Gastric Sleeve vs Gastric Bypass: Which Bariatric Surgery Is Right For You?

Key Takeaways

Gastric Sleeve vs Gastric Bypass Differences: Gastric sleeve removes a portion of the stomach, while gastric bypass creates a small stomach pouch and reroutes the digestive pathway.

Weight Loss Results: Gastric bypass patients lose 65-75% of excess body weight, while gastric sleeve patients typically lose 60-70%.

Health Benefits: Both procedures effectively treat obesity-related conditions like diabetes and sleep apnea through weight loss and hormonal changes.

Cost Considerations: Gastric sleeve costs $8,500-$18,500, while gastric bypass ranges from $15,500-$18,500, with insurance coverage options available in New Jersey.

Table of contents

Bariatric surgery for obesity can be a life-changing step for many people in New Jersey, and the decision between a gastric sleeve vs gastric bypass procedure can lead to a lot of questions.  Choosing the right bariatric surgery becomes less overwhelming when informed, and a consultation with a fellowship-trained, board-certified NJ bariatric surgeon can help you decide between having a gastric sleeve vs gastric bypass. Before deciding whether the gastric sleeve vs gastric bypass surgery is right for you, consider these key factors:

How the Gastric Sleeve vs Gastric Bypass Surgery Jumpstarts Weight Loss

Bariatric Surgery, whether Gastric Sleeve or Gastric Bypass, decreases the size of your stomach, which limits the amount of food you can eat at one time. This results in leaving you feeling fuller sooner and longer.  And, with both the gastric bypass or gastric sleeve procedure, you will decrease your levels of hunger hormones so you will feel less hungry.  As you eat less food, your body will stop storing excess calories and start using its fat supply for energy.

The gastric sleeve (sleeve gastrectomy, VSG) surgery jump starts weight loss by removing a portion of the stomach and narrowing the remaining part to the size of a banana or a thin vertical “sleeve.”  The gastric bypass aids in weight loss by creating a small stomach pouch and rerouting the standard path food takes through the digestive system so that it “bypasses” a large section of the stomach and a portion of the small intestine.

Gastric Sleeve vs Gastric Bypass: Determine Your Weight Loss Goal

All bariatric surgery procedures, including Gastric Sleeve and Gastric Bypass, will result in an initial weight loss, but the amount lost can differ depending on which procedure you choose and the changes you commit to after surgery.

Estimated Weight Loss:

Patients who choose the gastric sleeve can see a loss between 60 to 65 percent of their excess body weight. Gastric bypass can result in a bit more weight loss with 65 to 75 percent of excess body weight.

In this video, Dr. Buwen discusses weight loss with Gastric Sleeve vs. Gastric Bypass

Consider Your Medical Conditions When Evaluating Gastric Sleeve vs Gastric Bypass

The gastric bypass and gastric sleeve procedures are some of the most effective treatments for obesity-related illnesses like type 2 diabetes. The hormonal effects surgery has on the body can have a positive impact on a patient’s blood sugar. Additionally, people with sleep apnea can see improvements and/or resolution of their condition with surgery. Less weight means less of a chance for blocked airways while sleeping.

What is the cost of Gastric Sleeve vs Gastric Bypass?

When comparing bariatric surgery options, gastric sleeve procedures typically cost $8,500 to $18,500, while gastric bypass ranges from $15,500 to $18,500 for self-pay patients. This cost difference reflects gastric bypass surgery's greater complexity. Both procedures may be covered by health insurance for many people in New Jersey, making them a more affordable long-term weight loss option. While insurance typically covers most surgical costs, out-of-pocket expenses vary by your specific policy. New Jersey Bariatric Center® offers comprehensive insurance support with upfront benefit verification before your first appointment, and accepts many insurance plans except Medicaid and NJ FamilyCare. Our navigation team guides patients through insurance approvals with a strong success rate. For patients without full coverage or facing high deductibles, flexible financing through CareCredit is available.

Commit to Follow-Up Visits to Monitor Your Progress

Whether you choose the gastric sleeve or the gastric bypass surgery, you will need to routinely meet with your surgeon and nutritionist to ensure you are on the right track. Attending support groups frequently helps you stay motivated. You can connect with others who are going through a weight loss journey too. NJBC is composed of a team of weight loss experts including fellowship-trained bariatric surgeons, on-site nutritionists and psychologists. They help guide you through this weight loss journey and beyond.

For information about the procedures including benefits and risks, click here.

Frequently Asked Questions

Which is better Gastric Sleeve or Gastric Bypass?

Determining whether a gastric sleeve or gastric bypass is 'better' depends on individual patient needs and goals. Gastric bypass typically results in slightly more weight loss (65-75% of excess body weight) compared to gastric sleeve (60-70%). However, both procedures effectively treat obesity and improves, and in some cases resolves, obesity-related illnesses such as type 2 diabetes, high blood pressure and sleep apnea.

The right procedure is determined by a patient and their doctor, after a through review of medical history, and weight loss goals. Consult with a qualified bariatric surgeon to determine which procedure is right for you.

Can you eat more with Gastric Sleeve or Gastric Bypass?

Both the gastric sleeve and gastric bypass reduce the amount of food you can consume at one time. However, because the gastric bypass creates a smaller stomach pouch and reroutes the digestive tract, it may result in slightly greater restriction in food intake compared to gastric sleeve. Neither procedure allows for large meal consumption. Both procedures are designed to restrict the amount of food a person can eat at one time. And, to also decrease the hunger hormone - grehlin. Each procedure results in feeling full faster, and for longer periods of time.

What are the side effects of Gastric Sleeve vs Gastric Bypass?

