Where We Are Now
Over two years have passed since our surgeries at Weight Loss Riga in March 2024. James has lost over 12 stone from a starting weight of nearly 30 stone. Kirsten has lost over 8 stone from around 18 stone. Both of us are in maintenance rather than active loss. The before-and-after photographs have been taken. The rapid phase is over. This is just life now.
And there are things about this stage that we did not see documented when we were researching, or that we underestimated based on what we read. This article is an attempt to name them honestly.
The Loss Does Not Keep Going
In the first six months especially, weight loss after gastric sleeve can be dramatic and continuous. People sometimes assume this trajectory carries on indefinitely. It does not. At some point – for most people somewhere in year one to two – the loss slows significantly or stops at a new set point. This is normal and expected. It is how the body is supposed to work.
What it means practically is that long-term success requires active maintenance rather than relying on the restriction of the sleeve. The sleeve prevents overeating but it does not prevent gradual drift if habits slip. Consistent protein intake, regular movement, supplement compliance, and staying engaged with the habits that got you here – those things remain the work, indefinitely.
Your Stomach Capacity Does Increase
Not to its original size, and not dramatically – but noticeably. Two years in, we can eat more at a sitting than we could at six months post-op. Some expansion is normal and expected over time. The sleeve does not remain at its minimum capacity forever.
This is worth knowing before surgery rather than after, because some people are surprised by it and interpret it as something going wrong. It is not. It is the body adapting. What it means is that the long-term results of bariatric surgery depend on internalising habits rather than just relying on the physical restriction to do all the work.
The Comorbidities That Resolved
Within three weeks of surgery, James’s liver function had returned to normal – after ten years of non-alcoholic fatty liver disease and stage 2 liver failure heading towards stage 3. By three months, his blood pressure had normalised and his pre-diabetic markers had cleared. All before he had lost anywhere near his total eventual weight. The metabolic effects of the sleeve happen faster than most people expect and are one of the most underappreciated benefits of the surgery.
If you are considering surgery partly for health reasons beyond weight, this is worth knowing. The resolution of comorbidities is not necessarily gradual – it can happen quite quickly, and it can happen before the weight loss itself is complete.
The Nutritional Work Is Permanent
We went through a deficiency crisis at month eleven – fatigue, brain fog, cold intolerance – because we had let our supplementation slip. It took several months of consistent effort to correct. That experience made something concrete that had previously been abstract: supplements after bariatric surgery are not optional, and deficiency does not announce itself with immediate obvious symptoms. It builds quietly until it becomes a problem.
Two years on, the supplementation routine is as fixed a part of our daily life as brushing teeth. Blood panels every six months. Adjustments when something is drifting. It is not burdensome, but it is non-negotiable.
The Psychological Journey Does Not Have a Finish Line
Two years on and we are still learning things about our relationship with food, our bodies, and the patterns that drove our eating before surgery. The sleeve changes the physical container. The mental habits built over decades do not resolve on a matching timeline.
This is not a criticism of surgery or a warning against it. It is just reality. Head hunger still occurs. Food still carries emotional weight in certain situations. The identity adjustment after major body change is ongoing. For James in particular, the body dysmorphia – the difficulty reconciling the before-self and the after-self – is something actively worked on rather than resolved.
None of this is surprising in retrospect. But it was underrepresented in what we read before surgery, and we would rather name it than have people feel ambushed by it.
What We Wish We Had Known
That the psychological work is as significant as the physical. That the first year and the second year feel completely different – year one is transformation, year two is integration. That some things get easier and some things remain effortful, and the mix of those is not always what you would predict.
That “maintenance” is an active state, not a passive one. You do not reach a destination and stay there automatically. You keep making the choices that got you there.
That the surgery was, without question, the right decision. That we would do it again. That the health transformation – the resolved comorbidities, the physical capability, the absence of the weight that was there before – is real and lasting and worth every hard thing that came with it.
It Was Worth It
Unequivocally, unreservedly, with full knowledge of the hard parts, the deficiency crisis, the identity disorientation, the ongoing work – yes. It was worth it. We would do it again. The life on this side of surgery is not perfect, but it is genuinely better in ways that matter, and that was always what we were aiming for.
Sources
BOMSS (British Obesity and Metabolic Surgery Society) – Guidelines on perioperative and postoperative biochemical monitoring and micronutrient replacement for patients undergoing bariatric surgery
Welbourn R et al. – Laparoscopic sleeve gastrectomy: a systematic review (Annals of Surgery, 2019)
NICE CG189 – Obesity: identification, assessment and management (National Institute for Health and Care Excellence)
Sarwer DB et al. – Body image concerns of bariatric surgery patients (Surgical Obesity and Related Diseases, 2015)
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: 17 January 2026 | Last Reviewed: 7 June 2026 | Next Planned Review: 7 December 2027