Year Two Is Different
The first year after gastric sleeve surgery is dominated by rapid change – significant weight loss, dramatic health improvements, a fundamental reshaping of your relationship with food. The second year is different. The rate of loss slows, the dramatic physical changes become more incremental, and the focus shifts from transformation to maintenance. Setting realistic expectations for year two avoids a lot of unnecessary disappointment.
We entered year two in March 2025, both of us having had surgery at Weight Loss Riga in Latvia the previous year. James had lost over 12 stone in the first year; Kirsten over 8 stone. The second year brought different challenges and different kinds of progress.
Weight Loss Slows – That Is Normal
By month 12 to 18, most sleeve patients are losing weight much more slowly than in the first six months. Some are in maintenance. Some find the scale moving backwards slightly before settling. This is physiologically normal – the body is adapting – but it can feel like failure if you are still mentally benchmarking against the rapid loss of the honeymoon period.
The better measure for year two is not weekly weight change but health markers, energy levels, fitness capacity, and how consistently you are maintaining the habits that produced the loss. James focused increasingly on strength and performance in year two, including entering a bodybuilding competition, rather than on the scale as the primary metric.
New Goals Beyond Weight
Year two is when many bariatric patients benefit from setting goals that are not about weight at all. Fitness targets – a distance run, a gym milestone, a sport taken up or returned to – provide motivation and structure that does not depend on the scale. Mental health goals – working with a therapist, building a more settled relationship with food, addressing the emotional patterns that contributed to obesity – are often the work that year two actually calls for.
Kirsten, who has Crohn’s disease alongside her post-sleeve life, found year two required a more nuanced approach to nutrition than the straightforward protein focus of year one. Her goals shifted to include gut health and managing flare-ups alongside the broader bariatric maintenance picture.
What Consistency Looks Like in Year Two
The habits of year two are less dramatic than year one but more important in the long run. Supplementation must continue indefinitely – the nutritional needs created by the surgery do not diminish with time. Protein-first eating remains the foundation. Blood tests annually at a minimum keep any developing deficiencies visible before they become crises. James’s deficiency episode at month eleven was a reminder of what happens when supplementation slips, and both of us treat it as an ongoing commitment rather than something to gradually relax.
Sources
NICE CG189 – Obesity: identification, assessment and management
BOMSS – Guidelines on the peri-operative nutritional management of bariatric patients
NHS – Weight loss surgery: what to expect afterwards
British Psychological Society – Psychological aspects of obesity
About this content
This blog is written by James and Kirsten, a couple from the UK who had gastric sleeve surgery together in March 2024.
We started this blog because we couldn't find any sources of content that details before surgery, the surgery and then life post surgery - so we decided to write one ourselves.
Everything on this site is based on our own experience and the research we have done along the way. It is not medical advice. Gastric sleeve surgery is a serious procedure and every patient's journey is different. Please always consult your own bariatric team or GP before making any decisions about your health or treatment.
Some posts on this site may contain featured or sponsored content, or affiliate links. Where this is the case, it will always be clearly stated at the top of the article. Our opinions are always our own.
Publish Date: 18 December 2025 | Last Reviewed: 7 June 2026 | Next Planned Review: 7 December 2027