Why Am I Not Losing Weight After Gastric Sleeve Surgery? Common Myth Debunked!

One of the common post-procedure concerns a bariatric patient may have is: “Why am I not losing weight after gastric sleeve surgery?” Patients may go through a low phase post-operatively if they had a poor understanding or misplaced expectations about how a weight loss surgery works. 

An experienced bariatric surgeon will educate the patient during the initial consultation to help them make an informed decision. They will discuss how much weight loss after gastric sleeve could be achieved and share data regarding the average monthly weight loss after gastric sleeve.   

Gastric sleeve weight loss can be very substantial in almost every case. But if the patient is unaware about the estimated timeline or fails to follow the post-op instructions of the surgeon, the results could be disappointing.

If the patient is worried about achieving little to no weight loss after gastric sleeve surgery, they should discuss the concern with their bariatric surgeon and nutritionist. In the rare case of a gastric sleeve weight loss failure, the surgeon may recommend a revision to gastric bypass surgery. A gastric bypass would involve rerouting of the small intestine to reduce calorie absorption. This could help the patient achieve their weight loss goals more successfully and on a sustainable level.

No weight loss after gastric sleeve: Myth or reality?

The biggest myth about not losing weight after gastric sleeve is that a massive weight loss will occur as soon as the surgery gets completed. Patients should understand that gastric sleeve weight loss is different from fat loss (which can occur instantly by way of liposuction).

Gastric sleeve surgery is designed to eliminate excess body weight in a safe and gradual manner, and not instantaneously. Patients should have realistic gastric sleeve weight loss expectations, especially with regard to the weight loss timeline. 

Gastric sleeve expected weight loss typically begins to occur right after the procedure, but some patients may even report no weight 3 weeks after gastric sleeve. 

As the patient recovers from the surgery, they will start feeling less hungry than before. Gastric sleeve weight loss will become more rapid with the passage of a few weeks and months as the surgery enables the patient to adopt healthier eating habits. 

A reduced urge to eat following the surgery will serve as an effective solution to achieve safe, healthy and sustainable weight loss after gastric sleeve.

Related: Gastric sleeve surgery post op diet

Weight loss after gastric sleeve: All you need to know

Patients who are constantly worried about, “Why am I not losing weight after gastric sleeve,” or that gastric sleeve is not working should know that gastric sleeve surgery results are directly related to the change in dietary and lifestyle habits. 

vertical sleeve gastrectomy

Sleeve gastrectomy is aimed at facilitating this process of healthy habits. During the procedure, the bariatric surgeon will remove a portion of the stomach to make it smaller (roughly the size of a banana). 

When the size of the stomach is permanently reduced, it will naturally reduce the patient’s appetite. Their meal portions as well as frequency of meals will reduce. 

Gastric sleeve surgery also induces healthy hormonal changes that further curb the appetite. 

Based on this, patients who are concerned about not losing weight after gastric sleeve should understand the permanent healthy changes to their body and how it will help them naturally achieve massive weight loss.     

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Gastric sleeve expected weight loss

The expected weight loss after gastric sleeve will be in the range of 65 to 70 percent (of excess weight) within the first year. The average monthly weight loss after gastric sleeve is in the range of 8 to 12 pounds per month. 

Timeline for gastric sleeve expected weight loss

Expected Weight Loss After Gastric Sleeve

At 3 months 25 to 30 percent excess weight loss
At 6 months 45 to 50 percent excess weight loss
At 12 months 65 to 70 percent excess weight loss
At 18 months 70 to 80 percent excess weight loss


Gastric sleeve weight loss expectations in the long-term can vary from one individual to another, depending on their personal commitment to a healthy lifestyle and balanced diet. 
However, on average, the expected weight loss after gastric sleeve in five to ten years is about 50 to 60 percent of the excess weight.

Patients should know that these are only ‘averages’, and on an individual basis, it is possible for a person to achieve far more dramatic results than the average patient. Stemming from this, while it’s necessary to maintain reasonable expectations, a patient should have ambitious gastric sleeve weight loss goals.

Related: Gastric sleeve before and after

Can you gain weight after gastric sleeve?

Yes, you can gain weight after gastric sleeve under certain conditions. Marginal weight fluctuations, temporary weight regain, and weight loss plateau are normal and expected events during your post-operative weight loss journey. Moreover, if weight regain appears to be progressive and irreversible, you should contact your bariatric surgeon for advice.

Percent of weight gain after gastric sleeve

Percent of weight gain after gastric sleeve can widely vary between patients. This will depend on the underlying cause as well as the time period after your VSG surgery when the weight regain occurs. Research says that the percentage rate of weight gain in the long-term could vary from 5.7% at two years after surgery to 75.6% at six years.

Why am I gaining weight 3 weeks after gastric sleeve

Bariatric surgeons sometimes receive frantic calls from their patients who want to know: “Why am I gaining weight 3 weeks after gastric sleeve?” In most cases, weight regain at three weeks is not a cause for concern. Chances are you might have shed several pounds rapidly in the first three weeks, and thereafter your metabolic system may be taking a temporary break. But if the weight gain persists beyond a few days, it is important to investigate the underlying cause.

