (HTN).

There are different types of bariatric surgeries.

1. Sleeve gastrectomy (up to 80 % of the stomach is removed) is very effective for weight loss and diabetes improvement.

2. Roux-en-y- gastric bypass (RYGB) creates a small stomach pouch and reroutes the small intestine to bypass part of the stomach and duodenum. Most effective for type 2 diabetes remission.

3. Mini gastric bypass (one anastomosis bypass) is a shorter surgery, with fewer complications. Effective for weight loss and diabetes.

4. Adjustable gastric banding has a high rate of long-term complications and reoperations.

5. Biliopancreatic diversion with duodenal switch (BPD-DS) can provide the highest weight loss and diabetes remission rates. It has a high risk of malnutrition and requires lifelong strict vitamin and protein supplementation.

The main difference between sleeve gastrectomy and Roux-en-Y gastric bypass is :

Sleeve gastrectomy:

1. About 75–80% of the stomach is removed, leaving a narrow gastric sleeve.

2. No intestinal bypass; only restrictive.

3. Reduces stomach volume and decreases ghrelin (hunger hormone). Minimal malabsorption and lower risk of deficiencies.

4. Weight loss is around 60-70 %.

Roux-en-Y Gastric Bypass (RYGB):

1. A small stomach pouch is created and connected directly to the jejunum.

2. Bypasses the duodenum and part of the jejunum.

3. Both restrictive and malabsorptive.

4. Reduces intake and nutrient absorption, also altering gut hormones.

5. Significant malabsorption; higher risk of deficiencies in iron, B12, and calcium.

6. Weight loss is around 65-80 %, slightly more than sleeve gastrectomy.

The complications include ;

1. Bleeding.

2. Infections.

3. Anastomosis leakage.

Recovery period:

1. Usually, the hospital stay is one to three days.

2. Can do full activity within four to six weeks.

3. You will follow a structured plan starting with liquids, then soft foods, then regular meals over a few weeks.

4. Most patients lose 60–80 % of excess weight and maintain long-term improvements in blood sugar and pressure.

You will need to commit to regular follow-up, nutritional counseling, and possibly vitamin supplements for life.

With bypass, you can observe the following:

1. Up to 80 % of patients reduce or stop insulin.

2. Leaks are rare (< one %) in experienced hands.

3. Major complications are uncommon when done in high-volume centers.

4. You reduce risks by following pre-operative instructions (diet, smoking cessation, blood sugar control).

5. It is likely you will have some excess skin with major weight loss.

6. Whether it bothers you depends on your personal and aesthetic priorities.

To summarize:

1. Gastric bypass gives you the best chance to reverse diabetes and lose substantial weight before your wedding.

2. Sleeve is safer for some, but reflux risk and less diabetic effect may make it less ideal in your case.

3. You need a metabolic surgeon experienced in high-risk diabetes cases.

With proper follow-up, nutritional risks are manageable, and insulin freedom is possible—maybe even likely.

Kindly consult a specialist doctor, talk with them, and take medications with their consent.

I hope this helps.

Thank you.