Side effects occur with bariatric surgery mainly because of the amount of weight lost in such a short period of time. Both gastric sleeve and gastric bypass surgeries carry potential side effects.
General side effects can include nausea, vomiting, gallstones and lactose intolerance. Side effects for gastric bypass specifically include dumping syndrome and mineral and vitamin deficiencies. Regularly taking vitamins, minerals and protein supplements can prevent deficiencies. Also, routinely see your doctor and a registered dietitian to be tested for any deficiencies. Many of these side effects are seen in people who have lost a significant amount of weight without surgery also.

Gastric Sleeve and Weight Loss - 4 FAQs

Estimated reading time: 3 minutes

The gastric sleeve, also known as the vertical sleeve gastrectomy (VSG), is one of the most popular weight loss procedures in New Jersey, and the most performed weight loss surgery here at New Jersey Bariatric Center®. 

At New Jersey Bariatric Center® we get a lot of questions about gastric sleeve surgery, also known as the vertical sleeve gastrectomy (VSG), from how it helps you lose weight to the health benefits for the procedure. If you’re considering a gastric sleeve surgery, here’s 4 FAQs about the gastric sleeve: 

1. Gastric Sleeve Helps You Lose Weight in 2 Ways

First, gastric sleeve surgery jumpstarts weight loss by removing a portion of the stomach and narrowing the remaining part of the stomach into a thin “sleeve-like” tube. The reduced stomach size holds less food so you feel full faster, while still allowing for the digestion of key nutrients. The second way is that the gastric sleeve procedure reduces the secretion of ghrelins in your stomach. Ghrelins are hormones responsible for making you feel hungry. Patients on average can lose about 40-70% of their excess body weight after a gastric sleeve procedure. 

2. The Health Benefits Go Beyond the Numbers on the Scale

Not only does the gastric sleeve help you to lose weight, but it can also offer other health benefits and improvements for obesity-related conditions. In a study by the American Society for Metabolic and Bariatric Surgery (ASMBS), after gastric sleeve surgery: 

As with any surgery there are side effects and risks to weight loss procedures. To learn more, visit our Side Effects & Risks page.

3. Gastric Sleeve Surgery is performed Laparoscopically or Robotically-Assisted

During gastric sleeve surgery our surgeons make small incisions in the abdominal wall to remove 75-80% of the stomach. This reduces the capacity of the stomach to 3-4 ounces, resulting in patients feeling full, faster on a smaller portion of food. At New Jersey Bariatric Center® the surgery is performed either laparoscopically or is robotically-assisted, and usually lasts approximately 1-2 hours.

4. Hospital Stays are Generally 1 Day 

Both methods - laparoscopic or robotic-assisted - of surgery involve smaller incisions through the stomach, which often leads to, for many patients, less pain and a short, 1 day hospital stay, in general. To learn more about recovery at home, post-surgery nutrition as well as returning to work and regular activity, click here.

For more questions about gastric sleeve or to schedule an appointment give us a call at 908-481-1270. To register for one of our free webinars, click here. 

*Metabolic and bariatric surgery. (2018, October). In the American Society for Metabolic and Bariatric Surgery. Retrieved November 10, 2020, from https://asmbs.org/resources/metabolic-and-bariatric-surgery

New Jersey Bariatric Center moves to Telemedicine

Telemedicine now available at NJBC

In our effort to help stop the spread of COVID-19 and accommodate our patient’s needs, New Jersey Bariatric Center now offers telemedicine appointments.

Scheduling a Telemedicine Appointment

Call our office at 908-481-1270 or click here to schedule a telemedicine appointment. After scheduling, patients will receive a confirmation email from us with a link to access their appointment.  Telemedicine appointments will be conducted via Doxy.me. The platform is secure, easy-to-use and allows patients to stay connected with their New Jersey Bariatric Center doctors.  Telemedicine appointments are available for current and new patients.   

What to Expect during a Telemedicine Appointment

During a telemedicine session, patients will speak directly with a member of the New Jersey Bariatric Center clinical staff – surgeons, physician assistant or nutritionists – based on the type of appointment they schedule. Current pre-op patients can stay on track for their future procedures, new patients can learn about weight loss surgery procedures like the gastric sleeve and gastric bypass and post-op patients can maintain their care and follow-up.

At New Jersey Bariatric Center the safety of our patients, staff and communities we serve is a priority.  We hope by introducing telemedicine to our patients during the NJ Coronavirus Stay-At-Home Order we can keep everyone safe, healthy and on their weight loss journey.

For more information about scheduling a telemedicine appointment or if you have questions about an existing appointment, please call our office at 908-481-1270. 

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Healthy Summer Grilling

During the summertime I really enjoy grilling  for my family. I like to include lean protein such as chicken and steak along with nutrient dense veggies with our meals. One of my favorite healthy summer grilling meals is chick and stank with veggies. I use pre-marinated chicken that we found at Whole Foods, flank steak, bell peppers and onions plus some jalapeno to kick things up a notch.

The best thing about cooking on the grill is that you can get creative. If you don’t love peppers and onions, try zucchini, eggplant or any veggie of your choice. For protein, if you don't love pre-marinated chicken, use regular chicken, prepare and season to taste. Test out different seasoning combinations to find your favorite. Here’s my healthy summer grilling recipe: 

Ingredients:

Instructions:

  1. Slice all veggies and add to a bowl with olive oil and salt, pepper to taste. Toss to combine. 
  2. Season flank steak with salt and pepper. 
  3. Heat grill to medium. 
  4. Add all steak and chicken to the grill first. Then add veggies and cook to your desired doneness. 
  5. I like to finish everything off with a squeeze of fresh lime juice and serve.

If you enjoy grilling in the summer and want a healthy summer grilling option, try this recipe and let me know how you like it.

Our team of registered dietitians have created many healthy recipies that can be found on our blog. For additional recipes ideas, click here.