  • Failure of diet plan: If you are wondering, “Why am I gaining weight after sleeve surgery,” the first step is to review your post-op diet plan. Are you diligently following your prescribed gastric sleeve diet? Any significant deviations from it may result in weight regain.
  • Physiologic changes: Some patients may go through physiologic changes, resulting in a spike in hunger hormone levels, dilation of the residual pouch, or notable upper GI tract symptoms that prevent a strict adherence to post-op diet. Seek help from your surgeon in these conditions.
  • Surgical errors: If you had your gastric sleeve surgery from a less qualified or less experienced surgeon, there is a risk of inadequate stomach tissue removal. You may be left with a big gastric fundus or large sleeve, which does not restrict your food storage and eating capacity as it should.

8 Reasons why gastric sleeve is not working for you

To answer the all-important question of “Why am I not losing weight after gastric sleeve surgery,” researchers have identified five possible reasons why your weight loss after gastric sleeve may not be up to the expectations. 

RelatedHow to avoid gastric sleeve failures

1) You are not consuming the prescribed calories

It may seem counter-intuitive that eating less than the recommended amount of daily calories after your gastric sleeve or gastric bypass surgery can actually stall your weight loss. But the scientific fact is that your body needs a certain minimum number of calories every day to produce energy. The reduction of hunger hormones following your weight loss surgery may result in a lack of urge to eat.

You might feel it is astute if you are consuming even less calories than prescribed, but in reality your body will start starving. To survive, the body will start burning the available fat deposits and muscle. The loss of muscle will make it difficult to lose weight and you may experience a weight loss plateau. Therefore, do not deviate from your surgeon’s recommended post-op diet plan.

Related: 5-day pouch reset

2) You are eating unbalanced meals 

It is possible that you are strictly maintaining your recommended calorie intake of 1,000 to 1,200 calories a day after your gastric sleeve, but still you are not losing weight. The reason could poor meal planning and lack of a balanced diet. Your diet should include the right amount of lean proteins every day. Proteins will boost your muscle build-up and help you lose weight without losing the vital muscle and fat.

Sometimes you may be eating all the daily carbohydrates in one time, daily protein during the second meal, and veggies and fruit in a third meal. The correct way is to include all the vital nutrients proportionately in every meal in small portions. Consult with your nutritionist about correct meal plans, and follow them diligently. You may also request your nutritionist to provide a few recipes to make it easier to follow your recommended meals.

Related: Eating after gastric sleeve surgery

3) You are not tracking your daily nutrition

Weight loss after gastric sleeve or gastric bypass surgery may sometimes fail when you stop keeping a track of your daily food intake. In the first few days or weeks after your surgery, you may be highly motivated to maintain your daily diet exactly as advised by your bariatric surgeon. However, with the passage of time, you may start getting lax about keeping a careful record of what to eat, when to eat, and how much to eat.

Some people initial lose weight rapidly, and then start taking it easy because they believe they are progressing well. In some other cases, patients simply get tired of monitoring and measuring every meal and every snack break – all 7 days of the week. But the moment you start losing track of what you eat, it gets easy to violate your diet plan. If you continue that way, you may develop poor eating habits once again before you know it.

4) You are grazing and snacking more than you should

During your post-surgery gastric sleeve diet, focusing on whole foods and single-ingredient foods day after day, week after week can get tiresome or monotonous after a while. To break this monotony, your dietitian and surgeon would introduce two daily snack breaks between meals. But sometimes, you only look forward to your snack breaks because you relish the comfortable and delicious foods that are part of your snacks.

You may also sometimes develop the habit of “grazing” between meals. Grazing can disrupt your diet plan, and it won’t get measured or tracked either. Another problem with snacks is that they do not provide satiety, and the urge to eat only keeps growing. Too much of snacking and grazing could quickly result in a weight loss plateau. Even if you skip a main meal and replace it with a snack, it will still obstruct your weight loss journey.

RelatedGastric sleeve complications

5) You are not hydrating sufficiently enough

At the time of your nutrition planning after your gastric sleeve or gastric bypass surgery, your weight loss surgeon will recommend you to drink at least 64 oz. (about 8 full glasses) of water every day. They will also advise you to avoid drinking water or other liquids with your meals as well as 30 minutes before and after a meal. If you are not following these guidelines, you could be setting yourself up for a weight loss plateau.

Staying sufficiently hydrated at all times will give you the feeling of fullness, and it will get easier to maintain your diet control. Secondly, your urge to have other beverages such as sodas, tea and coffee, and alcohol will reduce when you are in the habit of drinking plenty of water each day. Almost all other beverages except pure water will add empty calories to your diet, and will make it hard for you to achieve your weight loss goals.

RelatedBuilding muscle after gastric sleeve surgery

6) You are lacking in physical activity and exercise

While the primary weight loss needle-mover after your gastric sleeve surgery is going to be your diet, you cannot afford to ignore your physical fitness regimen either. A sedentary lifestyle not only poses risks for your health, it will also make it more difficult for you to achieve your weight loss goals. In the first three months after your bariatric surgery, you will have to avoid vigorous exercises, but you can still do walking and mild exercises.

