The Basics of Sleeve Gastrectomy for Weight Loss

The Basics of Sleeve Gastrectomy for Weight Loss

Sleeve gastrectomy is a weight loss surgery that involves the removal of a large portion of the stomach, resulting in a smaller sleeve-shaped pouch. This procedure helps individuals struggling with obesity achieve significant weight loss and improve their overall health. Understanding the anatomy of sleeve gastrectomy, eligibility criteria, benefits, risks, and the recovery process is crucial for those considering this surgical option. Additionally, maintaining weight loss after sleeve gastrectomy requires long-term commitment and lifestyle changes. In this article, we will explore the various aspects of sleeve gastrectomy, from its mechanism of action to post-surgery care, to provide a comprehensive understanding of this weight loss procedure.

1 Understanding Sleeve Gastrectomy as a Weight Loss Surgery

Sleeve gastrectomy is an effective weight loss surgery that involves reducing the size of the stomach. This procedure, also known as gastric sleeve surgery, promotes weight loss by restricting the amount of food that can be consumed, leading to a feeling of fullness sooner and reduced calorie intake. In this article, we will delve deeper into the key aspects of sleeve gastrectomy, its benefits, and considerations for potential candidates.

I. How Sleeve Gastrectomy Works

  • The surgeon removes a large portion of the stomach, creating a smaller, banana-shaped stomach pouch.
  • The smaller stomach limits food intake, promoting weight loss.
  • The procedure also affects hunger hormones, reducing appetite and improving satiety.

II. Benefits of Sleeve Gastrectomy

  • Significant and sustained weight loss: Most patients experience substantial weight loss in the months following the surgery.
  • Improved health conditions: Sleeve gastrectomy has been found to resolve or improve obesity-related health issues such as type 2 diabetes, hypertension, and sleep apnea.
  • Enhanced quality of life: Patients often report increased mobility, improved self-esteem, and better overall well-being.

III. Considerations for Potential Candidates

  • Body mass index (BMI): Sleeve gastrectomy is typically recommended for individuals with a BMI of 40 or higher, or a BMI of 35-39.9 with obesity-related health issues.
  • Commitment to lifestyle changes: Candidates must be willing to adopt long-term dietary and exercise modifications to ensure successful weight loss and maintenance.
  • Surgical risks and complications: Like any surgery, sleeve gastrectomy carries certain risks, including infection, bleeding, and potential complications related to anesthesia.
  • Psychological evaluation: Candidates undergo psychological assessments to determine their readiness for the procedure and ensure they have realistic expectations.

Sleeve gastrectomy is a weight loss surgery that can provide significant and sustainable results for individuals struggling with obesity. By reducing the size of the stomach and modifying hunger hormones, this procedure helps patients achieve substantial weight loss, improve their overall health, and enhance their quality of life. However, it is crucial for potential candidates to consider the criteria, commitment to lifestyle changes, and potential risks associated with the surgery before making a decision. Consulting with a qualified healthcare professional is essential to determine if sleeve gastrectomy is the right option for their individual circumstances.

2 The Anatomy of Sleeve Gastrectomy: How It Works

Sleeve gastrectomy, also known as gastric sleeve surgery, achieves weight loss by altering the anatomy of the stomach. This procedure involves the removal of a large portion of the stomach, leaving behind a smaller, banana-shaped pouch. Here, we will explore the details of sleeve gastrectomy and how it effectively promotes weight loss.

I. Reduction of Stomach Size

  • Surgeons remove approximately 75-85% of the stomach, transforming it into a narrow tube-like structure.
  • The smaller stomach restricts the amount of food that can be consumed at one time, leading to portion control.
  • The reduction in stomach size also limits the production of hunger-stimulating hormones, resulting in reduced appetite.

II. Changes in Digestion and Absorption

  • Sleeve gastrectomy does not involve rerouting or bypassing the intestines, as in gastric bypass surgery.
  • The remaining stomach functions normally in terms of acid production and digestive enzymes.
  • However, the smaller stomach volume slows down the digestion process, allowing for better absorption of nutrients.

III. Hormonal Effects

  • The surgery affects the production of several hormones that regulate hunger and satiety.
  • The removal of a portion of the stomach alters the levels of ghrelin, the hormone responsible for stimulating appetite.
  • With reduced ghrelin production, patients experience a decreased desire to eat and an improved sense of fullness after consuming smaller meals.

