The Honest Version
Most of what you read about gastric sleeve surgery focuses on the weight loss – and the weight loss is real. But there is a lot that happens around and after the operation that does not get as much attention. This is our honest account, two years on from our surgery at Weight Loss Riga in March 2024.
The First Few Weeks
The immediate post-op period is more physically demanding than many people expect. The liquid and puree phases are uncomfortable. You are healing from major surgery while your body is also adjusting to a radically different relationship with food. Energy is low. Discomfort is normal. James found the first ten days genuinely difficult; the improvement from week two onwards was noticeable and consistent.
Pain management in the early weeks is important. The surgical sites are sore. Gas pain from the laparoscopic procedure can be unexpectedly significant – moving around gently helps. Sleep is disrupted. None of this lasts long, but going in expecting an easy recovery is likely to result in a harder one.
The First Six Months
This is the honeymoon period – rapid weight loss, high motivation, dramatic physical changes. The sleeve’s restriction is at its most pronounced. Most people find this phase relatively manageable once the early recovery is complete, because the physical restriction does much of the work.
The challenges in this period tend to be psychological rather than physical. Head hunger – the desire to eat when you are not physically hungry – can be intense. Social situations involving food require navigation. The identity shift that comes with rapid visible change is disorienting in ways that are difficult to prepare for in advance.
Both of us had our blood pressure and pre-diabetic markers resolve within three months of surgery. James’s NAFLD, which had been stage 2 for over a decade, returned to normal liver function within three weeks. These improvements are well-documented and were a significant part of why surgery was the right choice for us.
Months Six to Twelve
The rate of weight loss slows. The sleeve’s restriction begins to ease slightly as the stomach adapts. This is normal but can feel like regression if you are not prepared for it. Habits matter more in this period than in the first six months, because the physical restriction is doing less of the work.
James went through a nutritional deficiency crisis at month eleven – fatigue, brain fog, cold intolerance – that required medical attention and a reassessment of his supplementation routine. It was a reminder that the surgery creates ongoing nutritional needs that must be actively managed. Supplements are not optional and cannot be skipped without consequence.
Year Two and Beyond
Two years on, both of us are in what the bariatric community calls maintenance. The dramatic phase of weight loss is complete. The work now is sustaining the habits – protein-first eating, consistent supplementation, regular blood tests – that produced the results. James entered a bodybuilding competition in year two, which was not something either of us would have predicted when we boarded the plane to Riga.
The sleeve is a tool, not a solution. What it does is create conditions in which changing your relationship with food becomes possible. The work of actually making that change is something you have to do regardless.
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
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: 8 December 2025 | Last Reviewed: 7 June 2026 | Next Planned Review: 7 December 2027