Hair Loss After Bariatric Surgery

Help! My Hair Is Falling Out! What You Need To Know About Hair Loss After Bariatric Surgery.

You had bariatric surgery. Your weight loss is at a steady pace and you feeling great! Then one morning, you notice more hair than normal in the drain after your shower. What’s going on, you wonder. And more important, how can I stop it? Then a thought enters your mind: What if it’s permanent?

Hair Loss Is a Common Side Effect of Significant Weight Loss

Many bariatric surgery patients are surprised to learn that hair loss is a common side effect of weight loss surgery and it doesn’t matter if you’ve had Gastric Bypass, Gastric Sleeve or Gastric Band (also known as LAP-BAND). The truth is many patients will experience some degree of hair-thinning, especially between the third and sixth month after surgery.  The good news is that there are several treatment options for this problem. And the better news is that since the hair follicles are not damaged, the hair will grow back.

Normal hair follicles go through a cycle of hair growth, followed by an inactive stage when the hair stops growing, and then the hair eventually falls out.  After rapid weight loss (even for those who’ve lost weight without bariatric surgery), this process is accelerated, leading to hair loss.

Preventing Hair Loss After Bariatric Surgery

There are some simple things you can do to prevent or treat hair loss after bariatric surgery:

Remember, hair loss after bariatric surgery is temporary.  Reach out to your surgeon, nutritionists and NJBC staff for continued support through your weight loss journey.

Reference:  “Hair Loss Among Bariatric Surgery Patients”  Silvia Leite Faria, MS, Orlando Pereira Faria, MD, et al.  Bariatric Times Online.  November 11, 2010.

Excess Skin After Weight Loss Surgery

                                  Excess or Loose Skin After Gastric Sleeve or Gastric Bypass Surgery A Concern For Many Weight Loss Surgery Patients in NJ

Having loose or excess skin after weight loss surgery, whether Gastric Sleeve or Gastric Bypass, is a very common concern among our New Jersey patients, and rightfully so.  It can be upsetting to find that after losing a significant amount of weight, patients still might be unhappy with their appearance because of unwanted excess "hanging" skin in areas such as the abdomen, thighs, and arms.

A common misconception is that loose, excess skin only occurs after dramatic weight loss from bariatric surgery.  The truth is, unwanted hanging skin can happen after any weight loss, whether through a change in diet, exercise, medical weight loss or weight loss surgery.  This condition occurs because of reduced skin elasticity.  Everyone’s skin has varying ability to “snap back” to its original shape, which is why different patients develop different degrees of loose skin. Here are a few factors that contribute to skin elasticity:                   

Age: The younger your skin, the more elastic it is.

Smoking: Smoking decreases skin elasticity.

Genetics: There is some truth to the saying that “good genes lead to good skin.” Sometimes things are out of our control, and skin elasticity or lack thereof can be inherited.

Time: The amount of time someone has been overweight contributes to the likelihood of loose skin.  The longer your skin is stretched, the more likely it is that you will have some loose skin after losing the weight.  Another time factor is the rate at which you lose weight.  Some experts say that losing weight at a slower pace (1-2 pounds per week) can give the skin time to gradually get back to its pre-stretched state.

Amount of Weight Loss: The more weight loss, the higher the chance that you may have some loose skin.

Skin Removal Procedures

The only way to truly get rid of unwanted excess skin is to surgically remove it.  When you’re considering skin removal the New Jersey Bariatric Center® surgeons will guide you through the process and help you evaluate the best option for you, whether it’s a panniculectomy, where fat and skin is removed without tightening the abdominal wall muscles, an abdominoplasty (“tummy tuck”), a mammoplasty (breast lift), or other “body lifts.”  We recommend waiting about one year after weight loss surgery before going for a consultation regarding skin removal.  Most surgeons will want you to be at a stable weight for at least 6 months before they perform these procedures.  Be sure to check with your insurance company, many usually do not cover these procedures because they consider them cosmetic.

Improving Skin’s Appearance

While surgery is the most definitive way to eliminate excess skin after weight loss, here’s additional ways you can improve your skin’s appearance.

1.Build Muscle: Resistance or weight training exercises can be helpful to build muscle underneath your skin. This can help your skin appear more defined.

2. Protein: Be sure that you are eating or drinking adequate amounts of protein each day. Inadequate protein intake can lead to muscle wasting and worsen the appearance of loose skin.

3. Drink Water: Adequate hydration is essential for overall health, including that of skin and muscle.

Remember that weight loss is one of the best steps you can take to improve your health and overall quality of life.  While loose skin can be an unwanted side effect of weight loss, many of our patients say it is worth it once they experience the many positive health benefits that weight loss brings to them.

Semaglutide Compound Restrictions: FDA Ends Compound Versions of Ozempic® & Wegovy®: Here Are Available Options

FDA Declares End to Semaglutide and Tirzepatide Shortage, Restricting Compounding Production of the GLP-1s for NJ Residents Using These Medications for Weight Loss

May marks a significant transition for many people on weight loss medications across New Jersey. As the FDA's April 22nd deadline for many compounding pharmacies has passed and the May 22nd deadline arrives for small compounding pharmacies to stop producing semaglutide, many people in NJ on these medications are left wondering if the brand name medications Wegovy®, Ozempic® (semaglutide) and Zepbound® (tirzepatide) are options for them moving forward. 

FDA Restrictions on Compound GLP-1 Medications

This regulatory action follows the FDA's February 2025 declaration that the semaglutide shortage is officially "resolved." For compounded tirzepatide (Zepbound®), the deadline was earlier - March 2025. Novo Nordisk, the manufacturer of semaglutide now says all doses are "continuously shipped" to meet U.S. demand, removing the legal basis for compounding these medications under current regulations.

