There is an obesity epidemic in this country, according to a multitude of experts. The prevalence of obesity is blamed on a sedentary lifestyle and high-fat diet, a poor metabolism, or a combination of both. But while many people can lose weight through a balanced diet and regular exercise, some struggle to maintain a healthy weight no matter how hard they try. These individuals may consider weight-loss surgery, also called bariatric surgery,  to achieve their health goals.

There are different types of bariatric surgery used to treat obesity, including procedures that alter the anatomy of the digestive system. Dr. Jayaraj Salimath, D.O., medical director of the Methodist Weight Loss and Surgery Center, describes another option: the sleeve gastrectomy. The procedure was conceived of in the mid-1990s and refined in the past 3 years.

People with a body mass index (BMI) over 35, or approximately 100 pounds or more overweight, usually qualify for a sleeve gastrectomy, Dr. Salimath says. Prospective candidates undergo a screening process that includes patient education and a psychological evaluation.

How a Sleeve Gastrectomy Works
The sleeve gastrectomy is a procedure in which the stomach is trimmed into a narrow tube, about the size and shape of a banana, by permanently removing most of the stomach. Dr. Salimath explains, “It is a purely restrictive procedure, meaning it restricts the amount of food you can eat. By removing the majority of the stomach, we reduce the amount of appetite-producing hormone called ghrelin (produced by the stomach). Since stomach volume is greatly decreased, the average person will be able to eat only two to three ounces of food at a time.”

How is a Sleeve Gastrectomy Different from Other Procedures?
Dr. Salimath notes that the operation leaves the pyloric sphincter—a ring of muscle at the end of the stomach that contracts when the stomach is full—intact.  “The pyloric sphincter naturally acts as a band to prevent quick gastric (stomach) emptying, or dumping (into the small intestine),” which can cause vomiting and bloating.

Because the sleeve gastrectomy does not reroute the small intestine (like lapbastricbypass gastric bypass surgery), or insert a foreign body (like the Lap-Band), Dr. Salimath states this procedure has resulted in “very few” complications. And since most of the body’s absorption of nutrients, vitamins, minerals, and water occurs in the small intestine, leaving the digestive organ’s anatomy unaltered makes malabsorption (poor absorption) and resulting malnutrition less likely. Many patients who are not candidates for other types of bariatric surgery often qualify for the sleeve gastrectomy because it is less invasive, he adds.

“People with a body mass index (BMI) over 35, or approximately 100 pounds or more overweight, usually qualify for a sleeve gastrectomy.”

Possible Benefits The chronic health problems that commonly accompany obesity can often be reversed when a patient loses 80-100 pounds following surgery, Dr. Salimath explains. Many patients with diabetes, high blood pressure, elevated cholesterol levels, sleep apnea, and joint and back pain have shown marked improvement after weight loss. “Because of all this, they have a lot more energy and time to do other things (they enjoy).”

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