How Bariatric Surgery Works: The Sleeve


As I mentioned two weeks ago there are basically three different procedures that we do for weight loss: the band, the sleeve and the bypass.  Two weeks ago I discussed how the band works (of the three procedures it is the simplest and the easiest to understand).  Today I want to discuss the sleeve.  Many people haven't heard of the sleeve because until a year and a half ago, most insurance companies weren't covering it.  Today, most insurances cover it, with one very important exception….Medicare!  Currently Medicare does not cover the sleeve, although hopefully that will change at some point in the future…

Dr. Michael BilofDr. Michael BilofAs I mentioned last time, of the three procedures we do
for weight loss the band only does one thing to help a patient lose weight..that is restriction or portion control.  The analogy I used was to think of the band like an hour glass or a speed bump in your stomach.  If you would like to read the full description of the band the link is here:


One thing I would like to mention right here at the beginning is if you are a patient who had a band in the past and have not had success losing weight, it is possible to remove the band and convert it to a sleeve!  So, if you have had a band in the past and not had success with it,  I want you to know there are definitely still options available for you and you may want to come to the office to discuss it.

Today I want to discuss the sleeve and compare it to how the band works.  The sleeve does two things to help a patient lose weight, the first (like the band) is that it restricts how much food a person can eat.  This is accomplished by removing part of the stomach (so this is truly a permanent procedure, once this part of the stomach is removed it cannot be put back).  To give you an idea of how much smaller your stomach will be consider that your stomach is about 32 ounces (picture a quart of milk) and after a sleeve it will be about 4 or 5 ounces (picture a small to medium sized banana).  This will obviously decrease the amount of food a person can eat!

The second way the sleeve helps patients lose weight is by shutting off your appetite..I call it the big "off switch" for your appetite.  This is a very consistent part of this surgery, but in all honesty we don't really know exactly why it happens.  It is an active area of research and there are many theories out there.  If you Google it or do some web surfing you will undoubtedly see references to "Ghrelin" and other intestinal hormones as the reason for the dramatic decrease in appetite.  While I suspect these hormones and other chemicals are part of the reason for this dramatic decrease in a person's appetite I doubt it's the entire answer, but in some sense it doesn't really matter how it happens, all that matters is that it does happen!

So the sleeve has two ways to help patients lose weight…restriction, by making the stomach smaller and this "chemical/hormonal" effect of shutting down a person's appetite.  If you think about it for a minute I think you will realize how important that chemical effect is much easier to decrease the calories you consume  (and thereby lose weight) if you don't feel hungry!  I must mention however that this hormonal effect will not last  your entire life, but it will last for quite a long time, usually at least a year and often as long as several years! By the way I call this period of time during which you don't have much of an appetite, "the honeymoon"…it will never be easier to lose weight than during the honeymoon!

So far, I have discussed the band and the sleeve and if you have read both hopefully you can see how differently they work.  The band simply does restriction the sleeve does the restriction plus the "chemical/hormonal" effect of shutting off your appetite, next time I'll discuss the gastric bypass and hopefully give  you an idea of how that works and compare it to the band and the sleeve.

Support Groups

Going forward we are going to have one support group per month.  The summer schedule is as follows:

Wednesday June 8th:  We will have a guest speaker, Gary Goldberg, licensed psychologist

Wednesday July 13th: Plastic Surgery Options after Weight Loss Surgery

Wednesday: August 10th:  Nutrition Topic: Eating on the Run and Dining Out Tips

All sessions will be held at the Ambulatory Care Center, 200 South Orange Ave, Livingston, NJ from 6:00 PM until 7:30 PM

Pt Information Seminar:

If you know anyone who would like to find out more information about all the different options for weight loss surgery we have an informational seminar this Wednesday, June 8th where you can do just that.  It is free and open to anyone who would like to attend.
It will be at our Millburn office: 225 Millburn Ave, Suite 204, Millburn, NJ starting at 6:30 PM.

Patient Information Seminar (Ocean County)


We'll be having a new patient informational seminar for Ocean County patients on Thursday June 16th from 5:30 PM to 7:30 PM.  As usual the seminar is free and open to anyone who wants to find out about bariatric surgery.  Please feel free to forward this email to anyone you think might be interested.


It will be held at the:


Center for Healthy Living

198 Prospect St.

Lakewood, NJ 08701


For those of you familiar with the area it is basically right next to Kimball Hospital.

If you would like to attend we would appreciate it if you could pre-register by calling 1.888.724.7123 and press Prompt #4 or you can just call our office at 732 269 6800 and register with my office


End Quote:  


I have to give you a little background for today's end quote…about 18 months ago my wife bought a dog.  Any of you who are dog owner's can understand how an 8 pound ball of fur can work it's way into your heart!  So now 18 months later I have to say she is my dog too…with that background here is today's end quote


"I want to become the person my dog thinks I am"  Anonymous


As always th
anks for reading and choosing Garden State Bariatrics for your healthcare

Michael Bilof

Contact Information
Web address:
phone: (973) 218-1990

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