Sleeve gastrectomy is a physiologically wrong operation and a 'transgression against God's creation', because the stomach is not a bag but an endocrine, muscular and immune organ whose functions are lost.
Original statement
قلت يا جماعه التكميم عمليه فيها تعدي على خلق الاله اصلا انت بتقص معده فاكرها كيس بتصغر غاره لا هي مش كيس ده نسيج غدد صماء بتفرز هرمونات حضرتك جاسترين وبتفرز هرمون هيستامين
verbatim according to source. Translation by the project; the Arabic wording is authoritative.
Translation
Sleeve gastrectomy is a physiologically wrong operation and a 'transgression against God's creation', because the stomach is not a bag but an endocrine, muscular and immune organ whose functions are lost.
Origin
- Source status
- Video transcript (own words)
- Attribution
- Elawady (machine transcript)
- Video
- المرض المستحدث (Open source)
- Published
- 22 December 2025
- Timestamp
- 0:07:13 (location in the original video’s automatic YouTube caption track; confirms where the words occur, not who speaks)
- Attribution uncertainty
- Archive transcript (YouTube CC or AI-generated); wording may contain transcription errors; no timestamps available.
- Claimed mechanism
Loss of gastric endocrine, digestive and immune (acid barrier) function.
- Claimed health effect
Multiple diseases.
- Population concerned
All sleeve patients
- Geographic restriction by Elawady
none found
Diverging source versions
- Source status
- Archive quote (no location given)
- Attribution
- Elawady (archive paraphrase; source video not given)
- Origin
- https://eltayebat.com/rule/bariatric-surgery/
- Attribution uncertainty
- The archive attributes this wording to Dr. Diaa but gives no video reference.
- Source status
- Video transcript (own words)
- Attribution
- Elawady (machine transcript)
- Video
- Dr.D Clinics - Diaa Al Awady is live!التكميم (Open source)
- Published
- 6 May 2025
- Timestamp
- not available (transcript has no timings)
- Attribution uncertainty
- Archive transcript (YouTube CC or AI-generated); wording may contain transcription errors; no timestamps available.
Scientific assessment
Mostly false – Essential parts of the statement are not supported by the evidence or are strongly exaggerated.
Certainty of evidence: low – Further research is likely to change the assessment considerably.
1. What was claimed?
That sleeve destroys the stomach's functions and is therefore wrong in principle.
2. What is demonstrably correct?
The stomach does have endocrine functions (e.g., gastrin, histamine-producing cells) and an acid barrier; sleeve gastrectomy permanently alters anatomy and physiology, with documented consequences (reflux, gallstones, and nutrient deficiencies, which are however more frequent after bypass or BPD than after sleeve, A-BAR-20).
3. What is wrong or exaggerated?
The stomach does not lose its functions: acid production continues (reflux is the main problem), and digestion and absorption continue with supplementation. Outcome data show average net benefit in severe obesity (lower mortality, I-BAR-01; diabetes improvement, A-BAR-24). The statement that 'nobody should cut a working part of the body' is a value judgement, not a scientific finding.
4. What remains unclear?
The theological and moral framing ('transgression against creation') is outside the scope of a scientific fact-check.
5. Which studies support it?
A-BAR-07 (reflux). Physiology premise: gut hormones change after sleeve (ghrelin down, GLP-1/PYY up; I-BAR-147) and gastric emptying accelerates (I-BAR-148); iron deficiency rises over years (I-BAR-120). These show altered, not lost, function.
6. Which studies contradict it?
I-BAR-01, A-BAR-05, A-BAR-24; sleeve-specific lower mortality vs usual care (I-BAR-101, I-BAR-102); A-BAR-20 (pylorus preserved; less anaemia after sleeve than bypass/BPD).
7. What applies to Germany and Europe?
Most key data are European (Sweden SOS/SOReg, Finland SLEEVEPASS, Switzerland SM-BOSS). European and international society guidelines consider bariatric surgery for severe obesity with lifelong follow-up.
8. What is known about Egypt?
No Egypt-specific outcome data were identified in this review. Elawady states in a transcript that sleeve gastrectomy is very widely performed in Egypt ('مصر كلها بتعملها'); the procedure-specific risks (reflux, deficiencies) apply wherever it is performed, and follow-up quality (supplements, endoscopy, mental-health screening) determines part of the risk.