Alternative Options to Compound Weight Loss Medications

The popularity of compounded GLP-1 medications stemmed primarily from their affordability—typically $100-$200 monthly compared to more than $1,000 for brand-name versions. This price advantage made weight management accessible to many people whose insurance wouldn't cover the brand medications. With compounded options ending, here are a few alternatives to consider:

  1. Brand-Name GLP-1 Medications: According to the New York Times, Eli Lilly and Novo Nordisk now offer their brand-name drugs for approximately $500 a month to people who pay out-of-pocket instead of going through insurance. While still more costly than compounded versions, this represents a significant reduction from the previous price point of more than $1,000 per month. Patient Assistance Programs:
    • Wegovy®/Ozempic® (Novo Nordisk): If you have insurance that covers these medications, copay cards can significantly reduce your costs. Research Novo Nordisk's savings program for details.
    • Zepbound®/Mounjaro® (Eli Lilly): Similar assistance programs are available through Eli Lilly Connect.
  2. Alternative FDA-Approved Weight Loss Medications: If GLP-1 medications are now out of reach financially, consider these alternatives:
    • Saxenda (liraglutide): Saxenda is an injectable GLP-1 agonist FDA-approved specifically for weight loss. It works by mimicking a hormone that targets areas of the brain that regulates appetite and satiety (fullness), this can help with your overall portion control and ultimately weight loss. Unlike weekly GLP-1 injections, Saxenda requires daily administration.
    • Other Weight Loss Prescription Options:
      • Qsymia (phentermine-topiramate): A combination medication that suppresses appetite and increases feelings of fullness
      • Contrave: Works on brain pathways involved in hunger and cravings
  3. Weight Loss Surgery Options
    • For those with significant obesity or weight-related health conditions, bariatric surgery might be a more viable solution:
    • Gastric Sleeve: Removes approximately 80% of the stomach
    • Gastric Bypass: Creates a small stomach pouch and reroutes the digestive tract

4. Nutritional Support and Meal Plans

At New Jersey Bariatric Center®, our registered dietitians provide personalized nutritional counseling and custom meal planning to help combat weight regain during your transition from GLP-1 medications. As you adjust to this change, our nutrition experts can guide you with tips to maintain the progress you've achieved while using weight loss medications.

What If You Regain Weight After Compound Medications End?

RELATED: Will I Regain Weight After StoppingPrescription Weight Loss Medications?

A common concern when stopping GLP-1 medications is potential weight gain. Research suggests that without continued treatment or lifestyle modifications, some weight gain is likely. An NIH study concluded that patients may regain approximately 2/3 of their lost weight within a year of stopping GLP-1 medications.

This underscores the importance of working with a qualified weight loss doctor to develop sustainable strategies beyond medication. The weight loss team at NJBC provides a comprehensive approach to patients transitioning from compound weight loss medications.

From regular monitoring and support, personalized nutrition plans, lifestyle modification techniques and exercise programs, we are here for you.

Our commitment is to support patients through this transition. Questions? Call 908-481-1270 or click here to schedule an appointment.

FAQs About the FDA Compounding Ban

Can I still get my compounded medication after the deadline?

While some compounding pharmacies might attempt to continue offering modified formulations, the FDA's directive is clear. Patients should transition to FDA-approved alternatives under medical supervision.

Will my insurance cover brand-name GLP-1 medications?

Coverage varies significantly by insurance provider and specific plan. Many insurers require prior authorization documenting medical necessity. Consult your insurance provider to confirm weight loss medication coverage. Call NJBC for questions about what to ask your insurance provider.

Are compounded GLP-1 medications less safe?

The FDA has expressed concerns about compounded versions, noting they "received multiple reports of adverse events, some requiring hospitalization, that may be related to dosing errors associated with compounded injectable semaglutide products." However, many patients used compounded versions successfully under proper medical supervision.

SADI SURGERY AND WEIGHT LOSS RESULTS IN NJ

What is SADI-Surgery and How Does it Help Weight loss Patients in New Jersey

Are you considering weight loss surgery and wondering if SADI surgery might be right for you? This comprehensive guide explains everything you need to know about this increasingly popular bariatric surgery procedure.

What is SADI Surgery?

SADI surgery - Single Anastomosis Duodeno-Ileostomy - combines aspects of multiple weight loss surgeries into one procedure. Also known as SADI-S (sleeve gastrectomy), SADI is a weight loss surgery that combines the restrictive part of the gastric sleeve with the malabsorptive nature of surgeries like a gastric bypass or duodenal switch, without disrupting the continuity of the small intestine.

This procedure is endorsed by the American Society of Metabolic and Bariatric Surgeons (ASMBS) as both a primary weight loss option and as a revisional procedure for those who didn't achieve sufficient results with previous surgeries.

How Does SADI Surgery Work?

SADI surgery jumpstarts weight loss through a dual approach:

  1. Restriction: First, the stomach is reduced in size similar to a gastric sleeve, which helps you feel full faster and eat smaller portions.
  2. Malabsorption: Next, a significant portion of the small intestine is bypassed, limiting the calories and nutrients your body can absorb from food.

The combination not only helps patients with significant weight loss but also improves blood sugar and metabolism. Additional hormonal benefits include:

Benefits of SADI Surgery

The procedure offers several benefits that make it an effective option for many patients:

Significant Weight Loss

Patients typically lose 80-90% of their excess weight or up to 40% of total body weight following SADI surgery.

Improved Metabolic Health

SADI surgery is particularly effective for treating type 2 diabetes by reducing insulin resistance. The procedure also helps improve other obesity-related conditions like:

Reduced Complication Risk

With only one intestinal connection (compared to multiple connections in other procedures), there is a lower risk of leaks and internal hernias.