IV. Long-Term Effects

  • Sleeve gastrectomy results in significant and sustained weight loss, with most patients experiencing a loss of 50-70% of their excess body weight.
  • The procedure has been found to improve obesity-related health conditions such as type 2 diabetes, high blood pressure, and sleep apnea.
  • Patients often report increased mobility, improved self-confidence, and a better overall quality of life.

Sleeve gastrectomy works by reducing the size of the stomach, promoting portion control, and modifying hunger hormones. This surgery does not involve intestinal rerouting and allows for normal digestion and nutrient absorption. The long-term effects of sleeve gastrectomy include substantial weight loss and improvements in obesity-related health conditions. By understanding the anatomical changes and physiological mechanisms behind sleeve gastrectomy, individuals considering this procedure can make informed decisions in their weight loss journey.

3 Eligibility Criteria for Sleeve Gastrectomy

Sleeve gastrectomy is a surgical procedure aimed at promoting weight loss by reducing the size of the stomach. It has gained popularity as an effective treatment for obesity and related health conditions. However, not everyone is eligible for this procedure. In this section, we will outline the eligibility criteria for sleeve gastrectomy, ensuring that patients meet the necessary requirements to undergo the surgery.

3.1 Body Mass Index (BMI) Requirement

Firstly, candidates for sleeve gastrectomy must have a body mass index (BMI) of 40 or higher. This criterion ensures that the procedure is reserved for individuals with severe obesity, as BMI is a reliable measure of body fat percentage. Additionally, patients with a BMI between 35 and 39.9 may be considered eligible if they have obesity-related health conditions, such as type 2 diabetes or hypertension.

3.2 Previous Non-Surgical Weight Loss Attempts

Moreover, it is essential for patients to have attempted and failed to lose weight through non-surgical methods, such as diet and exercise. Sleeve gastrectomy is typically recommended for individuals who have struggled to achieve sustainable weight loss through conservative approaches. Therefore, patients must demonstrate a commitment to improving their health and willingness to follow the post-operative guidelines for successful weight management.

3.3 Overall Health Assessment

Furthermore, candidates for sleeve gastrectomy should be in good overall health and free from any medical conditions that could increase the risks associated with the surgery. A comprehensive evaluation by a healthcare professional is necessary to assess the patient’s medical history, including past surgeries, allergies, and current medications, to ensure that they are suitable candidates for the procedure.

3.4 Psychological Readiness

In addition, patients must be psychologically prepared for the significant lifestyle changes that accompany sleeve gastrectomy. They should have a clear understanding of the implications of the surgery and be willing to adopt healthier eating habits and regular physical activity for long-term success. Psychological counseling and support groups may be recommended to help patients manage the emotional and psychological aspects of the weight loss journey.

The eligibility criteria for sleeve gastrectomy include having a BMI of 40 or higher (or BMI between 35 and 39.9 with obesity-related health conditions), failed attempts at non-surgical weight loss methods, good overall health, and psychological readiness for the procedure. Meeting these criteria ensures that patients are suitable candidates for sleeve gastrectomy and increases the likelihood of positive outcomes in terms of weight loss and overall well-being.

4 Benefits of Sleeve Gastrectomy for Weight Loss

Sleeve gastrectomy, a surgical procedure aimed at reducing the size of the stomach, offers numerous benefits for individuals struggling with obesity and seeking sustainable weight loss. In this section, we will explore the advantages of sleeve gastrectomy as an effective approach to achieving weight loss goals.

4.1 Significant and Sustained Weight Loss

One of the primary benefits of sleeve gastrectomy is its ability to promote significant and sustained weight loss. By reducing the stomach’s capacity, the procedure restricts the amount of food that can be consumed, leading to a reduced calorie intake. As a result, patients typically experience a substantial decrease in body weight over time. Studies have shown that individuals who undergo sleeve gastrectomy can achieve weight loss of 50% or more of their excess body weight, with many maintaining this loss in the long term.

4.2 Improvement in Obesity-Related Health Conditions

Sleeve gastrectomy not only aids in weight loss but also has a positive impact on various obesity-related health conditions. Many individuals with obesity suffer from conditions such as type 2 diabetes, hypertension, sleep apnea, and joint problems. Following sleeve gastrectomy, patients often experience significant improvement or even remission of these conditions. For instance, studies have shown that a high percentage of patients with type 2 diabetes achieve substantial reductions in blood sugar levels and may even eliminate the need for diabetes medication.

