Is Gastric Sleeve Surgery Right for You?

A gastric sleeve can help people who have tried for years to lose weight and keep it off. It is also a big decision, with real changes afterward. Here is how to think about whether it might be right for you.

The medical side

Guidelines use your body mass index (BMI) together with your health to decide who may benefit from bariatric surgery.

• Canadian guidelines say surgery can be considered with a BMI of 40 or more, or 35 or more with at least one weight-related condition, such as type 2 diabetes or sleep apnea.
• They add that surgery may be considered with a BMI of 30 to 35 when weight-related conditions have not improved enough with other treatment.
• International guidelines from 2022 (ASMBS and IFSO) recommend surgery from a BMI of 35, and say it should be considered from a BMI of 30 for people with metabolic disease or when other methods have not worked.

At 360 Sleeve, a private clinic in North York, most people we see have a BMI of 30 or higher, and the sleeve is usually offered to adults aged 18 to 65. Your surgeon also looks at your health history, your medicines, any reflux, earlier operations and your goals.

Some situations mean surgery should wait, or that another approach is safer. Examples are active alcohol or drug misuse, a mental health condition that is not stable yet, or a pregnancy in the coming year or so. If you smoke, Canadian guidelines ask you to stop before surgery and to stay smoke-free for life.

Being ready for the changes

The operation takes one day. The changes that follow last for years. People who do well after a sleeve are usually ready to:

• Follow the eating stages after surgery, then eat small, protein-first meals for life.
• Take bariatric vitamins every day, for life, and have regular bloodwork.
• Build up regular activity, week by week.
• Keep their follow-⁠up appointments, especially in the first two years.
• Ask for help early if eating, mood or weight start to slip.

Surgery can also change how you see yourself and how others react to you. Some people notice changes in their relationships, their body image or how they cope with stress. Talking these through before surgery, with your team and the people close to you, helps.

Realistic expectations

A sleeve removes about 80% of the stomach. Most people feel full sooner and much less hungry, and lose weight steadily in the first one to two years. But obesity is a chronic condition, and a sleeve is a tool for it, not a cure.

In long-term studies, results vary widely from person to person, and some weight regain after the first years is common. The habits you build with your care team make a real difference.

Questions to ask yourself

• What have I tried before, and what got in the way?
• Do I understand what I will eat in the first weeks, and later?
• Who will help me in the first days after surgery?
• Am I ready to take vitamins and come to follow-⁠ups for years?
• What do I hope will change, beyond the number on the scale?

The clearest way to find out

A consultation with a surgeon is where you get a clear answer for your own situation. At 360 Sleeve it is free, in person in North York or online, and there is no obligation. You can ask anything. If a sleeve is not the right fit, your surgeon will tell you and talk through other options, such as SADI-⁠S, ESG or medical treatment.