Once your surgeon gives you the go-ahead for strenuous exercises and weight training, you should focus on building muscle mass for a toned and sculpted body. This will keep you physically fit, and prevent conditions such as stalling of weight loss after gastric bypass or gastric sleeve surgery. Fitness will help you counter issues such as emotional or binge eating and shift your perspective towards healthy eating and healthy living.

7) Your physiological condition is posing challenges

Thyroid disorder, sleep apnea, gut imbalances, PCOS (polycystic ovarian syndrome), adrenal fatigue, hormonal fluctuations, insomnia, and toxicity are some of the medical conditions that could create hurdles in your weight loss after gastric sleeve. To address these conditions, you may be taking certain medications which could make it more complicated to lose weight or even induce weight regain after your surgery.

Remember that these underlying health problems are not your fault, so do not blame yourself for your lack of weight loss. Your goal should be to get treated for these conditions and follow your doctor’s advice. Once these underlying symptoms are resolved, your weight loss challenges may also dissipate. From your side, do not ignore the nutrition supplements that your surgeon may recommend, especially after gastric bypass surgery.

8) You are going through emotional problems

A weight loss surgery can put you on the path to a healthy and obesity-free life. But it cannot guarantee that you won’t face emotional problems in your personal life. Sometimes your partner, if you have one, may not be able to synchronize with the favorable physical, mental, social, and professional changes that may occur in your life post-surgery. This may create a rift and become the cause of your emotional distress.

Some people experience emotional challenges after bariatric surgery for different reasons. They may get obsessed with their diet plan, become too hard on themselves to lose weight, search for quick fixes to reach their weight loss goals early, get frustrated or start hating or blaming themselves for even small weight loss hiccups. Emotional problems encourage binge eating, failure of diet discipline, and could disrupt your weight loss journey.

Related: Gastric sleeve complications

Weight loss stall 6 months after gastric sleeve

In the first few months following your VSG, you may consistently lose several pounds of excess weight each month. But all of sudden, this exciting journey may hit a weight loss stall 6 months after gastric sleeve. But don’t let this temporary setback dampen your enthusiasm or detract you from your goal to eliminate obesity.

  • A false alarm: In many cases, the weight loss plateau 6 months after gastric sleeve may not be real, and it could be just an aberration. You may have marginally slackened in adhering to a rigorous diet plan, or your body may be taking just a temporary metabolic break.
  • Weight loss plateau: If you observe that the weight loss stall 6 months after gastric sleeve is persistent, it is time to take corrective measures. Make adjustments to your diet in consultation with your nutritionist, try some new exercises, and modify your lifestyle to disrupt the stall.
  • Consult your surgeon: Despite your best efforts, if the weight loss stall 6 months after VSG does not reverse, you should consult your bariatric surgeon. They may order a few tests to investigate the cause and recommend solutions. In a rare case, you may need a revision surgery.

Related: Gastric sleeve regrets

How to be successful after gastric sleeve

Gastric sleeve surgery is aimed to aid your weight loss process, but it will not work without your personal commitment to achieve your ideal body weight. If you want to know how to be successful after gastric sleeve, here are a few proven tips that will help you beat the odds and emerge a winner with permanent freedom from obesity.

  • Avoid empty calorie foods and beverages, and maintain a strong focus on a wholesome, nutrient-dense diet for consummate health.
  • Prioritize lean proteins in your diet, and make it point to eat protein foods first in every meal. Choose even snacks which contain proteins.
  • Plan every meal both scientifically and creatively to maintain a balanced diet, while still getting variety and taste for easy compliance.
  • Drink plenty of water each day to stay well-hydrated, and continue to avoid sugary, carbonated, caffeinated and alcoholic beverages.
  • Eat your meals in small portions, eat slowly, and chew thoroughly to make it easier on your digestive system, and to minimize nausea.
  • Do not allow a sedentary lifestyle to thwart your plans of how to be successful after gastric sleeve, and follow a regular fitness regimen.
  • Measure your calories in each meal, track your daily intake, and maintain a journal so that you don’t deviate from your goals.
  • Be diligent about taking your daily supplements and vitamins as prescribed by your bariatric surgeon to promote good health.
  • Get adequate sleep, learn to manage your stress levels, do yoga or meditation, and maintain a moderate and healthy lifestyle.
  • Enlist emotional support from friends and family, participate in online or offline support groups, and maintain self-confidence.
  • Maintain your follow-up appointments with your bariatric team and continue to adhere to their professional advice for best results.

Gastric sleeve results of Jet Medical Tourism’s patients

Choose Jet Medical Tourism® for Best Weight Loss Results with Gastric Sleeve!

At Jet Medical Tourism®, we regularly have patients who achieve significant excess weight loss after gastric sleeve surgery. If you are wondering whether gastric sleeve surgery is the right choice for you, give us a call today or contact us online to schedule a consultation.

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