9. What practical conclusion is appropriate?
Sleeve has real physiological downsides that patients should know; it is not without function loss, but it is not shown to be net harmful in indicated patients.
Assessment details
- Rationale for certainty of evidence
The physiological premise is partly correct but the conclusion ('functions lost', net harm) conflicts with outcome data; the religious/moral component cannot be assessed scientifically.
- Source quality
Elawady's reasoning from physiology without outcome data. The archive quote ('physiological transgression', 'lethal', 'crime', 'wrong idea', stomach 'pouch' turned into a 'tube') is consistent with transcripts (0ScIsnGw5cU, khw1PTnCL-M, E3fDJyXYP7E).
- Regional transferability
Universal.
- Individual exceptions
Some individuals develop severe reflux, deficiencies or other complications that make the operation harmful for them.
- Regional scope of the claim
- general (biological/medical)
- Last reviewed
- 26 October 2026 provisional
Scientific evidence in detail
Not supported by high-quality evidence – There is no good evidence for the claim; this alone does not prove it wrong.
Research question: Does sleeve gastrectomy destroy the endocrine, muscular and immune functions of the stomach such that the operation causes net harm (is physiologically wrong) in people with severe obesity?
Research question in detail (PICO)
- Population
- Adults with severe obesity
- Intervention or exposure
- Sleeve gastrectomy
- Comparison
- Preoperative physiology; non-operated people with obesity
- Geographic scope
- universal biology; the religious/moral component is outside scientific assessment
- Outcomes
- Gastric hormone secretion and motility
- Nutrient status
- All-cause mortality and major outcomes
Study results as reported by the authors. Our assessment follows below.
What speaks for the claim?
Meta-analysis: gut hormones after sleeve
McCarty et al.. Ann Surg 2020 · PMID 31592891 · DOI 10.1097/SLA.0000000000003614 Meta-analysisabstract checkednewly addedMeta-analysis: hormone output changes after sleeve (ghrelin down, GLP-1/PYY up) - confirms the stomach is an endocrine organ altered by surgery.
- Actual result
- Ghrelin Hedges' g -1.49; GLP-1 +1.10; PYY +1.40.
- Methodological quality
- moderate
- Relevance
- supports the premise only
- Limitations
- Changes are linked to benefit, not harm
Finnish trial: sleeve vs bypass after 10 years
Salminen P et al.. JAMA Surg 2022 · PMID 35731535 · DOI 10.1001/jamasurg.2022.2229 Randomised controlled trialabstract checkedSLEEVEPASS: oesophagitis 31% vs 7% after bypass - a real functional downside.
- Actual result
- 31% vs 7%.
- Methodological quality
- high
- Relevance
- indirect (one harm)
- Limitations
- Comparison with bypass
Meta-analysis: anaemia after sleeve
Nie et al.. Obes Rev 2023 · PMID 36323610 · DOI 10.1111/obr.13516 Meta-analysisabstract checkednewly addedIron deficiency and anaemia rise after sleeve.
- Actual result
- Anaemia 18-25% at 3-5 y.
- Methodological quality
- moderate
- Relevance
- indirect (functional consequence)
- Limitations
- Observational
What speaks against the claim?
Israeli study: deaths after sleeve, bypass and banding vs usual care
Reges et al.. JAMA 2018 · PMID 29340677 · DOI 10.1001/jama.2017.20513 Cohort studyfull text checkednewly addedSleeve patients had lower mortality than matched usual-care patients.
- Actual result
- Surgery vs control HR ~0.62 (0.40-0.98) for sleeve.
- Methodological quality
- moderate
- Relevance
- direct for net harm
- Limitations
- Short follow-up
US study: survival after sleeve and bypass
Courcoulas et al.. Ann Surg 2023 · PMID 34387200 · DOI 10.1097/SLA.0000000000005155 Cohort studyfull text checkednewly addedSleeve associated with lower 5-y mortality vs matched controls.
- Actual result
- HR 0.28 (0.13-0.57).
- Methodological quality
- moderate
- Relevance
- direct
- Limitations
- Attrition
Meta-analysis: weight-loss surgery and survival
Syn NL et al.. Lancet 2021 · PMID 33965067 · DOI 10.1016/S0140-6736(21)00591-2 Meta-analysisabstract checkedMeta-analysis: longer life after surgery, similar across sleeve, bypass and banding.