4.3 Enhanced Quality of Life

Another significant benefit of sleeve gastrectomy is the improvement in overall quality of life. Excessive weight can negatively affect various aspects of life, including mobility, self-esteem, and social interactions. Through successful weight loss, individuals often experience increased mobility, improved body image, and a boost in self-confidence. These changes contribute to enhanced mental well-being and overall satisfaction with life, allowing individuals to engage in activities and relationships with newfound freedom and confidence.

4.4 Reduced Risk of Obesity-Related Complications

Obesity is associated with an increased risk of developing various life-threatening complications, such as heart disease, stroke, and certain types of cancer. Sleeve gastrectomy can significantly reduce these risks by aiding in weight loss and improving overall health. By shedding excess weight, individuals decrease their chances of developing obesity-related complications, leading to a longer and healthier life.

4.5 Long-Term Maintenance of Weight Loss

Unlike many other weight loss methods, sleeve gastrectomy offers long-term success in maintaining weight loss. The procedure not only helps patients lose weight but also facilitates sustainable lifestyle changes. The reduced stomach size helps individuals feel fuller with smaller portions, promoting portion control and healthier eating habits. Moreover, regular follow-up visits and ongoing support from healthcare professionals contribute to long-term weight management and provide guidance to patients on maintaining their weight loss achievements.

Sleeve gastrectomy offers numerous benefits for weight loss, including significant and sustained weight loss, improvement in obesity-related health conditions, enhanced quality of life, reduced risk of complications, and long-term maintenance of weight loss. By considering these benefits, individuals can make informed decisions regarding sleeve gastrectomy as a viable option to achieve their weight loss goals and improve their overall well-being.

5 Risks and Complications of Sleeve Gastrectomy

While sleeve gastrectomy is generally considered a safe and effective weight loss procedure, like any surgical intervention, it carries certain risks and potential complications. In this section, we will discuss the potential risks associated with sleeve gastrectomy to ensure individuals have a comprehensive understanding of the procedure.

5.1 Surgical Risks

As with any surgery, there are inherent risks associated with anesthesia and the surgical procedure itself. These risks include adverse reactions to anesthesia, bleeding during or after surgery, infection, blood clots, and damage to surrounding organs or structures. Although rare, these complications can occur, and healthcare professionals take precautions to minimize the risk by conducting thorough preoperative evaluations and closely monitoring patients during and after surgery.

5.2 Leakage or Fistula Formation

One of the specific complications associated with sleeve gastrectomy is the possibility of leakage or fistula formation. This occurs when there is a breakdown in the surgical staple line, leading to the leakage of stomach contents into the abdominal cavity. While advancements in surgical techniques have reduced the occurrence of leaks, they can still happen. Leakage or fistula formation may require additional surgical interventions to repair and can result in infection or abscess formation.

5.3 Stricture or Narrowing of the Stomach

Another potential complication is the development of a stricture, which is the narrowing of the stomach along the surgical site. This narrowing can restrict the passage of food, leading to difficulties in eating, persistent vomiting, or reflux symptoms. In some cases, a stricture may require endoscopic procedures or further surgery to correct the issue.

5.4 Nutritional Deficiencies

Following sleeve gastrectomy, individuals may experience nutritional deficiencies due to the reduced food intake and changes in the digestive system. This can lead to deficiencies in essential nutrients such as vitamins, minerals, and proteins. Patients must adhere to a strict post-operative dietary plan and take prescribed supplements to prevent nutritional deficiencies and ensure optimal health.

5.5 Gastroesophageal Reflux Disease (GERD)

In some cases, individuals may develop gastroesophageal reflux disease (GERD) after sleeve gastrectomy. This condition involves the backward flow of stomach acid into the esophagus, leading to symptoms such as heartburn, regurgitation, and chest pain. Medications, lifestyle modifications, and in some cases, surgical interventions may be necessary to manage GERD symptoms.

5.6 Long-Term Risks

Long-term risks associated with sleeve gastrectomy include potential complications such as weight regain, stretched stomach pouch, and the development of new or worsening gallstones. These risks emphasize the importance of ongoing follow-up care, dietary adherence, and lifestyle modifications to maintain weight loss and minimize complications.

