Preparing for gastric sleeve surgery isn’t just about booking a date and packing a bag. It’s about getting your body, mind, and circumstances ready for a change that will affect every part of how you live. We knew going in that the surgery itself was only part of the story – the real work began beforehand, and two years on we’re certain that the preparation we did before March 2024 made a measurable difference to how we recovered and adapted afterwards.
The mental preparation
The hardest truth to accept before bariatric surgery is that the sleeve is a tool, not a fix. It will permanently restrict how much you can eat, but it won’t automatically resolve emotional eating, food addiction, or the habits that developed over years. We had to take an honest look at how we had used food – as comfort, as reward, as distraction – and start changing that relationship before surgery day, not after.
What helped us was getting clear on why we were doing this. For both of us, it wasn’t primarily about appearance. It was about health and longevity. James had reached a point where his weight was directly threatening his health – non-alcoholic fatty liver disease that had progressed to stage 2 liver failure and was heading towards stage 3, along with high blood pressure and pre-diabetic markers. Kirsten was dealing with pain, fatigue, and health complications worsened by her weight. Remembering those reasons kept us grounded when the process felt overwhelming.
Being honest about fear also mattered. Even though we were confident in our decision, neither of us slept well the night before surgery. The nerves were real. But we’d both learned that fear in this context is a sign of understanding – you know what you’re doing, and you’re taking it seriously. Talking through those fears with each other, with our surgeon, and with others in our support group helped us process them rather than bottle them up.
Building a support system early was one of the best things we did. We told family, friends, and workplaces what we were planning. Being open created a network that helped practically after surgery and emotionally throughout. We also joined online support groups and connected with people having surgery around the same time – people who were a few weeks further along told us what to expect in ways that no clinical briefing could.
The physical preparation
The liver reduction diet is the part nobody looks forward to, but it matters. We started ours on 11 March 2024, two weeks before surgery, significantly reducing calorie intake to shrink the liver. An enlarged liver makes laparoscopic surgery more difficult and risky; a reduced liver gives the surgeon more room and reduces operative time. Both our surgeons confirmed on arrival that our livers were in good condition – that preparation paid off directly.
It’s hard. We won’t pretend otherwise. Fatigue, headaches, and cravings were real. The last evening before flying to Riga, we had a final meal at McDonald’s – which ended up being anticlimactic enough that we barely touched it. Looking back, that felt symbolic. Food had been so central for so long, and suddenly it was already losing its hold.
In the months before surgery, we made gradual changes alongside the liver diet: cutting back caffeine and alcohol to avoid withdrawal complications post-op, increasing protein intake to support healing, walking daily to build cardiovascular fitness, and getting into a consistent sleep routine. We also started basic multivitamins in advance – “not to replace post-op supplementation, but to ensure we weren’t starting surgery already depleted.
Preparing your home for recovery
We set up the house before travelling. The fridge and freezer were stocked with liquid-stage foods – broths, protein shakes, smooth soups, yoghurt. Medications were organised. We raised the bed slightly so sitting up post-op was less of a strain. Smaller bowls and spoons were out. Bottled water and electrolytes were ready throughout the house.
Coming home from major surgery to a house that isn’t set up means you’re doing that work while you’re at your most fatigued. Setting it up in advance takes maybe an hour and makes the first days of home recovery significantly smoother.
Preparing as a couple
Doing this together had distinct advantages and distinct challenges. We went through the pre-op diet simultaneously, held each other accountable, and could be honest when one of us was struggling without having to explain the context. When one was having a hard day, the other stepped up.
The recoveries were different though. Kirsten bounced back faster in the early weeks. James faced more complications including his known anaesthetic reaction. Accepting that we would recover at different speeds – and not measuring one person’s progress against the other’s – was something we had to consciously work at.
If you’re doing this alone, seek out communities where people understand. The pre-op period is isolating if you’re not surrounded by people who grasp what’s involved. Online bariatric groups, local NHS weight management services, or a bariatric support group can provide that context even without a partner going through it alongside you.
The day before
We stayed overnight at the hospital in Riga before our 6am start. Having that extra day to complete final tests, meet with the team, and settle into the environment made the morning itself feel less abrupt. By the time surgery day arrived, we felt as prepared as it’s possible to feel. Nervous, yes. But ready.
Preparation is the part of this you have most control over. The surgery itself, the recovery, the long-term outcomes – all of these depend partly on factors outside your control. But what you do in the weeks and months before surgery is yours entirely. That effort is not wasted.
Sources cited in this post: British Psychological Society – Psychological aspects of bariatric surgery and obesity
NHS – Preparing for surgery
BOMSS – Patient pathway and commissioning guidance for bariatric surgery
NICE CG189 – Obesity: identification, assessment and management
- NHS, “Weight loss surgery”: https://www.nhs.uk/conditions/weight-loss-surgery/
- NICE clinical guideline CG189: https://www.nice.org.uk/guidance/cg189
- British Obesity & Metabolic Surgery Society (BOMSS): https://bomss.org/
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: 2 November 2025 | Last Reviewed: 27 June 2026 | Next Planned Review: 27 December 2027