Preserved Digestive Function

SADI surgery preserves the pylorus (the muscular valve at the bottom of the stomach), which helps regulate digestion and minimize dumping syndrome.

SADI Surgery vs. Gastric Sleeve

While the gastric sleeve reduces stomach size, SADI surgery adds malabsorption by rerouting the small intestine. This results in greater weight loss and stronger metabolic benefits. SADI is often recommended when more significant weight loss is needed or when a previous sleeve gastrectomy didn't produce the desired weight loss results

SADI Surgery vs. Gastric Bypass

Both procedures reroute the intestines, but SADI surgery:

How Do I Qualify?

While any candidate for bariatric surgery might consider this procedure, it's particularly beneficial for:

The ideal candidate should also be willing to:

Potential Side Effects and Risks

Like all surgical procedures, there are potential risks and side effects:

Nutritional Considerations

Due to the malabsorptive component, patients must be vigilant about:

Surgical Risks

While less common when performed by experienced, fellowship-trained surgeons such as our team at NJBC, potential risks include:

Recovery Process After SADI Surgery

Most patients experience a recovery similar to gastric sleeve and gastric bypass:

Is SADI Surgery Right for You?

If you're seeking a weight loss solution that offers significant results with fewer complications than some traditional procedures, this surgery is an option to consider. The bariatric surgery procedure's combination of restriction and malabsorption makes it particularly effective for those needing significant weight loss or metabolic improvements.

The decision to undergo any bariatric procedure should be made carefully after thorough consultation with an experienced bariatric surgeon who can evaluate your specific needs and health goals.

To find out if you qualify, call 908-481-1270

References:

Shoar, Saeed, et al. "Single anastomosis duodeno-ileal switch (SADIS): a systematic review of efficacy and safety." Obesity surgery 28 (2018): 104-113.

Kallies, Kara, and Ann M. Rogers. "American Society for Metabolic and Bariatric Surgery updated statement on single-anastomosis duodenal switch." Surgery for Obesity and Related Diseases 16.7 (2020): 825-830.

Surve, Amit, et al. "Mid-term outcomes of gastric bypass weight loss failure to duodenal switch." Surgery for Obesity and Related Diseases 12.9 (2016): 1663-1670.

Lee, Yung, et al. "Single-or double-anastomosis duodenal switch versus Roux-en-Y gastric bypass as a revisional procedure for sleeve gastrectomy: a systematic review and meta-analysis." Surgery for Obesity and Related Diseases 15.4 (2019): 556-566.

Can You Re-Sleeve the Stomach? When a Second Chance with a Gastric Sleeve Revision is Possible

Bariatric Patients Seek a Gastric Sleeve Revision Years After Their Initial Bariatric Surgery

Yes, you can get gastric sleeve revision if your stomach has stretched enough after the initial procedure. Some bariatric patients seek a second gastric sleeve  - a re-sleeve - procedure years after their initial surgery. Gastric sleeve revision is an available option in New Jersey for those who qualify and want to continue with a restrictive weight loss method. Research shows that revision gastric sleeve surgery is an effective bariatric revision surgery with effective, long-lasting results when performed by experienced bariatric surgeons. However, if the stomach hasn't stretched enough, gastric bypass and SADI surgery are other options for weight loss surgery patients who qualify.

Stomach Stretching After Gastric Sleeve

The stomach is a thin-walled muscle designed to expand when you eat and decompress when empty. Its natural function includes stretching to accommodate food and grinding it into smaller pieces for digestion.

After gastric sleeve surgery (also called sleeve gastrectomy), more than 80% of your stomach has been removed. While you can never stretch your post-surgery stomach back to its original pre-surgery size, some stretching is normal and expected. Your sleeved stomach will continue to expand and contract with meals—just at a significantly reduced capacity compared to before.

Most weight gain after gastric sleeve surgery occurs not from extreme stomach stretching but from increased calorie intake, particularly from frequent snacking and high-calorie beverages that bypass the restrictive benefits of the sleeve.

Gastric Sleeve Revision: A Second Chance at Weight Loss Success

This procedure can help patients who have regained weight or didn’t reach their weight loss goals with their first gastric sleeve. To determine eligibility for a re-sleeve, an endoscopy to examine the stomach will be performed by your bariatric surgeon to measure stomach size and see if there's sufficient dilation to qualify for gastric sleeve revision.

Once eligibility is determined, your New Jersey Bariatric Center® surgeon can re-sleeve your sleeve. Re-sleeving works by reducing the size of your stretched stomach back to an optimal size, helping to restore the feeling of fullness and portion control that you may have lost over time.

Studies show that approximately 18.7% of all revision surgeries after gastric sleeve are re-sleeve procedures, making it the second most common revision option after gastric bypass. 

When a Revision of the Gastric Sleeve Isn't the Answer

If your stomach has not stretched significantly, a revision of the gastric sleeve is not an option. Patients with GERD should also avoid re-sleeving as it can worsen reflux symptoms. For  patients who do not qualify for gastric sleeve a second time, a gastric sleeve revision to a gastric bypass or a SADI (Single Anastomosis Duodenal-Ileal Bypass) surgery can provide more significant weight loss through both restriction and malabsorption.

Getting Back on Track

Obesity is a disease that bariatric surgery cannot cure. It is a tool to jumpstart weight loss. It's a journey with ups and downs rather than a linear path. If you're experiencing weight gain or struggling to meet your goals after gastric sleeve surgery, schedule a consultation with our New Jersey Bariatric Center® team to review your options, which may include:

Our comprehensive approach ensures you receive personalized recommendations based on your unique needs. Call us at 908-481-1270.

