An Egyptian woman, who weighs around 500kg, reached Mumbai for a weight-reducing bariatric surgery in a specially arranged chartered flight on Saturday. 
 
 The 36-year-old Eman Ahmed Abd El Aty stepped out of her house for the first time in 25 years to come to Mumbai. She has been suffering from multiple medical conditions and her treatment will be a long process which is expected to stretch over a couple of years. 
 
 Here are 10 things about the resident of the port city of Alexandria: 
 
 1) Abd El Aty weighed about 5kg when she was born and started to put on weight by the age of 11. 
 
 2) She had to discontinue schooling after Class 5 due to lethargy caused by thyroid problems. 
 
 3) The continuous weight gain restricted her lower extremities and she started to crawl instead of walking. 
 
 4) In 2014, when she weighed 300kg, Ahmed had high cholesterol level and a sudden stroke left her paralysed, impacted her speech and left her completely bedridden. 
 
 5) By 2016, Abd El Aty weighed about 500kg and was diagnosed with severe lymphedema and water retention, type 2 diabetes, hypertension, and hypothyroidism. She has severe obstructive and restrictive lung disease, gout and is at a very high risk of pulmonary embolism. 
 
 6) After repeated attempts to avail medical aid from doctors in Egypt and Greece, Abd El Aty’s sister Shaimaa started an online campaign which caught the attention of noted laparoscopy surgeon, Dr Muffazal Lakdawala. 
 
 7) External affairs minister Sushma Swaraj, during her stay at AIIMS Delhi, communicated with officials at the Indian embassy in Egypt who had rejected Abd El Aty’s visa application to come to India for treatment. 
 
 8) Abd El Aty, who lay in a specially created bed by Egyptian artisans, traveled in Egyptair freighter aircraft Airbus 300-600 to Mumbai and was brought to Saifee Hospital in an open to sky truck, covered by all sides for security purposes. 
 
 9) She is currently at a specially created 1,000 sqft first-floor facility, which used to be the accounts office previously. A ground floor structure, created by Saifee for Ahmed was demolished by Brihanmumbai Municipal Corporation (BMC) due to lack of permission. 
 
 10) Abd El Aty is currently under observation. Before any surgical intervention, she will need a series of medical tests including routine body check-up and a complete body profile test. Doctors will also do a special gene study for the 91 different types of biomarkers isolated with obesity related syndrome. 

 Gastric Sleeve Surgery - 14 Ways It Will Affect You 
 
 Gastric sleeve surgery (vertical sleeve gastrectomy) removes about 80% of the stomach. As a result, patients: 
 
 TABLE OF CONTENTS 
 
 If you’re brand new to bariatric surgery, we recommend starting on our Bariatric Surgery for Beginners page. 
 
 If you’re already familiar with the basics, read the sections below for everything you need to know about the vertical sleeve gastrectomy procedure. 
 
 Click here to take the 5-question quiz 
 
 Will You Be Approved for Gastric Sleeve? Click here to take the 5-question quiz 
 
 Will You Be Approved for Gastric Sleeve? Click here to take the 5-question quiz 
 
 Will You Be Approved for Gastric Sleeve? Click here to take the 5-question quiz 
 
 1. How the Gastric Sleeve Works Procedure reduces stomach size by 80% 
 
 Patient feels full sooner while eating due to smaller stomach 
 
 Patient feels less hungry because smaller stomach secretes fewer hunger-causing hormones During surgery, your surgeon will make between 1 and 5 small incisions in your abdomen (which minimizes gastric sleeve scars), insert various laparoscopic instruments, and remove about 80% of your stomach. This leaves a banana-shaped “sleeve” that connects the esophagus to the small intestines. [Some surgeons will then reinforce the staple line.] Your much smaller stomach will cause you feel full sooner and result in long-term weight loss. It is done laparoscopically in one to two hours. The gastric sleeve procedure is done for patients of all ages, from children to the elderly. How Gastric Sleeve was “Discovered” Gastric sleeve started as the first step in the two-step duodenal switch (DS) procedure. DS surgeons saw impressive weight loss and health improvement before performing the second step. This caused them to test gastric sleeve as its own procedure. Back to Table of Contents 
 
 2. Weight Loss Up to 70% of excess weight within 1 year ENTER YOUR STATS FOR YOUR WEIGHT LOSS PROJECTIONS English Metric HEIGHT (feet) (in) WEIGHT (lbs) Enter your height & weight, then click the button: ENTER HEIGHT Cm. WEIGHT Kg. Enter your height & weight, then click the button: ENTER Weight loss happens fast after gastric sleeve surgery: Month 3: About 33% of excess weight is gone 
 
