Skilled Surgeon’s Guide to Gastric Sleeve Recovery

If you’re looking for a guide to gastric sleeve recovery, look no further! As a weight loss surgeon with over 20 years of experience and Medical Director of JourneyLite in Cincinnati, Ohio, I have performed thousands of gastric sleeves over my career. In this article, I’ll walk you through a gastric sleeve recovery timeline and answer FAQs.

Gastric Sleeve Surgery Recovery Timeline

It usually takes about a month after a gastric sleeve before a patient is back to a totally normal schedule and solid food. However, most people are about 90% there at the two-week mark. Of course, there will be some discomfort at your incisions right after surgery, and sometimes some nausea and/or vomiting at first. But, given the tremendous improvement in quality of life and weight-related medical issues after a VSG, this is a small price to pay when you look at your long-term outcome.

Browse the overview of the recovery timeline below. Then read on for a detailed breakdown of what your recovery might look like after a VSG.

Immediate Post-Surgery (Day 1)

• Surgery typically lasts less than an hour under general anesthesia.
• Patients are encouraged to walk within an hour after the procedure.
• Discharge may occur approximately 4 hours after surgery completion, depending on the patient’s recovery and location. Overnight stay may be required for those living more than an hour away.

Pain Management and Medications (First Few Days)

• Prescriptions prepared in advance, except for pain medication, which is provided on the surgery day.
• Pain and nausea medications are administered, with some being preemptive.

Week 1

• Limited to clear liquid diet (water, broth, unsweetened/diluted juice, clear protein shakes, low-calorie sports drinks).
• Light walking around the house encouraged; avoid strenuous activities.
• Lifting limited to 10 pounds maximum.

Week 2

• Transition to pureed foods.
• Increase physical activity gently; lifting limit increases to 20 pounds.
• Return to desk jobs or work from home may be possible.

Weeks 3-4

• Continue with pureed food diet.
• Gradual increase in physical activity; lifting limits increase to 30 pounds in week 3 and 40 pounds in week 4.
• Those with physical jobs may begin returning to work.

Week 5 and Beyond

• Advance to soft solid food; the staple line should be nearly fully healed.
• No restrictions on lifting; full lifting allowed.
• Cardio exercises can be intensified; no restrictions on cardio after week 4.
• Regular exercise recommended (aim for 4 days a week, with a minimum of 30 minutes per session).

Want more information? Check out this guide to the pros and cons of gastric sleeve surgery.

Post-Surgery Gastric Sleeve Recovery : Day 1

At JourneyLite, A VSG usually takes less than an hour and is done under general anesthesia. When the procedure is complete, our anesthesia team will slowly awaken you and move you over into recovery where you will be met by specialized PACU nurses. At first you will remain in your bed until our skilled nursing staff makes sure that your vitals are stable, and your pain is controlled.

At this point, usually we can have you family come back and sit with you until you are discharged. We will likely have you up and walking within an hour of your procedure, and most patients are ready for discharge after a minimum of four hours from your procedure completion time. If you are local you will be able to go home. If you live more than an hour from the center, we will keep you overnight (at least one night) at the nearby Wingate Inn. If a hotel stay is necessary, JourneyLite will make the room reservation automatically, and cover the cost of the room!

Pain Management and Medications : First Few Days

Our experience at JourneyLite has enabled us to develop pathways to minimize issues after surgery! We will have you fully prepared coming in to your procedure so that you can have all of your prescriptions (except for pain medication) filled and ready to go prior to your surgery date. Board of Pharmacy rules prevent us from sending pain scripts in advance, so if you are local, we will send it on the day of surgery to your regular pharmacy.

If you are an out-of-town patient, there is a Walgreen’s conveniently located right across the street from the center and we can send your script there. Don’t worry, we give you plenty of powerful nausea medications including one that can even be taken prior to your procedure so that it can be in your system already when anesthesia is administered.

At-Home VSG Surgery Recovery Timeline : Weeks 1-4

Once you’re at home, you will be able to be up and about, and taking care of yourself for the most part. As with any general anesthetic procedure, we do require that a responsible adult stay with you for the first 24 hours after surgery. You can walk as much as you want right away, and you can go up and down steps immediately. We don’t want you doing any driving, however, until you are completely off of your pain and nausea medications, as these can slow your reaction time. For most patients this is around 3-5 days after surgery.