Frequently Asked Questions About A Second Gastric Sleeve Surgery

  1. Is it possible to get a second gastric sleeve surgery?  Yes, a second gastric sleeve surgery, known as a gastric sleeve revision can be an option if the initial sleeve has stretched considerably. However, a thorough evaluation is necessary to determine if it is the most appropriate procedure for a bariatric revision surgery.  
  2. How long after my first gastric sleeve can I get a revision? At NJBC we recommend waiting at least 18-24 months after your initial procedure before considering gastric sleeve revision surgery.
  3. Will insurance cover a gastric sleeve revision? Coverage varies by insurance provider and policy. Documentation of medical necessity, including evidence of stomach stretching and weight regain is typically required. Contact your insurance provider for more information about your coverage.
  4. What are my options for a second bariatric surgery if my stomach isn't stretched?    If significant stomach stretching is not found during the endoscopy, a second gastric sleeve is not a viable option. Alternatively, gastric bypass and SADI (Single Anastomosis Duodeno-Ileal bypass with Sleeve Gastrectomy are available solutions).
  5. How do I know if I'm a candidate for bariatric sleeve revision surgery?  The best way to determine your candidacy for a second gastric sleeve surgery is to schedule a consultation with an experienced bariatric surgeon at NJBC. They will evaluate your medical history, weight loss progress, current health, and the condition of your existing gastric sleeve to recommend the most suitable course of action for your second chance.

Why is Weight Loss So Hard?

Weight Loss is Hard Because Obesity Is a Disease Caused By Several Factors That Fight Against Our Body to Lose Weight

When most of our patients here in NJ come through our doors, they’ve tried countless diet and exercise programs but still have not been able to achieve weight loss or keep it off.  They often feel frustrated and depressed, and rightfully so. When I meet with a patient for the first time I let them know that I believe in them. I know they’ve tried to lose weight.  I understand that what they’re suffering from is a disease.  And it’s NOT their fault. I can often see patients breathe a sigh of relief that we understand it’s not as simple as “eat less and move more.” Words that they’ve undoubtedly heard countless times before.

Factors That Fight Against Our Body to Lose Weight

At NJBC we explain to our patients why they have been unsuccessful in fighting the uphill battle of weight loss.  The reason - obesity is a disease of hormonal imbalance that is caused by several factors that fight against our body losing the weight.

These factors include: 

Genetics: People are either born with a predisposition for obesity, or they are not.  For many it is in their DNA, much like someone who might have a gene that increases their risk of developing certain cancers.  

Hormones:  Certain hormones can trigger weight gain during puberty, pregnancy or menopause.  Other hormones, such as Ghrelin and Leptin, are responsible for hunger and satiety.  Many times these hormones – Ghrelin and Leptin - are imbalanced in people who suffer from obesity.

Medications and Medical Conditions:  Medications such as steroids, certain antidepressants and some blood pressure ones can cause people to gain weight.  Medical conditions, such as Insulin resistance, make it more difficult for certain people to lose weight.  In this case, carbohydrates and sugars are not metabolized efficiently and lead to rapid fat storage in the body.  

Life Events: Life events such as an injury or illness that lead to long periods of inactivity can make it difficult to eat healthy foods and participate in physical activity. 

Set Point: Set point is the weight that one’s body is trying to defend.  Think of it like a thermostat, when the body detects that less calories are being eaten it adjusts its hormones to try and prevent weight loss from happening.  The body does this by increasing the signals to the brain that cause hunger and decreasing the body’s ability to burn calories. 

Bariatric Surgery Is An Effective Treatment for Obesity

Our bodies are extremely complex and there are countless reasons why it’s difficult for a person to lose weight.   If it were as simple as weight loss equals calories in (what we eat) minus calories out (exercise), we would not be facing the obesity epidemic that we see today.  What we do know is that bariatric surgery is the most effective treatment for obesity. It has been proven to break the ineffective dieting cycle by treating the hormonal imbalances of this disease, which can lead to dramatic and sustainable weight loss, resolution of chronic illnesses such as diabetes and sleep apnea, and ultimately a healthier journey forward for many of our patients.

Bariatric Surgery - A Treatment for Type 2 Diabetes

Studies Show Gastric Sleeve and Gastric Bypass Surgery Can Be Effective Treatments for Type 2 Diabetes

Bariatric surgery – gastric sleeve and gastric bypass -  can be one of the most effective treatments for Type 2 diabetes.  These bariatric surgeries can lower a patient’s blood sugar and improve health problems related to Type 2 diabetes.  In fact, post bariatric surgery, Type 2 diabetes is resolved in more than 82% of patients*

What is Type 2 Diabetes?

Type 2 diabetes is a long term metabolic disorder in which afflicted patients have elevated sugar (or glucose) in their blood.  It is the most common form of diabetes, accounting for approximately 95% of all cases according to the American Society for Metabolic and Bariatric Surgery.

Type 2 diabetes occurs because of a condition called Insulin resistance.  Insulin is a hormone released by the pancreas in response to a meal containing sugar or carbohydrates.  Insulin’s job is to lower the amount of sugar circulating in the blood by making it enter the cells.  When people are Insulin resistant, their bodies need to produce extra amounts of Insulin to effectively lower the amount of sugar in their blood.  The cells are not “listening” to the insulin, so more and more of the hormone is produced in order to get the same effect.

The association between obesity and Insulin Resistance, or Type 2 diabetes, is undergoing much research.  There are several explanations of why people who suffer from obesity are more likely to develop diabetes.  One thought is that increased visceral fat (or fat that is found around abdominal organs) leads to “fatty liver” which in turn impairs effective signaling by Insulin.  Another explanation is that visceral fat causes inflammation and disrupts the Insulin signaling pathways.

For patient who are obese, some medical treatments for diabetes, such as insulin, actually cause patients to gain more weight, leading to a vicious cycle of weight gain, worsening blood sugars, higher doses of insulin, etc.