 Month 6: About half of excess weight is gone 
 
 Month 12: Up to 70% of excess weight is gone Most patients reach a plateau around the one to two year mark. Patients who eat and exercise right are usually able to keep the weight off or lose even more. But many patients let their dedication slip and regain some weight. This is due to the stomach stretching over time, which is usually caused by overeating. By 5 years after surgery, the average patient has kept off over half of their excess weight. Successful patients avoid weight regain by: Working closely with their surgeon’s dietitian or nutritionist 
 
 Using a personal trainer 
 
 Attending in-person or online support groups at least twice per month 
 
 Keeping a food journal 
 
 Having the support of family and friends 
 
 Maintaining motivation and dedication For more information, see our page on Gastric Sleeve Weight Loss. See our Gastric Sleeve Before and After page for pictures of other gastric sleeve patients, including women, men, and celebrities. Back to Table of Contents 
 
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 3. Health Benefits Cures or improves diabetes, sleep apnea, hypertension, and at least 12 other conditions Gastric sleeve results in complete “resolution” (cure, as long as weight loss is maintained) of many obesity-related health problems, including those listed below. Note that patients who have a strict follow-up schedule with their surgeon at 3-, 6-, and 12-months post-op see greater improvements in or remission of their diabetes, high blood pressure (hypertension), and high cholesterol than patients who skip these visits (1). Diabetes 
 
 Sleep apnea 
 
 Hypertension 
 
 Asthma 
 
 Cholesterol problems 
 
 and at least 10 other conditions Patients who aren’t cured usually experience a noticeable improvement. Gastric sleeve weight loss improves joint health. For every pound of weight lost, there is a 4 pound reduction in pressure on the knee (2). This improves mobility and reduces pain in the knees. 88,000 participants were involved in data collection on cancer research. Results state that patients who undergo weight loss surgery have 33% less risk of developing cancer (3). Risk rates were even further reduced for obesity-related cancers, including (4): Colon cancer 
 
 Postmenopausal breast cancer 
 
 Endometrial cancer 
 
 Pancreatic cancer For the full list of health issues cured or improved by gastric sleeve surgery, see the Health Benefits section of our Gastric Sleeve Results page. Back to Table of Contents 
 
 4. How to Qualify 30+ body mass index (BMI) required 
 
 If BMI under 40, must have at least one obesity-related health problem You could be a good candidate for gastric sleeve surgery if: You have a body mass index (BMI) of 40 or more, OR 
 
 Your BMI is between 30 and 39.9 and you have a serious obesity-related health problem Serious obesity-related health problems most commonly include: 
 
 High blood pressure 
 
 High cholesterol 
 
 Type 2 diabetes 
 
 Sleep apnea 
 
 Many others (see Health Benefits section above) Use the BMI Calculator below to determine your body mass index. If you do not meet one of the above two BMI requirements, you still might qualify for one other less invasive procedure: the Gastric Balloon. See our Gastric Balloon Patient Guide for more information. See our Gastric Sleeve Qualifications page for more information about who qualifies and who does not. 
 
 For a list of frequently asked questions about qualifying, see our “Do I Qualify For Weight Loss Surgery?” page. Back to Table of Contents 
 
 5. Insurance Gastric sleeve is covered if your insurance policy includes bariatric surgery Gastric sleeve insurance coverage varies by country and insurance policy. Your insurance will cover gastric sleeve if your specific policy includes weight loss surgery and you have: Completed a medically supervised diet program 
 
 A body mass index (BMI) over 35 with health problems or over 40 without health problems Click here to use our Check My Insurance Tool. In the U.S., gastric sleeve cost with insurance is about $3,500, depending on your policy. Scroll down this page to learn about the cost of gastric sleeve surgery without insurance. See our Gastric Sleeve Insurance Guide for everything you need to know about getting insurance to pay for surgery. Back to Table of Contents 
 
 6. Cost Without Insurance Average Patient Pays: $500 to $5,000 with insurance, $12,000 to $22,000 without insurance 
 
 Loan Payment: $445/month, on average 
 
 Discounts & Tax Savings: Usually available According to our annual surgeon cost survey, the average total gastric sleeve cost without insurance is $19,000. However, cost range widely by state and surgeon. For example, our survey found that the highest average cost of gastric sleeve, $58,000, can be found in Alaska while the lowest average cost, $12,000, is available in Texas and South Dakota. See the full survey results by state and region in the interactive map below. Many insurance plans cover gastric sleeve surgery, which will drop your out-of-pocket costs considerably. Patients with insurance that covers gastric sleeve can expect to pay an average of $3,500 for the procedure, although some plans will drop that amount well below $1,000. If you don’t have insurance that covers the procedure, the good news is that: Insurance may still cover some of your costs, such as pre-op testing, even if weight loss surgery is not an included benefit under your plan 
 
 Gastric sleeve patients save about $11,000 per year compared to the medical costs they would have incurred had they remained obese. In other words, gastric sleeve pays for itself in under two years. 
 