While sleeve gastrectomy is generally a safe procedure, it is essential to understand the potential risks and complications involved. By discussing these risks with healthcare professionals and adhering to post-operative guidelines, individuals can make informed decisions and minimize the likelihood of complications, ensuring a successful and safe weight loss journey.

6 Preparing for Sleeve Gastrectomy Surgery: What to Expect

Preparing for sleeve gastrectomy surgery involves several important steps to ensure a smooth and successful procedure. In this section, we will outline what individuals can expect during the preoperative phase and provide guidance on how to prepare for sleeve gastrectomy surgery.

6.1 Preoperative Consultation and Evaluation

The journey towards sleeve gastrectomy begins with a preoperative consultation and evaluation. During this initial meeting, healthcare professionals will assess the patient’s medical history, conduct a physical examination, and perform various tests, including blood work and imaging studies. This evaluation helps to determine the individual’s overall health status, identify any potential risk factors, and ensure they meet the necessary criteria for sleeve gastrectomy.

6.2 Dietary and Lifestyle Modifications

Prior to sleeve gastrectomy surgery, individuals will need to make specific dietary and lifestyle modifications to optimize their health and prepare for the procedure. These modifications typically involve adopting a low-calorie diet to promote weight loss and reduce the size of the liver, which facilitates safer surgical access to the stomach. Healthcare professionals will provide detailed dietary guidelines and may recommend meeting with a registered dietitian to develop a personalized preoperative meal plan.

Additionally, individuals will be advised to quit smoking and limit alcohol consumption, as these habits can interfere with the healing process and increase the risk of complications. Engaging in regular physical activity and incorporating exercise into the daily routine can also help improve fitness levels and enhance surgical outcomes.

6.3 Preoperative Education and Support

Education and support play a crucial role in preparing individuals for sleeve gastrectomy surgery. Patients will receive comprehensive information about the procedure, including its risks, benefits, and expected outcomes. They will be educated on the preoperative and postoperative dietary guidelines, lifestyle changes, and long-term expectations. This education process often includes attending preoperative support groups or counseling sessions, which provide emotional support, answer questions, and help individuals prepare mentally and emotionally for the surgical journey.

6.4 Preoperative Testing and Preparations

Before the surgery, individuals will undergo additional preoperative testing, such as cardiac evaluations, pulmonary function tests, and possibly psychological assessments, depending on the healthcare provider’s recommendations. These tests aim to ensure that the patient is physically and psychologically ready for the procedure.

Individuals will also receive instructions regarding fasting before the surgery, which typically involves abstaining from food and drink for a certain period before the procedure to minimize the risk of complications during anesthesia.

6.5 Preoperative Checklist

In the days leading up to sleeve gastrectomy surgery, patients will need to follow a preoperative checklist provided by their healthcare team. This checklist may include guidelines for medication management, instructions on what to bring to the hospital, and preoperative hygiene protocols.

It is essential to communicate openly with the surgical team, ask questions, and address any concerns or anxieties before the surgery to ensure a comfortable and confident experience.

Preparing for sleeve gastrectomy surgery involves a series of steps, including preoperative consultations, dietary and lifestyle modifications, education and support, preoperative testing, and following a preoperative checklist. By diligently following these guidelines and collaborating closely with healthcare professionals, individuals can maximize their chances of a successful sleeve gastrectomy surgery and pave the way for a healthy and transformative weight loss journey.

7 Recovery and Aftercare Following Sleeve Gastrectomy

The recovery and aftercare period following sleeve gastrectomy surgery is crucial for ensuring optimal healing, adapting to dietary changes, and achieving long-term weight loss success. In this section, we will discuss what individuals can expect during the recovery phase and outline the key aspects of postoperative care.

7.1 Hospital Stay and Immediate Recovery

After sleeve gastrectomy surgery, individuals typically remain in the hospital for a few days to monitor their initial recovery. During this time, healthcare professionals will closely monitor vital signs, administer pain medication as needed, and gradually introduce liquids. Patients will be encouraged to walk and move around to promote blood circulation and reduce the risk of blood clots.