- Actual result
- +6.1 years.
- Methodological quality
- moderate-high
- Relevance
- direct
- Limitations
- Observational
What does the overall evidence say?
Editorial assessment based on the studies above – not itself a study result.
Which position is better supported?
The stomach is indeed a hormonal and muscular organ and sleeve gastrectomy permanently changes it, with real downsides (reflux, iron deficiency); but its functions are altered rather than lost, and on average outcomes in severe obesity are better, not worse.
Why some studies weigh more
Outcome studies (mortality, morbidity) answer the "net harm" question; physiological studies only support the premise.
Is a causal relationship established? Not established No evidence that loss of gastric function causes net harm; hormonal changes are part of the therapeutic mechanism.
Remaining uncertainty
Very long-term consequences of altered gastric physiology (e.g., Barrett, iron status).
Justified conclusion
Premise partly correct; conclusion not supported; theological component not assessable.
Why do studies seem to disagree?
Physiological change (premise) and net clinical benefit (outcomes) are not contradictory: the same hormonal changes contribute to weight loss and diabetes improvement.
Does this depend on the country?
- General biological effects
- Universal.
- Eating habits
- Not applicable (surgical procedure, not a food).
- Origin of the food
- Not applicable (surgical procedure, not a food).
- Contaminants
- Not applicable (surgical procedure, not a food).
- National production conditions
- Not applicable.
- Legal rules
- Not applicable.
- Actual monitoring data
- Not applicable.
A regional difference that changes the conclusion is not supported by robust data.
Statistical re-check
- Sleeve-specific HR inversion – Surgery vs control 0.62 (0.40-0.98). recalculated
Certainty of the overall evidence (GRADE, simplified)
- Main outcome
- Net clinical harm of sleeve gastrectomy (mortality) vs usual care
- Starting level
- low (observational studies)
- Reasons for downgrading
- indirectness to the physiological claim
- Reasons for upgrading
- large effect
- Result
- low
Simplified assessment by a single reviewer, following the GRADE approach; not a formal GRADE panel. GRADE rates the body of evidence for one outcome, not individual studies.
Clinical guidelines and official statements checked
- ASMBS/IFSO: 2022 ASMBS and IFSO Indications for Metabolic and Bariatric Surgery (I-BAR-11) (2022) · Original publication
Metabolic and bariatric surgery is recommended for BMI >35 regardless of comorbidities and should be considered for BMI 30-34.9 with metabolic disease; long-term results consistently demonstrate safety and efficacy (abstract; erratum noted in PubMed). - NICE: Overweight and obesity management (NG246), section 1.18 Bariatric surgery (2025 (last updated 8 Jan 2026)) · Original publication
Offer referral for bariatric surgery assessment with BMI >=40, or 35-39.9 with a significant weight-related condition, if the person agrees to lifelong follow-up; lower thresholds by 2.5 for people of Middle Eastern, South Asian, Chinese and Black African/Caribbean background; follow-up >=2 years in the bariatric service and at least annual nutritional monitoring and supplementation afterwards.
Search strategy
Documented literature searches for this review (search strings in the original database syntax).
| Database | Date | Search | Looking for | Hits | Included |
|---|---|---|---|---|---|
| PubMed | 26 October 2026 | (sleeve gastrectomy[ti]) AND (ghrelin[tiab] OR gastric acid secretion[tiab] OR parietal[tiab] OR gastrin[tiab]) AND (human* OR patients) | supporting evidence | 137 | |
| Europe PMC | 26 October 2026 | TITLE:"sleeve gastrectomy" AND (TITLE:"ghrelin" OR TITLE:"gastrin" OR TITLE:"acid secretion" OR TITLE:"gastric emptying" OR TITLE:"hormone*") AND (PUB_TYPE:"Meta-Analysis" OR PUB_TYPE:"Review" OR TITLE:"systematic review") | both directions | 4 | |
| Europe PMC | 26 October 2026 | (TITLE:"sleeve gastrectomy") AND (TITLE:"mortality" OR TITLE:"survival") AND (TITLE:"usual care" OR TITLE:"nonsurgical" OR TITLE:"matched" OR TITLE:"cohort") | contradicting evidence | 4 | |
| PubMed | 26 October 2026 | (sleeve gastrectomy[ti] OR bariatric[ti]) AND (all-cause mortality[ti] OR long-term mortality[ti]) AND (usual care OR nonsurgical OR matched controls) | contradicting evidence | 9 |
Open questions
Long-term gastric physiology after sleeve (acid secretion, iron absorption).
