Is Bariatric Surgery Right for Me?
Bariatric surgery is recommended for patients who meet specific criteria. In Singapore, guidelines align with international standards:
- BMI ≥ 37.5: Surgery recommended with or without comorbidities
- BMI 32.5–37.5: Surgery recommended with at least one significant obesity-related comorbidity (type 2 diabetes, hypertension, sleep apnoea, joint disease)
- BMI 27.5–32.5 (Asian criteria): Consider surgery if multiple comorbidities, particularly uncontrolled diabetes
- Failed sustained weight loss with at least 6 months of non-surgical management
- Psychologically ready; no active substance dependence; no major psychiatric illness
Sleeve vs Bypass: Which Is Better?
| Procedure | Mechanism | Weight Loss & Benefits | Cost (SGD) |
|---|---|---|---|
| Sleeve Gastrectomy (VSG) | Remove 75–80% of stomach; no intestinal rerouting | 50–70% EWL at 1 year; good for type 2 DM; may worsen GERD | $18k–$30k |
| Roux-en-Y Gastric Bypass (RYGB) | Small gastric pouch + intestinal bypass (150cm) | 65–80% EWL; excellent for type 2 DM and GERD; highest metabolic benefit | $22k–$35k |
| One Anastomosis Gastric Bypass (OAGB/MGB) | Pouch + single anastomosis bypass (200cm) | 60–75% EWL; fewer anastomoses than RYGB; good DM outcomes | $20k–$32k |
| Adjustable Gastric Band | Inflatable band around upper stomach | Lower EWL; most reversible; no stomach resection; higher long-term failure rate | $15k–$22k |
The Sleeve Gastrectomy Procedure
- Pre-operative preparation: 2-week liver-shrinking diet; stop blood thinners; pre-op assessment (gastroscopy, sleep study, bloods)
- Under general anaesthesia: 4–5 small laparoscopic incisions made
- Stomach stapled and cut: 75–80% of stomach removed along the greater curvature
- Leak test performed: Blue dye or air injected to check staple line integrity
- Hospital stay: 2–3 days; liquids only for first 2 weeks
- Dietary progression: Liquids → purée → soft food → solid food over 6–8 weeks
See our researched shortlist: subspecialty focus, credentials and clinic websites, checked against public records.
View the shortlist →Sleeve gastrectomy (also called gastric sleeve or VSG — vertical sleeve gastrectomy) is a laparoscopic bariatric surgery in which approximately 75–80% of the stomach is removed, leaving a narrow tube (sleeve) roughly the size of a banana. This dramatically reduces food intake, reduces hunger-stimulating hormone ghrelin, and leads to significant weight loss without bypassing any intestine.
Average excess weight loss (EWL) is 50–70% at 1 year and 55–65% at 5 years. For example, if you are 40kg overweight, you can expect to lose 20–28kg in the first year. Results are enhanced by post-operative dietary compliance, exercise, and follow-up with a bariatric team. Many patients achieve resolution of type 2 diabetes, hypertension, and sleep apnoea even before reaching goal weight.
No. Sleeve gastrectomy permanently removes a large portion of the stomach. It is not reversible. However, it can be converted to a gastric bypass (RYGB) if insufficient weight loss or significant reflux develops. This irreversibility underscores the importance of thorough pre-operative assessment, psychological preparation, and commitment to lifelong dietary changes.
Major risks include: staple line leak (1–3%, most serious complication), stricture (narrowing of the sleeve), bleeding, nutritional deficiencies (vitamin B12, iron, vitamin D), and worsening of GERD/reflux in some patients. With experienced bariatric surgeons and proper pre-op assessment, overall major complication rates are 2–5%. Mortality is approximately 0.1%.
Laparoscopic sleeve gastrectomy at a private hospital in Singapore costs approximately $18,000–$30,000, inclusive of surgeon, anaesthesia, hospital stay, and initial follow-up. Medisave (up to $7,000 per admission) and MediShield Life can be used. Some patients with IP insurance pay significantly less. There is currently no government subsidy specific to bariatric surgery beyond Medisave.