 Special discounts are usually offered to “self-pay” patients 
 
 Out-of-pocket costs may be tax deductible 
 
 Loans are available to make it more affordable Gastric Sleeve Cost by State, Region, and Country – Interactive Map See our Gastric Sleeve Cost page for more information or click here to contact a top gastric sleeve surgeon to ask for a free cost quote. Back to Table of Contents 
 
 7. Preparing for Surgery Proper preparation reduces your surgery risk, leads to more weight loss, & saves you money Your surgeon will work closely with you during the weeks leading up to surgery, including: Health assessment, including questions about your medical history, medications, and surgical history 
 
 Order certain tests like an ECG, x-ray, and blood tests 
 
 Establish a pre-surgery diet regimen, including: 2 Weeks Before No sugar Lower carbs Increased protein Increased veggies Plenty of fluids 2 Days Before Clear liquids, broth, one protein shake per day only Talk with your surgeon about whether you should stop taking any medications 12 Hours Before No food or drink, no tobacco 
 
 Your other big goal before surgery: lose as much weight as possible. Here’s why: The more weight you lose pre-op, the more weight you will lose after surgery 
 
 The lower your pre-op weight, the lower your risk of complications 
 
 You will regain weight if you slip into old habits. The sooner you can establish good diet and exercise habits, the more likely you will be to maintain them after surgery On surgery day, you’ll perform the typical pre-surgery routine: Remove all clothes and jewelry Put on your hospital gown Meet with your nurse and anesthesiologist Start your IV Receive medication for relaxation and sleep See our Preparing for Weight Loss Surgery page for more information. Back to Table of Contents 
 
 8. Recovery Hospital Stay: 2 to 3 days 
 
 Time Off Work: 1 to 3 weeks 
 
 Full Recovery: 4 to 6 weeks 
 
 Pain: Manageable – same as any laparoscopic surgery 
 
 Diet & Activity: Slow transition back to normal Gastric sleeve surgery recovery includes: Timeline: 4 to 6 weeks to full recovery Hospital Stay: 2 to 3 days Time Off Work: 1 to 3 weeks 
 
 Pain: Same as experienced after any laparoscopic surgery, managed with medication 
 
 Diet: Slow transition from clear liquids to solid foods 
 
 Activity: Slow transition back to regular activity and exercise 
 
 Challenges: Most side effects like nausea, digestive issues, and body changes go away over time or after adjusting diet/lifestyle habits Some surgeons allow you to return home on the same day as surgery. This practice isn’t common and the surgery must be completed without complications. If you’d prefer to recover at home, ask your surgeon if this option is available. See our Gastric Sleeve Recovery page for an in-depth recovery timeline and details about each aspect of recovery. Back to Table of Contents 
 
 9. Diet & Life After Restricted diet with supplementation 
 
 Regular exercise 
 
 Less hungry than before surgery 
 
 Personal relationships may change Weight loss after gastric sleeve surgery often takes center stage for new patients. It’s also important to consider what day-to-day life will be like. Your surgery is only a tool. Long-term success requires diligence and sometimes difficult change in other areas. The following sections give you an idea about what to expect before and after surgery. Every surgeon is different, and every patient is different. Please talk with your surgeon before acting on any of the following advice. Food & Drink : Your Diet Transition Schedule Diet requirements by timeframe are summarized in the chart below. Timeframe Range 2+ Weeks Before Surgery 2 Weeks Before Surgery 1 Week Before Surgery 2 Days Before Surgery Midnight Before Surgery to 7 Days After Surgery (Varies by Surgeon) In Hospital (Varies by Surgeon) Day 1 to Week 2 After Surgery (Varies by Surgeon) Day 2 to Week 3 After Surgery (Varies by Surgeon) Day 3 to Weeks 4+ After Surgery (Varies by Surgeon) Diet Requirements Timeframe(Varies Widely By Surgeon) – Diet Requirements Practice your post-sleeve diet 2+ Weeks Before Surgery – Practice your post-sleeve diet High protein, low sugar, low carbs 2 Weeks Before Surgery – High protein, low sugar, low carbs Stop or change some medications 1 Week Before Surgery – Stop or change some medications Clear liquids only 2 Days Before Surgery – Clear liquids only Nothing to eat or drink Midnight Before Surgery – Nothing to eat or drink Clear liquids only In Hospital to 7 Days After Surgery (Varies by Surgeon) Clear liquids only Add thicker drinks & smooth foods (no chunks) Week 2 After Surgery – Add thicker drinks & smooth foods (no chunks) Slowly test pureed & soft solid foods Week 3 After Surgery – Slowly test pureed & soft solid foods Slowly test solid foods Day 3 to Weeks 4+ After Surgery (Varies by Surgeon) Slowly test solid foods For details about each stage, see the following pages: Gastric Sleeve Pre-Op Diet 
 
