Visual representation of body composition and metabolic rate changes after sleeve gastrectomy.

Sleeve Gastrectomy: Is it a Healthy Way to Lose Weight?

Lena Voss in Health & Wellness June 2025 • 4 min read.

"Examining the Long-Term Effects on Body Composition and Metabolism"

Bariatric surgery's effectiveness is constantly being proven through facts and observable outcomes. There remains some level of debate about whether or not “healthy weight loss” is achieved. It is critical to remember that weight loss surgery is not just about reducing the numbers on a scale, but promoting health through proper diet and exercise.

We are now aware of the myriad health advantages that can be achieved by remission or improvements in various health or disease outcomes. Consistent reporting of outcomes has improved communication [1]. This study by Schiavo et al. [3] helps us maintain continuous progress in our understanding and demonstrating the benefits of weight loss surgery.

Terms such as resting metabolic rate (RMR), fat mass (FM), and fat-free mass (FFM) are familiar to nutritionists and exercise physiologists, but are not often discussed in the bariatric surgery community. Until recently, these measurements have been used to express concerns regarding the safety of weight loss surgery, with fears that surgery could lead to a catabolic state with negative nutritional and physiological consequences [2].

What Does the Research Say About Body Composition After Sleeve Gastrectomy?

Visual representation of body composition and metabolic rate changes after sleeve gastrectomy.

The study by Schiavo et al. [3] offers a comparison of weight-stable sleeve gastrectomy patients and healthy volunteers. After a three-year follow-up, outcomes were similar between surgical and non-surgical participants. The idea that surgically-induced weight loss is unsafe or unhealthy is challenged by solid data.

The data presented here is consistent with previous findings on Roux-en-Y gastric bypass and biliopancreatic diversion [4,5]. Sleeve gastrectomy has become a widely accepted procedure, and clarification of its effects is important. The authors discuss how, with some exceptions, an increase in FM is often accompanied by an increase in FFM to support the growing organism [2].

Preoperative State: Morbidly obese patients often have elevated FM and supranormal lean body mass (increased FFM).
Postoperative Changes: Surgically induced weight loss helps to restore a more normal body composition.
Medium-Term Outcomes: Postoperative sleeve gastrectomy patients demonstrate body composition characteristics comparable to normal-weight individuals.

While results aren't yet generalizable across the entire bariatric surgery population, the review shows substantial potential. Future challenges involve assessing outcomes in patients outside this limited cohort and those who do not achieve the study's defined endpoints. Further research includes standardizing body composition measurements (such as bioelectric impedance analysis and RMR) for all surgical weight loss patients, pre- and postoperatively.

Future Directions: Personalizing Weight Loss Strategies

To fully understand the impact of sleeve gastrectomy, it is important to look beyond weight loss and consider body composition and metabolic rate.

Future studies that address dietary composition and exercise habits will enhance understanding of how these positive outcomes can be achieved consistently. The limitations of this study, acknowledged by the authors, highlight the need for broader data collection across diverse surgical populations.

The challenge now lies in incorporating bioelectric impedance analysis and RMR measurements into standard patient assessments. Gathering more data will help address questions related to different age groups, diverse outcomes, and varying degrees of obesity. As technology advances and more data become available, variability in body composition measurements will likely decrease, leading to more tailored and effective weight loss strategies.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.soard.2017.08.001, Alternate LINK

Title: Comment On: Fat Mass, Fat-Free Mass, And Resting Metabolic Rate In Weight-Stable Sleeve Gastrectomy Patients Compared With Weight-Stable Nonoperated Subjects

Subject: Surgery

Journal: Surgery for Obesity and Related Diseases

Publisher: Elsevier BV

Authors: Karen E. Gibbs

Published: 2017-10-01

Everything You Need To Know

What is a sleeve gastrectomy?

A **sleeve gastrectomy** is a surgical procedure for weight loss. It is a form of bariatric surgery, where a portion of the stomach is removed to reduce its capacity. This leads to reduced food intake and, consequently, weight loss. It is important because it is widely accepted. The implications include restoring a more normal body composition in patients.

What are Fat Mass (FM) and Fat-Free Mass (FFM), and why are they important in the context of sleeve gastrectomy?

The main components of body composition discussed are **Fat Mass (FM)** and **Fat-Free Mass (FFM)**. FM refers to the total amount of fat in the body, while FFM includes everything else, like muscle, bones, and water. The study by Schiavo et al. [3] and others compare these components in patients who have undergone sleeve gastrectomy to assess the effects of the surgery on their body composition. It is critical to evaluate these components and their correlation to the surgery, and it's importance for long-term health outcomes.

What did the Schiavo et al. [3] study find about sleeve gastrectomy?

The study by Schiavo et al. [3] compared weight-stable **sleeve gastrectomy** patients with healthy volunteers. The results showed similar outcomes between the surgical and non-surgical participants after a three-year follow-up. This supports the idea that surgically-induced weight loss can be safe. The main implication of this is that the surgery, when coupled with a healthy lifestyle can yield positive health benefits.

How does body composition change after a sleeve gastrectomy?

Changes in body composition after a **sleeve gastrectomy** generally involve a reduction in **FM** (fat mass). The research also indicates that **FFM** (fat-free mass) can increase or remain stable. A preoperative state shows patients often having elevated FM and supranormal FFM. Postoperatively, there is a restoration to a more normal body composition. The implications of these changes are significant because they suggest that sleeve gastrectomy can lead to a healthier body composition, potentially improving metabolic health.

What is resting metabolic rate (RMR), and why is it relevant to the study of sleeve gastrectomy?

The term **resting metabolic rate (RMR)** refers to the amount of energy your body uses at rest. Though not discussed in the context of this bariatric surgery, it's importance is to highlight the connection between weight loss and metabolic health. Future research includes standardizing body composition measurements (such as bioelectric impedance analysis and RMR) for all surgical weight loss patients, pre- and postoperatively. This will help provide a more complete picture of the surgery's impact and can assist in personalizing weight loss strategies.