7.2 Transitioning to a New Diet

Following discharge from the hospital, individuals will transition to a liquid diet for a period determined by their healthcare team. This phase allows the stomach to heal and adjust to its new size. Gradually, patients will progress to pureed foods and then to a soft or regular diet, following the specific guidelines provided by their healthcare provider or dietitian. It is essential to strictly adhere to the recommended dietary plan to ensure adequate nutrition and support the healing process.

7.3 Postoperative Follow-Up Visits

Postoperative follow-up visits are a vital component of the aftercare process. These visits allow healthcare professionals to monitor the individual’s progress, assess healing, address any concerns or complications, and provide ongoing support. During these visits, patients may undergo blood tests to check for nutritional deficiencies and receive guidance on vitamin and mineral supplementation.

7.4 Physical Activity and Exercise

Engaging in regular physical activity and exercise is important for maintaining overall health, enhancing weight loss, and improving fitness levels following sleeve gastrectomy. However, it is crucial to follow the recommendations of the healthcare team regarding the timing and intensity of exercise. Initially, individuals may start with light activities such as walking and gradually increase their exercise regimen as their stamina improves.

7.5 Psychological Support and Lifestyle Changes

The psychological and emotional aspects of the weight loss journey should not be overlooked. Many individuals find it beneficial to seek support from psychologists, support groups, or counseling services specializing in bariatric surgery. These resources can provide guidance on coping with emotional challenges, body image issues, and adjusting to the lifestyle changes associated with sleeve gastrectomy.

7.6 Long-Term Follow-Up and Maintenance

Sleeve gastrectomy is a lifelong commitment to maintaining a healthy lifestyle and weight. Long-term follow-up visits with the healthcare team are essential to monitor progress, address any concerns or complications, and provide ongoing support and guidance. Regular monitoring of weight, nutritional status, and overall health will contribute to maintaining weight loss success and preventing weight regain.

The recovery and aftercare period following sleeve gastrectomy surgery involve proper wound healing, transitioning to a new diet, attending postoperative follow-up visits, engaging in physical activity, seeking psychological support, and maintaining long-term follow-up and maintenance. By actively participating in these aspects of aftercare, individuals can optimize their recovery, adapt to the necessary lifestyle changes, and achieve long-term weight loss success and improved overall well-being.

8 Maintaining Weight Loss after Sleeve Gastrectomy

Achieving weight loss through sleeve gastrectomy is a significant accomplishment, but it is equally important to focus on maintaining the weight loss in the long term. In this section, we will discuss key strategies and lifestyle changes that can help individuals sustain their weight loss achievements after sleeve gastrectomy.

8.1 Follow Postoperative Dietary Guidelines

Adhering to the postoperative dietary guidelines is crucial for maintaining weight loss after sleeve gastrectomy. This includes consuming small, nutrient-dense meals, prioritizing lean protein, vegetables, and fruits, and limiting high-calorie, sugary, and fatty foods. Patients should continue to eat slowly, chew thoroughly, and stop eating when they feel comfortably satisfied. It is important to work closely with a registered dietitian who can provide personalized guidance and support in developing a healthy and sustainable eating plan.

8.2 Regular Physical Activity

Incorporating regular physical activity into daily life is essential for weight maintenance and overall health. Engaging in aerobic exercises, strength training, and flexibility exercises can help burn calories, increase metabolism, build lean muscle mass, and improve cardiovascular fitness. Finding enjoyable activities and establishing a consistent exercise routine can contribute to long-term weight loss maintenance.

8.3 Behavioral Changes and Emotional Well-being

Addressing behavioral patterns and emotional well-being is crucial for sustaining weight loss. Working with psychologists or therapists specializing in weight management can help individuals identify triggers for unhealthy eating habits and develop strategies to overcome emotional eating or food cravings. Developing positive coping mechanisms, practicing stress management techniques, and prioritizing self-care are important aspects of maintaining long-term weight loss success.

8.4 Support and Accountability

Seeking support from healthcare professionals, support groups, or online communities can provide invaluable guidance and accountability. Sharing experiences, challenges, and successes with others who have undergone sleeve gastrectomy can foster motivation, provide encouragement, and offer practical tips for maintaining weight loss. Regularly attending support group meetings or engaging in online forums can help individuals stay motivated and connected to a supportive network.