 Gastric Sleeve Diet – How Successful Patients Eat Vitamins & Supplements : 5 Lifelong Supplements You will start taking a vitamin regime for the rest of your life after gastric sleeve surgery. This will help you make up for any nutrients you might not be getting in your daily diet. Here is a list of the vitamins your doctor may ask you to take: Vitamins Multivitamin Calcium Folate (folic acid) Iron Vitamin D Purpose Vitamins – Purpose Prevents general nutrition problems & vitamin deficiency Multivitamin – Entire body Keeps your bones strong Calcium – Keeps your bones strong Reduces risk of anemia Folate (folic acid) – Reduces risk of anemia Prevents stroke, heart attack, or other blood-related issues Iron – Prevents stroke, heart attack, or other blood-related issues Prevents rickets (weakening of bones, muscles, and teeth) Vitamin D – Prevents rickets (weakening of bones, muscles, and teeth) For detailed information about each vitamin, see our Gastric Sleeve Vitamins & Supplements section. Exercise: 2.5 hours per week, spread out over 2 to 4 days Exercise is almost as important as your diet when it comes to long-term success: Patients who exercise regularly lose more weight over the long-term 
 
 Physical and mental health benefits are incredible How much exercise do you need to for noticeable results? One study of gastric bypass patients found that 2.5 hours per week resulted in 5.7% greater excess weight loss (5). Working out regularly will also lead to quicker and better health improvement after surgery (6). To help you stay on track, block out time to exercise at the same times on the same days of the week. Also, spread your 2.5 hours per week out over 3 or 4 days (in other words, 30 to 45 minutes 3 or 4 days per week). This will make it less intimidating to get started each day and will help you build endurance. Exercise Types There should be 3 main goals of your exercise routine: Endurance – walking, stationary bike, and especially swimming 
 
 Flexibility – a good stretching routine. Yoga is best since it incorporates proper breathing and uses your own body weight to build strength 
 
 Strength – exercise balls, weights, and yoga Click here to learn more about exercise after weight loss surgery. Your Brain: Less Hungry, Careful About Food Addiction, New Mentality Will Change Behavior & Relationships Ghrelin Hormone & Hunger You may feel less hungry following surgery. When your stomach is empty, it secretes a hormone called ghrelin into your bloodstream. This causes your brain to generate hunger impulses. After you eat, the amount of secreted ghrelin drops then slowly rises until your next meal. Since your stomach will be so much smaller after gastric sleeve surgery, the amount of ghrelin it secretes may also go down. Less ghrelin in your system means you will feel less hungry than you did before surgery. See our page about Obesity & Genetics for more information. Food Addiction Our bodies secrete certain hormones (like ghrelin) that tell us when we’re hungry. Junk food may override those hormone signals by overstimulating our reward centers. This is just like the way our bodies and brains react to an addictive drug. You may have food addiction if your desire for food takes priority over other important parts of your life, such as: Personal health 
 
 Family 
 
 Friends 
 
 Work 
 
 Your appearance 
 
 Avoiding obesity related health issues like hypertension, sleep apnea, or diabetes If left unchecked, food addiction can lead to obesity. If not addressed before surgery, it can also lead to weight regain. To find out if you may be suffering from food addiction, take our Food Addiction Quiz. Relationships After Weight Loss Being thin again, or being thin for the first time, may be a shocking experience. Many patients express amazement at: No more obesity discrimination. For example, strangers tend to be nicer to thin people. 
 
 Being treated with more respect 
 
 Getting more romantic interest from others 
 
 Building deeper relationships by being able to physically keep up with kids and more physically fit friends 
 
 Getting more compliments from others 
 
 Increased self-confidence and the effect that has on others 
 
 Improvements in quality of sexual life (7) But there may be negatives to being thin as well. People who you’ve known for a long time will not be used to the way you look and may not know how to act around you. For example: How will overweight friends or family members feel when you’re losing weight but they are not? 
 
 Will your new healthier diet and smaller portion sizes make meals with others awkward? 
 
 Could intimacy with your spouse or partner be affected? 
 
 Could your spouse or partner become jealous now that others are noticing you more? 
 
 How will your coworkers react? Should you even tell them you are having surgery? 
 
 Will your friends or family make it difficult for you to stay on track by making bad diet choices? 
 
 Could your new self-confidence create conflict with people who are used the “old” you? And what about the new “skinny lens” you see the world through? For example: Would this person be treating me the same way if I hadn’t lost all this weight? 
 