Given its prevalence and effect on our health, patients and physicians alike are consistently searching for ways to improve the symptoms or resolve the condition completely.

Bariatric Surgery's Effect on Type 2 Diabetes

While many people know that Type 2 diabetes and obesity are related, most do not realize that it is the hormonal effects of bariatric surgery, in addition to weight loss, that help improve a patient’s blood sugar. This is evident in patients who have gastric bypass or sleeve gastrectomy, who often may not need to take their diabetes medication after surgery, even before they start losing significant amounts of weight.  The improved blood sugar levels result from changes in certain signals from the gut to the brain, liver, and muscles after a person’s anatomy has been changed with surgery.

Diabetes Sources:

*Schauer PR, Ikramuddin S, Gourash W, et al.  Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity.  Ann Surg 2000; 232(4): 515-29

*Wittgrove AC, Clark GW.  Laparoscopic gastric bypass, Roux-en-Y – 500 patients; technique and results, with 3-60 month follow-up.  Obes Surg 2000; 10(3): 233-9.

* Schauer PR, Brugera B, Ikramuddin S, et al.  Effect of laparoscopic Roux-en-Y gastric bypass on type 2 diabetes mellitus.  Ann Surg 2003; 238(4): 467-84; discussion 84-5.

Finding the Right Medical Weight Loss Doctor in NJ

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If you are struggling with weight loss despite your best efforts, you're not alone. Many New Jersey residents find that diet and exercise aren't always enough to achieve their weight loss goals. If you do not qualify for bariatric surgery or just are not ready to take that step, medical weight loss is an option. That's why finding the right medical weight loss doctor in NJ can make all the difference.

Key TakeAways

Why Does a Weight Loss Doctor Makes the Difference

Weight loss management is fundamentally a health issue, not an aesthetic one. When you work with a board-certified doctor you benefit from medical expertise that identifies and addresses underlying issues affecting your weight - whether they’re genetic, hormonal or lifestyle-related.

At New Jersey Bariatric Center®, we understand that each patient's weight loss journey is unique. As such, we use evidence-based treatments, including weight loss medications and injections, combined with compassionate care to help you achieve lasting results. Our patients tell us that this approach helps them succeed when years of dieting have failed.

How to Ask Your Doctor for Weight Loss Pills

How to ask your doctor for weight loss pills

"I was embarrassed to ask my primary care doctor about weight loss pills or injections." We hear this from some patients, and we understand. Many people worry about being judged, dismissed, or labeled as "looking for an easy way out". At NJBC®, you can set those concerns aside—weight management is our specialty, and after 20 years of serving patients we know that it's not the easy way out.

If you decide to discuss weight loss medications with your doctor, here's how to approach it effectively. Prepare for your appointment by documenting your weight history, previous diet attempts, and how excess weight affects your health. Then be direct: "I've struggled with my weight for some time now. Would weight loss pills or injections be an appropriate option for me?" Also, consider meeting with doctors who specialize in obesity medication like our weight loss experts.  We provide comprehensive care including metabolic testing, nutrition guidance, exercise classes and prescription medications for successful weight management.

Schedule an Appointment

What Sets NJ's Top Weight Loss Doctors Apart?

Top weight loss doctors offer a combination of qualities and skills that ensure effective results for their patients. They are board-certified physicians with specialized training in obesity and weight management. Offering a comprehensive approach to care through programs that address all aspects of weight loss, from nutrition to behavioral changes sets them apart. Finally, they offer long-term support beyond weight loss medications and injections to help their patients maintain results for life. New Jersey Bariatric Center® has a team of top weight loss doctors and registered dietitians with 20 years of experience in weight management. The success stories of their patients sets them apart.

Medical Weight Loss Programs in NJ

At New Jersey Bariatric Center®, we take a fundamentally different approach from fad diets or medspas that only offer weight loss medications and injection. Our weight loss program is physician-supervised, grounded in medical science and tailored to your individual needs. We start with a comprehensive assessment where we review your medical history, run appropriate lab tests, and assess your eating patterns and activity levels.

This thorough evaluation allows our NJ weight loss doctors to develop a weight management plan specifically for you. Your personalized program may include FDA-approved weight loss shots or capsules that help control hunger and metabolism, nutritional counseling and classes from our registered dietitians and monthly exercise classes that fit your daily life. Our approach addresses every aspect of weight management with medically-sound solutions that work with your body, not against it.

We don't offer quick fixes that can lead to regaining weight. Our program help you develop long term sustainable results.

What to Expect at New Jersey Bariatric Center®

First Appointment

Your initial consultation will typically include:

  1. Review of your medical history
  2. Discussion of previous weight loss attempts
  3. Physical examination
  4. Diagnostic testing if necessary
  5. Conversation about your goals and expectations

Follow-Up Care

Regular follow-up appointments allow your doctor to:

Real Patients, Real Stories

Our patients' results speak for themselves:

Eugenia's 118-Lb* Medical Weight Loss Journey on Wegovy®

Sean Lost 100 lbs with Gastric Sleeve Surgery and Wegovy®

Take the First Step with a Leading Weight Loss Doctor in NJ

Weight loss doesn't have to be a constant struggle. With the right medical guidance, you can achieve your health goals and maintain them for life.

New Jersey Bariatric Center®'s team of specialized weight loss doctors in NJ offers the medical expertise, personalized approach, and compassionate support you need to succeed where other methods have failed.

Now that you are ready to improve your health, contact one of New Jersey's top weight loss doctors today to schedule your consultation. Call us at 908-481-1270.

Frequently Asked Questions

Is medical weight loss covered by insurance?

Many insurance plans cover medical weight loss services when they're deemed medically necessary. Our staff can help verify your benefits and explain coverage options.