How deeply was this checked?
11 linked studies: 5 checked in full text (2 of them with a structured risk-of-bias assessment), 6 on the basis of the abstract, 0 bibliographically only. No formal assessment with two independent reviewers and no independent human expert review has taken place yet.
Last scientific review: 26 October 2026
History of the verdict
- 25 October 2026 · Phase 1 · Initial assessment: Mostly false (low)
- 26 October 2026 · Phase 4 (systematic evidence review) · Re-examined with extended evidence; verdict unchanged: Mostly false (low)
Unchanged (“Mostly false”, low). Sleeve-specific mortality data strengthen the contradiction of "net harm"; hormone meta-analysis confirms the premise. Certainty kept low because the claim bundles physiology, value judgement and religious framing.
New sources: I-BAR-101 I-BAR-102 I-BAR-120 I-BAR-147 I-BAR-148
In plain language
Elawady argued that the stomach is not a simple bag but a hormone-producing, muscular and immune organ, and that cutting it is wrong. It is true that the stomach does much more than store food and that sleeve surgery changes it permanently, with known side effects such as reflux and vitamin deficiencies. But the stomach keeps working after the operation, and large studies show that, on average, people with severe obesity live longer after surgery. The religious argument cannot be tested by science.
Studies on this claim
Studies supporting the claim (1)
-
Finnish trial: sleeve vs bypass after 10 years
Salminen P et al.. JAMA Surg 2022 · PMID 35731535 · DOI 10.1001/jamasurg.2022.2229Randomised controlled trialcited by the Tayebat archiveabstract checked★ key studyEsophagitis was found in 31% after sleeve vs 7% after bypass; Barrett's esophagus was 4% in both groups.
Does the study support the specific claim? Partly · Methodological quality: high · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Compare sleeve vs bypass
- How was the study done?
RCT with 10-year follow-up
- How many people, animals or samples were studied?
240 patients
- What was actually found?
More esophagitis after sleeve; Barrett's equal
- How large was the observed effect?
31% vs 7%; BE 4% vs 4%
- What do the results mean in everyday life?
Sleeve often causes reflux damage; bypass less so
- What are the study's limitations?
Attrition; small
- What does it say about Elawady's specific claim?
Supports reflux claim, not sleeve-specific Barrett's
- Do the results apply to Germany and Europe?
Directly European
- What can explicitly not be concluded from this study?
Cancer risk
No study in this group is marked as key.
Studies contradicting or limiting the claim (7)
-
Meta-analysis: weight-loss surgery and survival
Syn NL et al.. Lancet 2021 · PMID 33965067 · DOI 10.1016/S0140-6736(21)00591-2Meta-analysisindependent cross-checkabstract checked★ key studyAcross 174,772 people, surgery was linked to about half the risk of death and about 6 more years of median life expectancy; sleeve showed similar effects to bypass.
Does the study support the specific claim? No · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Survival
- How was the study done?
Meta-analysis of matched cohorts
- How many people, animals or samples were studied?
174,772
- What was actually found?
Lower mortality
- How large was the observed effect?
HR ~0.51; +6.1 years
- What do the results mean in everyday life?
Surgery is linked to longer, not shorter, life in severe obesity
- What are the study's limitations?
Observational studies
- What does it say about Elawady's specific claim?
Contradicts 'lethal'
- Do the results apply to Germany and Europe?
Includes Europe
- What can explicitly not be concluded from this study?
Exact causal size
-
Swedish 24-year study: surgery added about 3 years of life
Carlsson LMS et al.. N Engl J Med 2020 · PMID 33053284 · DOI 10.1056/NEJMoa2002449Cohort studycited by the Tayebat archivefull text checked★ key studyOperated patients lived about 3 years longer than non-operated patients with obesity, but still about 5.5 years less than the general population (non-operated: about 8.5 years less).
Does the study support the specific claim? Partly · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Life expectancy
- How was the study done?