 How do I handle obesity discrimination now that I’m on the “other side”? Be prepared for both the good and the challenging “shocks” of dramatic weight loss following surgery. For real life experiences and advice from other patients, see our Relationships After Weight Loss surgery page. Back to Table of Contents 
 
 10. Risks & Downsides Moderate risk of non-serious complications 
 
 Side effects may include digestion issues & sagging skin from rapid weight loss 
 
 Some weight regain possible The relatively simple gastric sleeve procedure results in a very high survival rate (99.7%, or 319 out of 320 patients) (8). But it does carry a risk of complications, side effects, and other challenges, some of which can be avoided. Complications The three most common serious gastric sleeve complications are: Staple line leaks – 2.1% of patients on average (between 1.09% and 4.66%, depending on the study) experience staple line leaks ( 9 ) ( 10 Occur when sealed or sutured (stitched) openings leak digestive contents into the abdomen. This can cause infection and abscess. Gastrointestinal leaks occur in as many as 5% of patients and can be repaired as long as it is caught early. Symptoms include fever, severe pain and a high heart rate. In order to prevent leaks, your surgeon should check the surgical connections a number of different ways, including (1) blowing air into the connection and observing whether any gets through and (2) using a dye to check for a leak. Leaks not discovered right away are usually treated by resting the stomach (being fed through an IV), but sometimes surgery is required to fix them. 
 
 Bleeding – 1.2% of patients ( 11 A copious discharge of blood from the blood vessels. One study showed that out of 1,700 laparoscopic bariatric surgery patients only 3 had hemorrhagic complications, none of which needed to be converted to open operations or needed reoperations. However, other studies have shown internal bleeding to be as high as 4% following Roux-en-Y gastric bypass surgery. After the surgeon determines the type and severity of internal bleeding, it can be resolved in a number of ways: on its own, replenishing bodily fluids, stopping the use of all anticoagulation drugs and (rarely) by transfusion or reoperation. 
 
 Stenosis/Strictures – 0.6% of patients ( 12 A narrowing or constriction of the diameter of a bodily passage or orifice. This is most common in procedures that rearrange your digestive system such as gastric bypass surgery (up to 8% of patients) and duodenal switch surgery and results from a build-up of scar tissue between your intestine and your reduced stomach or at an intestine-to-intestine connection (anastomosis). The staple line leak rate studies were done with less effective surgical techniques. Newer techniques may result in lower risks. Blood clots are a concern with any surgery. Your surgeon will take steps to reduce the risk, including blood thinners and the use of compression stockings after surgery. They will also have you up and moving as soon as possible after surgery. For more information about complications, visit our Gastric Sleeve Complications page. Side Effects & Challenges The most common gastric sleeve side effects and challenges include: (13) (14) (15) Digestive issues 
 
 Sagging skin 
 
 Weight regain Digestive Issues Potential digestive issues resulting from gastric sleeve surgery include: (16) (17) Gastroesophageal reflux disease (GERD) 
 
 Indigestion (Dyspepsia) 
 
 Gallstones 
 
 Intolerance to certain foods 
 
 Nausea and vomiting 
 
 Vitamin and mineral deficiency About 1 in every 5 patients experience Gastroesophageal reflux disease (GERD) in the first 12 months. The good news is that this tends to be a shorter-term issue. After 3 years, the GERD rate drops to around 3% (10). GERD is a highly variable chronic condition that is characterized by periodic episodes of gastroesophageal reflux and usually accompanied by heartburn. It may result in histopathologic changes (change in the microscopic structure) in the esophagus. It also often leads to esophagitis. GERD increases the risk of some bariatric surgery complications such as dumping syndrome and sepsis, but the condition is also improved for many following bariatric surgery. Several at-home treatments are effective for GERD, including avoiding certain foods and drinks (alcohol, citrus juice, tomato-based food, and chocolate), waiting 3 hours before lying down after a meal, eating smaller meals and elevating your head 8 inches when you lay down. If these don’t work, your doctor may recommend/prescribe antacids, H2 blockers or even Proton Pump Inhibitors (PPI). The other digestive issues listed above can often be addressed with diet and behavior changes. Sagging Skin For most obese patients, the skin has been stretched out for so long to accommodate the extra weight that it has lost its elasticity. Gastric sleeve surgery causes most patients to lose a lot of weight very quickly, and your skin simply can’t keep up. The extra skin may be embarrassing. It can also cause several issues ranging from minor to severe, including: Difficulty getting dressed 
 
 Difficulty exercising, which may impact long-term weight maintenance and health 
 
 Skin fold rashes or breakdown of skin 
 
 Skin fold infections In some cases, patients manage sagging skin with body-contouring undergarments. In more serious cases, patients have plastic surgery to remove the excess skin. Surgery to remove excess skin is often covered by insurance. See our Plastic Surgery After Weight Loss page for more information. Weight Regain After two years, about 1 out of 20 gastric sleeve patients have gained back some weight from their low point. That number increases to 3 out of every 4 patients after 6 years (18). At 5 years, the average gastric sleeve patient regains at least 25% and possibly as much as 50% of the weight they lost (19). Just as bad, the more weight you gain back, the more likely your health problems are to return. For example, one gastric sleeve study found this difference in Type 2 diabetes remission: Year 1: 56% of patients 
 
 Year 5: 20% of patients This return of Type 2 diabetes happened for patients who gained back weight (20). The reason for weight regain? Most patients who regain weight do so for one of the following reasons: They consume calories in liquid form, such as protein shakes, pureed foods, smoothies, etc. As reviewed in the Diet section above, your new sleeve stomach works by making you feel full sooner. Since liquids don’t make you feel as full as solid foods, you’ll eat more and gain weight if you get your calories from liquids instead of solids. 
 