If you have a desk job (or work from home), you can be back to work in as little as 1-2 weeks.  If you have a physical job, it will be more along the lines of 3-4 weeks. This will all be clarified prior to surgery, and we will complete any necessary paperwork for your time off in advance so that you won’t get any grief from your employer!

Gastric Sleeve Recovery-Diet

We advance your diet along slowly after a gastric sleeve. We want to protect the newly-formed staple line and not put any major stress on it until it has had time to heal. For the first week, patients will remain on a clear liquid diet. This is mainly things such as:

• Water
• Broth
• Unsweetened or diluted juice
• Clear protein shakes
• Low-calorie sports drinks
• Sugar-free gelatin

As long as you are tolerating clears, you will advance to pureed foods starting in week two. You will remain on the pureed stage for the next 3 weeks, and then you will advance to soft solid food after the 4th week. By this time, your staple line should be 99% healed! If at any time you have issues with any particular diet phase, our team of licensed, registered dietitians are here to help. In the long term, we want you focusing on solid food that is high in protein and low in carbohydrates. Don’t stress about it though, as you will have numerous virtual visits with our dietary team after surgery to keep you on track!

Physical Activity During VSG Recovery

For the first couple of days after going home we recommend just walking around the house as much as you feel like. If the weather is nice and you feel up to it, a short walk outside is even fine. Walking as important for your gastric sleeve recovery because it reduces the risk of complications such as blood clots and other lung issues.

As far as lifting, we limit it as follows:

• Week 1: 10 pounds maximum
• Week 2: 20 pounds maximum
• Week 3: 30 pounds maximum
• Week 4: 40 pounds maximum
• Week 5+: Full lifting allowed

As far as cardio, you can start some very light exercise after the first week. Walking slowly on a treadmill or doing the elliptical with minimal resistance are good places to start. Then you can slowly increase the intensity and duration of your exercise over the next few weeks. After week four, there are no restrictions on cardio.  We want you to aim for a goal of 4 days a week (with a minimum of 30 minutes per session) of exercise where you spend a decent amount of time in your target heart rate zone. A FitBit, Apple Watch, or some sort of tracker is highly recommended and can be very useful to track your progress.

We recognize that some patients have minimal exercise tolerance immediately after surgery and are unable to meet these goals at first. We just need you to start somewhere, and then as the weight comes off and your body hurts less, you will be able to do more and more. I have had a few patients who could barely walk after surgery who have sent me pictures of them at the finish line of a marathon, so the sky is the limit!

How Does Gastric Sleeve Recovery Compare to Gastric Bypass

For the most part things are fairly similar in terms of recovery after gastric sleeve and gastric bypass. I provide an in-depth comparison of gastric sleeve vs gastric bypass in this article.  But you can see an overview below.

Differences include:

• Slightly longer procedure time (around 2 hours)
• Overnight stay at JourneyLite (then a possible overnight stay at the Wingate Inn for out-of-town patients)
• Slightly more incisional pain than for gastric sleeve
• Somewhat slower return to work, although same overall timeline
• Must avoid NSAID’s and steroids permanently after gastric bypass (as compared to only for the first 4 weeks for gastric sleeve)

Weight Loss Timeline After Gastric Sleeve Surgery

How long will it take to get down to my goal weight?

Weight loss is achievable at any point in time after a gastric sleeve, but 90% of the time it stops at around the 12-month mark. In the first few months the weight may seem to fall off magically! Starting at around post-op month 6 things tend to slow down. So you have to make sure in the first 6 months you are working hard to develop the right eating and exercise habits, so that when you hit month 6 the scale keeps moving for you.

How much weight will I lose each month after surgery?

This varies a lot depending on the patients starting BMI and other factors. For example, if a patient weighs 500 pounds and has a BMI of 70, a 50 pound weight loss may be achievable in month one! On the other hand, a patient who was 200 pounds and has a 35 BMI may only lose 10 pounds during the same time period. The important thing to realize is that this is not a sprint, it’s more of a marathon. So as long as you are making steady progress and doing the right things with your diet and exercise program, you will get there eventually!

Gastric Sleeve Recovery FAQ’s

At JourneyLite, our team has the experience and expertise to help you succeed in your gastric sleeve recovery. Just fill out a no-obligation appointment request and our team of patient service representatives will contact you to answer all your questions and get you scheduled with Dr. Curry or Dr. Augusta. We operate on patients from all across the country, so if you’re out-of-town don’t let that discourage you as virtual appointments are available, usually within a few days!