Prospective controlled cohort with population reference
- How many people, animals or samples were studied?
5182 people
- What was actually found?
Surgery gained 3 years; gap to population 5.5 vs 8.5 years
- How large was the observed effect?
HR death 0.77; +3.0 years
- What do the results mean in everyday life?
Surgery reduced but did not remove the life-expectancy loss linked to severe obesity
- What are the study's limitations?
Not randomized; old operations
- What does it say about Elawady's specific claim?
Number correct, implication 'surgery shortens life' wrong
- Do the results apply to Germany and Europe?
Directly European
- What can explicitly not be concluded from this study?
That surgery causes the remaining 5.5-year gap
-
STAMPEDE: surgery vs medicines for diabetes
Schauer PR et al.. N Engl J Med 2017 · PMID 28199805 · DOI 10.1056/NEJMoa1600869Randomised controlled trialcited by the Tayebat archivefull text, structured risk-of-bias assessmentAfter 5 years, 23-29% of operated patients reached near-normal HbA1c vs 5% with medicines alone.
Does the study support the specific claim? No · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Diabetes RCT
- How was the study done?
RCT
- How many people, animals or samples were studied?
150
- What was actually found?
Surgery better
- How large was the observed effect?
29%/23% vs 5%
- What do the results mean in everyday life?
Surgery helps more, but most did not reach the target and only 15-22% reached it without diabetes medicines
- What are the study's limitations?
Small single-centre trial; not blinded; more drop-outs in the medical group; ITT result not significant
- What does it say about Elawady's specific claim?
Contradicts 'benefit erodes away'
- Do the results apply to Germany and Europe?
Applicable
- What can explicitly not be concluded from this study?
Hard outcomes
-
When is weight-loss surgery recommended?
Eisenberg D et al.. Obes Surg 2023 · PMID 36336720 · DOI 10.1007/s11695-022-06332-1Guideline / position statementindependent cross-checkabstract checkedSurgical societies recommend it for BMI above 35 and consider it from BMI 30 with metabolic disease.
Does the study support the specific claim? No · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Indications
- How was the study done?
Society statement
- How many people, animals or samples were studied?
n/a
- What was actually found?
BMI thresholds
- How large was the observed effect?
n/a
- What do the results mean in everyday life?
Surgery is for defined indications
- What are the study's limitations?
Professional society
- What does it say about Elawady's specific claim?
Contradicts blanket rejection
- Do the results apply to Germany and Europe?
International
- What can explicitly not be concluded from this study?
Individual decisions
-
Review: nutrition after weight-loss surgery
Lupoli R et al.. World J Diabetes 2017 · PMID 29204255 · DOI 10.4239/wjd.v8.i11.464Narrative reviewcited by the Tayebat archivefull text, structured risk-of-bias assessmentDeficiencies are common but can be prevented with lifelong supplements and monitoring.
Does the study support the specific claim? Partly · Methodological quality: low · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Review
- How was the study done?
Narrative
- How many people, animals or samples were studied?
n/a
- What was actually found?
Deficiencies (iron, B12, vitamin D, calcium, protein) are common, especially after bypass/BPD; many exist before surgery
- How large was the observed effect?
n/a
- What do the results mean in everyday life?
Supplements are required
- What are the study's limitations?
Narrative
- What does it say about Elawady's specific claim?
Supports with context
- Do the results apply to Germany and Europe?
Applicable
- What can explicitly not be concluded from this study?
Exact rates; that all procedures cause the same deficiencies; that sleeve abolishes stomach function
-
Israeli study: deaths after sleeve, bypass and banding vs usual care
Reges et al.. JAMA 2018 · PMID 29340677 · DOI 10.1001/jama.2017.20513Cohort studyindependent cross-checkfull text checked★ key studyPeople who had surgery, including sleeve, died less often over about 4 years than similar people with obesity who did not (sleeve 0.8% vs 1.3%).
Outcome data contradict net harm of sleeve.
Does the study support the specific claim? No · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Compare death rates after three operations with usual care
- How was the study done?
Matched cohort from health-fund records
- How many people, animals or samples were studied?
8,385 operated, 25,155 controls
- What was actually found?
Lower mortality with every operation, including sleeve
- How large was the observed effect?
Sleeve: HR about 0.62 (surgery vs control)
- What do the results mean in everyday life?