 They “slip” in their dedication and start to overeat or eat the wrong things. This can stretch out their smaller stomachs. 
 
 Even if you stick with the correct diet program, there’s still a risk of weight regain. Over time, the stomach may still stretch and lead to weight regain. Remember, gastric sleeve is one of the best tools for weight loss, but it is only a tool. To avoid weight regain, eat the right foods and make the right lifestyle choices. See our Weight Gain After Gastric Sleeve Surgery page for more weight maintenance advice. For surgical options to address weight regain, see our Gastric Sleeve Revision Surgery page. Back to Table of Contents 
 
 11. How Does Gastric Sleeve Compare to Other Weight Loss Procedures? One of the best for weight loss & health improvement 
 
 1 of 3 procedures that makes patient feel less hungry 
 
 Lower risk than other procedures that result in large amounts of weight loss 
 
 1 of 3 procedures that is not reversible Gastric sleeve surgery is the most popular surgical weight loss procedure by far. In the United States, it now makes up over 60% of all weight loss surgery procedures performed. This is up from 24% in 2011. During the same time frame: Gastric bypass dropped from 62% to 37% (click here to compare gastric sleeve vs bypass) 
 
 Gastric banding (e.g. LAP-BAND®) fell from 7.5% to 0.8% (21) (compare sleeve to LAP-BAND®) Newer procedures like gastric balloon, vBloc Therapy, and AspireAssist are becoming more popular, but they are still nowhere near as popular as the sleeve. Gastric Sleeve Surgery Positives Gastric sleeve has earned its place as the most popular procedure for several reasons: Weight loss is as good or better than gastric bypass. It is much better than after lap band surgery, gastric balloon, and vBloc Therapy. 
 
 is as good or better than gastric bypass. It is much better than after lap band surgery, gastric balloon, and vBloc Therapy. Health Improvement is better than every procedure other than duodenal switch. 
 
 is better than every procedure other than duodenal switch. Reduced hunger – only gastric sleeve, duodenal switch, and vBloc Therapy make you feel less hungry. 
 
 – only gastric sleeve, duodenal switch, and vBloc Therapy make you feel less hungry. Short-term risk of gastric sleeve is similar to gastric bypass and lower than duodenal switch. 
 
 of gastric sleeve is similar to gastric bypass and lower than duodenal switch. Long-term risk of gastric sleeve is lower than gastric bypass, duodenal switch, and lap band surgery. 
 
 of gastric sleeve is lower than gastric bypass, duodenal switch, and lap band surgery. No external device – There is no external device left inside the body after gastric sleeve surgery as there is with Lap-Band, gastric balloon, vBloc Therapy, and AspireAssist, so there is no risk of device-related complications. While the risk of device-related complications is relatively low for vBloc Therapy, gastric balloon, and AspireAssist, it is a concern and should be considered for Lap Band. 
 
 – There is no external device left inside the body after gastric sleeve surgery as there is with Lap-Band, gastric balloon, vBloc Therapy, and AspireAssist, so there is no risk of device-related complications. While the risk of device-related complications is relatively low for vBloc Therapy, gastric balloon, and AspireAssist, it is a concern and should be considered for Lap Band. Compared to gastric bypass and duodenal switch (DS): Comparable improvement in obesity-related health problems Quicker recovery than bypass or DS Complication rates are lower than bypass or DS Risk of vitamin deficiency is lower than bypass or DS Little to no risk of dumping syndrome (unlike gastric bypass) Side effects like nausea, vomiting, or diarrhea should be less likely than bypass or DS. If present, they are usually less severe than after gastric bypass. Less expensive overall than bypass or DS. Similar cost if you have insurance that covers weight loss surgery. If you are on anticoagulation medication (blood thinners), gastric sleeve surgery is probably a better choice than gastric bypass to reduce the risk of marginal ulcers. 
 
 Compared to Lap-Band surgery: Risk of long-term gastroesophageal reflux disease (GERD) is lower with gastric sleeve Risk of esophageal dilation, pouch dilation, and food trapping is much lower with gastric sleeve No risk of external-device-related issues like lap band erosion, band slippage, or port problems with Lap-Band surgery Much lower risk of long-term complications than Lap-Band surgery Fewer follow up doctor visits required than after Lap-Band surgery More expensive overall than Lap-Band surgery. Similar cost if you have insurance that covers weight loss surgery. 
 
