A procedure is one part of the plan
If you've lost weight before and it came back, the plan fell short, not you. We look at three things:
- Your stomach. A procedure changes how much you can eat and how quickly you feel full.
- Your hunger signals. Appetite is driven by hormones and biology. Where clinically appropriate, medication management helps with the signals a procedure doesn't reach.
- Your daily habits. Portions, pace, and routines are rebuilt with a registered dietitian and behavioural support while the change is new.
That's why every procedure comes with long-term aftercare, coordinated with our medical partner WeightSimple and included in the price.
What the aftercare includes
Years one and two: follow-up and aftercare
- 1 to 2 weeks: a symptom check and how you're tolerating your diet
- 6 weeks: a weight check and nutrition assessment
- 3 and 6 months: a progress review, then a weight and metabolic evaluation
- 12 months: a formal outcomes review with your surgeon
- Year 2: continued follow-up and aftercare
Between visits, connected devices share your progress with your care team, so changes are noticed early. Your dietitian guides you through each diet stage, and a psychologist helps with habits, triggers, and emotional eating. Surgeon follow-ups are virtual or in person in Brampton or Mississauga.
Years 3 to 5+: support for the long run
Scheduled follow-up visits finish after year two. You keep medical, nutrition, and behavioural support, medication management through WeightSimple if clinically indicated, and a direct path back to your surgeon when needed. It's support rather than scheduled follow-up, included in your procedure price at no extra cost.
If weight starts to return
Tell us early. Your care team reviews nutrition, behaviour, and medication, and discusses revision options, such as repeat endoscopic procedures or conversion to surgery, where appropriate. See the full care journey
How to choose among the six options
Your surgeon considers your BMI, health conditions, previous procedures, goals, and preferences. As a general guide:
- BMI 27 to 35: endoscopic sleeve gastroplasty (ESG, with related health conditions below BMI 30) or the intragastric balloon, a temporary first step
- BMI 30 to 40: ESG, with no external incisions, or any of our surgical options: sleeve gastrectomy, gastric bypass or SADI
- BMI 35 and above: sleeve gastrectomy or gastric bypass, especially with type 2 diabetes; ESG is still an option, with a GLP-1 medication if you want greater weight loss
- BMI 40 and above: SADI and gastric bypass are often discussed, and sleeve gastrectomy and ESG are still options
- Weight regain after a gastric bypass or mini bypass: transoral outlet reduction (TORe)
Typical total body weight loss ranges from 5 to 7% with the balloon to 35 to 45% with SADI.* The procedures with more weight loss involve incisions and a longer recovery, so the choice is a trade-off.
*Published literature, not SmartSleeveMD outcomes data. Individual results vary.
We'll recommend the option that suits you, even if that means a less invasive procedure, a less expensive one, or none at all. Whichever you choose, two years of follow-up and aftercare and 3+ more years of support are included. Compare all six procedures or see pricing and financing.
Your next step
A free consultation, by video or in person, is a conversation, not a commitment. You hear which options fit and which don't, and leave with written information. Check your BMI below to see where you might start.