T Nation

Sleeve Gastrectomy - Training and Nutrition Advice

A good friend of mine had a Sleeve gastrectomy:

He was 320lbs/6’2 (150kg/1.85m), and thankfully was still of relatively good health (no known deseases or anything off-charts) since he’s only 22 years old and moves around a lot (and is genetically well-built besides having had the cravings).

Now past the surgery he’s dropping 2kg/4.4lbs a week on average. He’s already at 281lbs/128kg.

Guy’s “problem” is that he can’t pack in food. He’s only now (four weeks past surgery) beginning to eat normal foods again (could only digest soups and such prior to that), and is having trouble eating more than say 200 grams of food in one meal.

He wants to start training so he could look better. I really don’t know if that’s wise, considering he can barely maintain sufficient nutrients to keep going throughout the day.

Have you guys had any experience with people in that situation?
Can such a man ever train hard, or train seriously at all?
If so - what kind of training and nutrition will best suit his condition?


Try it. If he gets stronger, you’ve succeeded, if he gets weaker, change the approach. Don’t do some high volume Arnold routine, just do a few exercises, top sets to failure, beat them next workout. For example.

I don’t agree with people getting this surgery instead of changing their habits. Yes, he will now have a hard time even getting in enough food to grow muscle sufficiently. He should have possibly thought of that before having surgery to achieve what hard work would have. 320lbs is big if most of that is fat but not THAT big at 6’2" that he couldn’t have simply worked it off over months.

I also don’t understand your statement that he is “genetically well built”. If that were the case, then it makes no sense for the surgery.

He will likely now drop back to something like 180-200lbs which is SMALL for someone who is 6’2" and lifts and he will have a hard time eating enough to get past it.

He will end up looking like Jared from Subway commercials.

Bottom line, think about things like that BEFORE the surgery.

He had no disease process, was “genetically well built”, wants to start lifting…but decided to make all of that harder on himself in the long run by using a short cut.


Big bodybuilders eat a shit load of food. He could have possibly kept his “cravings” and simply worked out harder. Oh well.

Yes, he’s genetically inclined to put on mass. He had more muscle mass than most people his size that don’t train, and is naturally a physically strong guy. He wasn’t extremely obese when he had the surgery - nothing like the guys on “the biggest looser”.

That said, authorities took him out of his house age 11 cause of domestic issues, he grew up in religious schools, and came out of the closet a few years ago. His mind is pretty fucked cause of all this mess, and eating was his way out (he’s well aware of this, was in therapy for many years). He simply couldn’t control it. He would actually eat mostly clean. It’s just that when he had the cravings, he could eat non-stop. Apparently, if you have the capacity to eat like that, even rice in large amounts can get you pretty big (ask 'em Sumo wreslers).

I was against the surgery and tried to convince him otherwise for months on end, but he couldn’t see any other way out of it. He’s a very hard-working and dedicated guy, but he lost his war against food. =\

Anyhow - what approach should such a guy take? When he’ll start training, what he’ll practically need is getting the most nutritional value for the size of his meals. The amount of food he can take in is very limited per meal, but he can possibly eat some 6-7 small meals a day. BTW - I suppose Aerobics are out of the question, right?

The bottom line is there isn’t all that much you can do. His body no longer works like it was built to. No one will know how his body will end up now or how his body will process food into energy or extra muscle…or if it can build extra muscle at all now with such a limited food intake.

All you can do is wait and see. He screwed himself judging by what you wrote. If he had good genetics for muscle, then he should have worked harder in the gym and at the table.

You can’t save everyone. The faster you learn that, the happier your life will be in the long run. Help the ones you can, but don’t let others drag you down.

He had the power to do something about that without surgery if his genetics were like that.

As far as aerobics, again, you would have to wait and see how he responds to just eating and doing everyday activities. No recommendations can really be made until he knows how his body responds now.

I’m going to try my best to sound semi-objective here…

What happened to a world of accountability? He made himself as fat as he was, he can’t take the time to lose the weight? That’s bullshit. He should’ve thought about ALL of the ramifications and consequences of his actions, pre and post-op. Doing anything lifting-wise is going to be difficult. He should try to train like anyone else here, and with proper caloric intake, but that’s not really feasible at this point. Sometimes you can’t have your cake and eat it too.

If the guy doesn’t have enough balls and discipline to lose fat (which, really, is one of the easiest things to do ever if you’re not worried about muscle retention,) how could he possibly expect himself to make great achievements with fitness withOUT having someone perform a surgery or him?

…and I guess the whole “objective” thing didn’t go too well.