 No dumping syndrome – Dumping syndrome is experienced by up to 7 out of 10 gastric bypass patients, although many patients report this being a “good thing” since it helps them keep their diet on track. Dumping syndrome is uncommon after gastric sleeve surgery. 
 
 – Dumping syndrome is experienced by up to 7 out of 10 gastric bypass patients, although many patients report this being a “good thing” since it helps them keep their diet on track. Dumping syndrome is uncommon after gastric sleeve surgery. Cost With Insurance – The cost of gastric sleeve is tied for the lowest with gastric bypass, duodenal switch, and Lap-Band surgery (gastric balloon and vBloc Therapy usually are not covered by insurance). Gastric Sleeve Surgery Negatives The gastric sleeve also has negatives compared to some of the other bariatric surgery types: Not reversible – Unlike lap band, gastric balloon, vBloc Therapy, and AspireAssist, gastric sleeve surgery is irreversible. You cannot change back your smaller stomach. This is not necessarily a “negative”, but it is worth noting. More on this below. Weight loss (on average) is usually lower than duodenal switch. Health Improvement is generally not as good as gastric bypass or duodenal switch Short-term risk is higher than lap band, gastric balloon, vBloc Therapy, and AspireAssist. Is Being Irreversible a Bad Thing? The fact that gastric sleeve (vertical sleeve gastrectomy) is not reversible may not be a bad thing. For example, any nausea, diarrhea, or vomiting are usually short-term issues. About 1 out of 5 sleeve patients have Gastroesophageal reflux disease (GERD) which also improves over time. The GERD rate drops to about 3% after three years. Patients’ bodies also tend to tolerate the sleeve better than procedures like lap band or gastric bypass. For example, gastric sleeve carries a much lower risk of the following compared to lap band: Esophageal dilation 
 
 Pouch dilation 
 
 Food trapping 
 
 Port problems (since the sleeve does not use a port or any other implanted device) For a more-detailed comparison, see our Types of Bariatric Surgery page. To learn which procedure is best for you, click here to take our Choose the Right Procedure Quiz. Back to Table of Contents 
 
 12. Summary 7 steps to long-term weight loss 1. Start Working with a Top Surgeon As Soon as Possible Top surgeons will help you effectively navigate the various procedure choices, pre-surgery steps, financing, and insurance options: Many surgeons offer a free initial consultation, free local seminar, or free webinar. These will give you a better idea of what to expect and allow you to ask questions. Many also provide a free insurance check. They will also help you appeal any denials or find financing. Most insurance companies need proof of a medically supervised diet program. Your surgeon will set this up for you if you haven’t done so already. Your surgeon will push you towards new habits that will be essential to success after surgery. Many surgeons will recommend support group meetings for feedback from actual patients. Find a Top Surgeon Essential Checklist: 3 to 6 Months Out 2. Two Weeks Out: Prepare for Surgery You will have completed your pre-op tests, physical, and any other required steps. You should have insurance approval by this point. You should also be well on your way towards developing your diet and lifestyle habits. In the week or two leading up to surgery, you’ll go to the hospital pre-surgery department. They will perform an EKG, blood work, and any last minute tasks or other pre-op tests. You’ll meet with the surgeon one more time to wrap up final tests and forms. The night before surgery, do not eat or drink anything starting at midnight. Essential Checklist: 2 Weeks Out 3. Surgery Day You’ll arrive at the hospital at least two hours before surgery to allow for prep time. The gastric sleeve procedure itself will take about 2 hours to perform. Immediately after surgery, you’ll have a dedicated nurse to manage your pain and check your vitals. Click here for more about what to expect in the hospital. 4. Recovery Most gastric sleeve patients are in the hospital for 2 or 3 days. You can’t eat or drink anything for at least 24 hours after surgery. And your your surgeon will want you to get up and walk around as soon as possible to start the healing process. You’ll leave as soon as your surgeon is confident that you are well on the road to full recovery. You’ll need someone to drive you home from the hospital and care for you for at least a few days following surgery. Full recovery generally happens within 2 to 4 weeks. Click here for more about the recovery process. 5. Adjust to Your New Post-Surgery Diet & Lifestyle For the first 4 to 5 weeks after surgery, you will go from a clear liquid diet to your “new normal” gastric sleeve diet. You should also continue your transition into a more active lifestyle. You will feel full sooner, less hungry, and start to experience weight loss within a couple weeks. Your surgeon’s dietitian or nutritionist will help you determine an appropriate diet. See the Diet & Life After section of this page for more information. 6. Attend Support Groups Regularly Regular support group participation leads to: Reduce post-op recovery time Lead to as much as 12% more long-term weight loss Your surgeon will be able to recommend an in-person group near you. 7. Ongoing Doctor Visits Your surgeon will schedule a follow up visit within 2 weeks to ensure you are recovering well and to answer any questions. Later visits will be scheduled as-needed. Back to Table of Contents 
 
