By Shawn Stevenson, DO, FACS – Chief of Bariatric and Foregut Surgery, Dignity Health
As a bariatric surgeon, one of the most common frustrations I hear is: “I can lose weight on a diet, but I can’t keep it off.” That’s not a failure of willpower—it’s your biology. When you restrict calories, your body pushes back with stronger hunger signals and a slower metabolism. Over time, that makes it nearly impossible to maintain progress through dieting alone.
That’s where sleeve gastrectomy comes in.
How the Sleeve Works
Sleeve gastrectomy is a minimally invasive procedure that reshapes the stomach and rewires hunger signals. During surgery, I remove the portion of the stomach that produces ghrelin, the hormone responsible for triggering appetite. With lower ghrelin levels, patients often experience a noticeable drop in cravings, additionally, the decreased size of the stomach will help to decrease the portion size of meals also contributing to ongoing weight loss.
Here’s what happens during the procedure:
- The stomach is divided vertically using a line of staples
- The larger portion is removed, leaving a narrow, tube-shaped stomach
- The new stomach holds just 1–5 ounces of food
- The procedure is performed laparoscopically, with small incisions and minimal scarring and requires little on no hospital stay post operatively.
What to Expect After Surgery
Recovery is typically quick. Most patients return to light activity within two weeks and feel fully recovered in about three. Beyond weight loss, many experience improvements in:
- Type 2 diabetes
- High blood pressure
- Sleep apnea
- Overall energy and mood
- Decreased risk of heart attack and stroke
- Decreased back and joint pain
Patients often tell me the biggest change isn’t just on the scale—it’s in how much better they feel day to day.
Why It Works
Sleeve gastrectomy isn’t just about shrinking the stomach. It changes the biology of appetite itself. By reducing hunger hormones and limiting food volume, it creates the conditions for sustainable weight loss—something diets alone rarely achieve.
Final Thoughts
If you’ve struggled with weight despite countless diets, know this: it’s not a personal failure—it’s your physiology. Sleeve gastrectomy is a safe, effective option that addresses appetite at its source and gives you a real chance at lasting change.