Are weight loss pills and injections covered by insurance?

Insurance coverage for weight loss medications varies by plan. Each insurance plan has different coverage for medical weight loss. To find out if you have coverage for prescription weight loss pills and injections, contact your insurance provider and ask if you have coverage for branded anti-obesity drugs. If you do not have coverage, you have the option to pay out of pocket if you qualify.

How often will I see my weight loss doctor?

Initially, you see your doctor every 2-4 weeks. As you progress, these visits may become less frequent while still providing the support you need.

Why is NJBC’s medical weight loss program different from other programs?

NJBC's team of board-certified physicians specialize in weight management, providing direct, personalized care, unlike online platforms like Hims and Hers, Ro and Zealthy that offer standardized protocols based on questionnaires. We conduct comprehensive lab work, monitor your progress in real-time, and adjust medications immediately as needed. We prioritize face-to-face accountability, building strong patient-doctor relationships that drive weight loss success

How much weight can I expect to lose with weight loss medications and injections?

Results vary based on individual factors, but many patients lose 10-15% of their starting weight within the first six months on a comprehensive medical weight loss program. Click here to calculate your potential weight loss.

Are weight loss medications safe?

When supervised by a qualified weight loss doctor, FDA-Approved medications are generally safe. Additionally, your health is monitored throughout the process, and your treatment is adjusted as needed to ensure both safety and effectiveness.

NJBC Eats: Slow Cooker Fiesta Chicken

Have you tried the slow cooker fiesta chicken? During the colder months, my family and I crave warm and hearty meals. I am a huge fan of the slow cooker and this slow cooker fiesta chicken recipe is always on rotation at my house. It’s easy to make, with minimal ingredients. My favorite part about this recipe is that it freezes well and makes great leftovers. It’s perfect for meal prep, too. To keep this dish low carb, try serving it over shredded lettuce or cauliflower rice with ⅛ cup shredded cheese and a dollop of guacamole. Try it and let us know how much you like it.

Yield: 8 servings
Prep Time: 10 min
Cook Time: 5-8 hours
Ingredients for slow cooker fiesta chicken:

Instructions

  1. In a slow cooker, mix together tomatoes, beans, corn, garlic, oregano, cumin and paprika. Add cayenne if using.
  2. Season both sides of chicken lightly with salt and pepper and slightly press the pieces into tomato mixture.
  3. Place the lid onto the slow cooker.
  4. Set temperature for 5 hours on high or 8 hours on low.
  5. When cooking has finished, remove chicken and shred with 2 forks. 
  6. Return shredded chicken to pot and mix with veggies.

Serve and enjoy your Slow Cooker Fiesta Chicken!

 

Protein Shakes and Weight Loss

Protein shakes have become a staple for many people in New Jersey looking to manage their weight. They can be a quick, healthy source of nutrition that supports weight loss. For individuals who’ve had bariatric surgery or are taking weight loss medications, protein shakes are a good way to get nutrients while eating less. 

How Protein Shakes Support Weight Loss and Muscle Health

Protein helps to promote feelings of fullness, which can help reduce overall calorie intake. When consumed as part of a meal or snack, protein shakes can curb hunger and minimize cravings. This makes it easier to stick to a calorie deficit essential for weight loss. With a calorie deficit one of the main concerns is the potential loss of muscle. Consuming protein shakes can help preserve lean muscle while promoting fat loss. Maintaining muscle mass is vital not only for strength but also for metabolic health. 

These shakes can be tailored to meet individual dietary needs and preferences. Whether you follow a vegan, vegetarian, or omnivorous diet, there are numerous protein sources available. Among them are whey, casein, pea, soy, and hemp. This versatility allows for creative combinations that can enhance flavor and nutrient content.

How to Make a Healthy Protein Shakes  

When making a healthy protein shake to support weight loss, start with a base of unsweetened almond milk, skim milk, or water for hydration and low calories. Add a scoop of your favorite protein powder—whey or plant-based—depending on your dietary preferences. For added nutrition, toss in a handful of leafy greens like spinach or kale, which blend easily and boost your vitamins without altering the taste. To enhance flavor, add a banana or a handful of berries, which provide natural sweetness and antioxidants. Lastly, consider adding extras like chia seeds or flaxseeds for fiber, and blend until smooth. These shakes are perfect for post-workout recovery or a quick meal on the go.

Fairlife® protein shakes offer a quick protein boost on the go.  Fairlife® skim milk is a good choice for a protein shake base since the milk is flowed through a special filter to concentrate the protein and calcium while removing most of the naturally occurring sugar.  Fast food chains like Smoothie King now have low sugar, high protein shakes blended with greens, fiber, and healthy fats. These ready-made drinks are convenient and support a balanced nutrition when you're busy.

When is the Best Time to have a Protein Shake? 

Deciding the best time to have one ultimately depends on your lifestyle and your specific needs. Here are some options to consider:

How Often Should You Have A Protein Shake?

At New Jersey Bariatric Center® we tell our patients to start with one protein shake per day. This can help ensure you're meeting your protein needs without over-consuming calories or diminishing the role of whole foods in your diet. The recommended frequency can vary depending on your individual circumstances. Your activity level, muscle-building goals, and overall caloric intake should all be considered when determining the optimal frequency for you. Speak with a registered dietitian to determine if adjusting your shake intake can better support your health and weight loss goals.

Maintaining a Balanced Diet

Protein shakes are meant to complement nutrient-dense foods, not replace them entirely.  It's important not to rely entirely on protein shakes and to focus on consuming a balanced diet rich in the following:

These whole, minimally processed food sources contain essential vitamins, minerals, and fiber. Overusing shakes could lead to them displacing the important role of these whole foods in your diet.

For more questions, call 908-481-1270.