8.5 Ongoing Monitoring and Follow-Up

Continued monitoring and follow-up with the healthcare team are vital for long-term weight loss maintenance. Regular check-ups allow for tracking progress, addressing any concerns or challenges, and modifying the treatment plan as needed. Monitoring weight, body composition, and nutritional status can help identify potential issues early on and prevent weight regain.

8.6 Mindful Eating and Portion Control

Practicing mindful eating and portion control is important even after sleeve gastrectomy. Paying attention to physical hunger and fullness cues, eating slowly, and savoring each bite can promote a healthier relationship with food and prevent overeating. It is essential to avoid using the smaller stomach capacity as a license to consume unhealthy or calorie-dense foods.

Maintaining weight loss after sleeve gastrectomy requires ongoing commitment and lifestyle changes. Following postoperative dietary guidelines, engaging in regular physical activity, addressing behavioral and emotional aspects, seeking support, monitoring progress, and practicing mindful eating are key strategies for sustaining long-term weight loss success. By incorporating these strategies into daily life, individuals can enjoy the benefits of sleeve gastrectomy for years to come and maintain a healthier weight and improved overall well-being.

In conclusion, sleeve gastrectomy is a transformative weight loss procedure that can have significant benefits for individuals struggling with obesity. By understanding the eligibility criteria, risks, and benefits associated with the surgery, individuals can make informed decisions about their healthcare journey. Preparing for the procedure involves dietary modifications, lifestyle changes, and education, while the recovery phase requires adherence to postoperative guidelines, regular follow-up visits, and ongoing support. Sustaining weight loss after sleeve gastrectomy involves lifelong commitment to healthy eating, physical activity, emotional well-being, and ongoing monitoring. With dedication and support, individuals can achieve and maintain long-term weight loss success, improving their overall health and quality of life.


Does the sleeve gastrectomy help you lose weight?

Yes, sleeve gastrectomy is an effective weight loss procedure. It involves reducing the size of the stomach, which limits food intake and promotes weight loss.

How much weight can you lose with a gastric sleeve?

The amount of weight loss varies from person to person. On average, individuals can expect to lose about 60-70% of their excess body weight within the first year after sleeve gastrectomy.

Can I lose 100% of excess weight with gastric sleeve?

While sleeve gastrectomy can lead to significant weight loss, it is uncommon to achieve 100% loss of excess weight. The goal is typically to achieve a healthy weight and improve overall health rather than reaching a specific weight loss target.

How fast do you lose weight after sleeve gastrectomy?

Weight loss following sleeve gastrectomy is typically rapid in the first few months. Many individuals experience significant weight loss during the first year, with the majority occurring in the first six months after surgery.

What is the safest weight loss surgery?

While all weight loss surgeries carry some risks, sleeve gastrectomy is considered one of the safest procedures. It has a lower risk of complications compared to some other surgical options.

What is the best weight loss surgery?

The best weight loss surgery varies depending on individual factors and goals. Sleeve gastrectomy is a commonly performed and effective procedure, but the best choice should be determined through discussions with a healthcare professional.

Are gastric sleeves safe?

Yes, sleeve gastrectomy is generally considered safe. However, like any surgery, there are risks involved. It is important to discuss potential risks and complications with a healthcare professional before deciding to undergo the procedure.

Which weight loss surgery is permanent?

Sleeve gastrectomy is a permanent weight loss surgery. The procedure involves removing a portion of the stomach, which permanently reduces its size and limits food intake.

Is weight loss surgery safe?

Weight loss surgeries, including sleeve gastrectomy, can be safe when performed by experienced surgeons in appropriate healthcare settings. However, there are potential risks and complications associated with any surgical procedure. A thorough evaluation and discussion with healthcare professionals can help determine the safety and suitability of weight loss surgery for an individual.



  1. Mayo Clinic – Sleeve Gastrectomy:
  2. American Society for Metabolic and Bariatric Surgery – Sleeve Gastrectomy:
  3. WebMD – Sleeve Gastrectomy:
  4. Obesity Action Coalition – Sleeve Gastrectomy:
  5. Cleveland Clinic – Sleeve Gastrectomy:
  6. National Institute of Diabetes and Digestive and Kidney Diseases – Bariatric Surgery Procedures:
  7. Healthline – What to Expect After Sleeve Gastrectomy:
  8. Verywell Health – The Benefits and Risks of Sleeve Gastrectomy:
  9. Johns Hopkins Medicine – Weight Loss Surgery:

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