 13. TEST YOUR KNOWLEDGE Click here to take the gastric sleeve quiz Gastric Sleeve: Test Your Knowledge Well-educated patients are more likely to be successful over the long-term. Test your knowledge to ensure that you’re ready to take the next step! YOUR GOAL: Try to answer at least 11 out of 12 questions correctly Take the Gastric Sleeve Quiz Back to Table of Contents 

 MUMBAI: After two months of preparations, the world's heaviest woman Eman Ahmed from Egypt who weighs over 500kg with a girth of five feet - flew into Mumbai on Saturday for medical treatment that could span over four years. The cost of moving Eman from her home in Alexandria into a cargo plane, loading her onto amini-truck at Mumbai airport and then using a crane to slide her customised bed into a specially prepared room on the first floor of Saifee Hospital on Charni Road has come to Rs 83 lakh."We have just paid Rs 83 lakh for the logistics and will collect another Rs 1 crore," said Dr Muffazal Lakdawala, the bariatric surgeon who has spearheaded the Save Eman campaign. Her treatment is being crowdfunded. But the wait isn't yet over for Eman, who left home after 25 years and her bed after 13. Dr Lakdawala said, "The earliest we may operate on her is after four weeks.''Doctors, who have already done a battery of tests on her, will over the next month work on reducing water-retention issues using medicines and a protein-rich diet. "We should be able to cut down 50-60 kg with this alone,'' said Dr Lakdawala. Incidentally, doctors aren't yet sure if Eman weighs 500 kg or more. "She was weighed five years back and was 330 kg then. Her sister says she is now double the size,'' said the doctor.Even the surgery in March will only be the beginning of a long weight-reduction exercise. As her doctor puts it, "We have worked out a four-year plan for her.'' The plan includes at least two operations, diet plans and physiotherapy sessions. After the surgery, Eman could lose around 100 kilos within the six months that she will spend in Mumbai.Her bed being lifted by crane at the hospital."We will perform a sleeve gastrectomy operation,'' said Dr Lakdawala, who travelled with Eman and her sister Shaimaa from the airport in a truck. In sleeve gastrectomy, the stomach is surgically reduced to about 15% of its original size and ends up looking like a sleeve or tube. She will leave for Egypt thereafter. "I want to ensure that Eman, who has been bedridden for over a decade, is able to travel back sitting in a business class seat to Alexandria," said Dr Lakdawala.After losing at least another 100 kilos she will return to Mumbai for the second surgery which is a relatively new procedure called SADI (to reduce the intestinal loops). Meanwhile, the Saifee team has reached out to five medical world leaders, including endocrinologists from Harvard University and Imperial College in London, to figure out why Eman is morbidly obese. Results of her genetic tests, which have already been done, will be available in four weeks. "If it is genetic abnormality, medicines can help," said Dr Lakdawala.Earlier on Saturday, Eman and her entourage landed at the Mumbai international airport around 3am. She was lifted from the cargo aircraft with the help of a crane and put into a mini-truck that left the airport around 4.45 am. She reached the Charni Road Hospital around 6.13 am and it took another 15 minutes for her bed to be lifted onto the platform leading to her firstfloor room. Eman has a long list of medical conditions, ranging from severe lymphedema and water retention to disabilities related to her stroke. Her right arm and leg are paralysed and she has type 2 diabetes, hypertension, hypothyroidism as well as severe obstructive and restrictive lung disease.
– It took two months of preparation and could take more than four years of treatment, but doctors are determined to help the person believed to be the world's heaviest woman survive. The Times of India reports that Eman Ahmed Abd El Aty was flown Saturday from her home in Egypt to Mumbai, India, where in March she'll undergo a weight-loss surgery called sleeve gastrectomy, which reduces the stomach to a fraction of its size. In the interim, medical staff hope to spur Abd El Aty—whose family thinks she weighs more than 1,100 pounds and who suffers from a litany of conditions, including Type 2 diabetes, hypothyroidism, and hypertension—to lose more than 100 pounds beforehand by feeding her a protein-heavy diet and giving her meds to help curb water retention. It wasn't an easy endeavor to transport Abd El Aty, who the Hindustan Times says is 36, to India, a trip that ran around $125,000 and required her to leave her home for the first time in a quarter-century. The Times and the Hindu describe the arduous process, which involved flying her via cargo plane from Alexandria to Mumbai, then transporting her from the airport in a custom-modified truck to Saifee Hospital, into which she was lowered by crane. After her eventual surgery, Abd El Aty will still follow a years-long regimen, including more operations and specialized diet plans, to continue losing weight while doctors try to figure out what caused her obesity in the first place. "If it is [a] genetic abnormality, medicines can help," says the bariatric surgeon who's been lobbying to get her treatment. (The onetime heaviest man in the world died at age 48.)