On average, sleeve did not shorten life in the first years
- What are the study's limitations?
Observational; short follow-up for sleeve
- What does it say about Elawady's specific claim?
Contradicts "sleeve is lethal"
- Do the results apply to Germany and Europe?
Health-system data from Israel; plausible for Europe
- What can explicitly not be concluded from this study?
Cannot prove causation or show very long-term effects
-
US study: survival after sleeve and bypass
Courcoulas et al.. Ann Surg 2023 · PMID 34387200 · DOI 10.1097/SLA.0000000000005155Cohort studyindependent cross-checkfull text checked★ key studyOver 5 years, people who had a sleeve died about 70% less often than similar people who did not have surgery (1.0% vs 2.7%).
Outcome data contradict net harm of sleeve.
Does the study support the specific claim? No · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Compare deaths after SG/RYGB with matched non-operated patients
- How was the study done?
Matched cohort, health records
- How many people, animals or samples were studied?
13,900 SG; 17,258 RYGB; 87,965 controls
- What was actually found?
Lower death rates after both operations
- How large was the observed effect?
SG HR 0.28 (0.13-0.57)
- What do the results mean in everyday life?
Sleeve was not associated with earlier death
- What are the study's limitations?
About one third lost to follow-up; observational
- What does it say about Elawady's specific claim?
Contradicts "sleeve kills"
- Do the results apply to Germany and Europe?
Plausible for Europe and Egypt
- What can explicitly not be concluded from this study?
Cannot exclude unmeasured confounding
No study in this group is marked as key.
Studies with mixed or unclear results (3)
-
Meta-analysis: anaemia after sleeve
Nie et al.. Obes Rev 2023 · PMID 36323610 · DOI 10.1111/obr.13516Meta-analysisindependent cross-checkabstract checked★ key studyAbout 1 in 5 sleeve patients had anaemia 4-5 years after surgery, mostly from iron deficiency; B12 and folate deficiency stayed rare.
Sleeve alters iron handling - a real functional consequence.
Does the study support the specific claim? Partly · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Track deficiencies after SG
- How was the study done?
Meta-analysis
- How many people, animals or samples were studied?
7,639
- What was actually found?
Anaemia rising to 18-25%
- How large was the observed effect?
Proportions
- What do the results mean in everyday life?
Iron checks and supplements matter after sleeve
- What are the study's limitations?
Observational
- What does it say about Elawady's specific claim?
Supports iron part; limits B12 part for sleeve
- Do the results apply to Germany and Europe?
Applicable
- What can explicitly not be concluded from this study?
Whether everyone is affected
-
Meta-analysis: gut hormones after sleeve
McCarty et al.. Ann Surg 2020 · PMID 31592891 · DOI 10.1097/SLA.0000000000003614Meta-analysisindependent cross-checkabstract checkedAfter sleeve the hunger hormone ghrelin fell and satiety hormones GLP-1 and PYY rose.
Ghrelin falls and GLP-1/PYY rise after sleeve: endocrine function changes (premise correct), changes are mechanistically beneficial.
Does the study support the specific claim? Partly · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Hormone changes after SG
- How was the study done?
Meta-analysis
- How many people, animals or samples were studied?
653
- What was actually found?
Ghrelin down, GLP-1/PYY up
- How large was the observed effect?
Hedges' g -1.49 (ghrelin)
- What do the results mean in everyday life?
The stomach is a hormone organ; surgery changes it
- What are the study's limitations?
Short follow-up
- What does it say about Elawady's specific claim?
Premise correct, conclusion not
- Do the results apply to Germany and Europe?
Applicable
- What can explicitly not be concluded from this study?
Long-term health effects
-
Review: how the gut works after sleeve or bypass
Steenackers et al.. Lancet Gastroenterol Hepatol 2021 · PMID 33581761 · DOI 10.1016/S2468-1253(20)30302-2Narrative reviewindependent cross-checkabstract checkedAfter sleeve, food leaves the stomach faster and bile acids rise; many other effects are still unknown.
SG changes gastric emptying and transit; many effects unknown.
Does the study support the specific claim? Partly · Methodological quality: low · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
GI physiology after surgery
- How was the study done?
Narrative review
- How many people, animals or samples were studied?
not applicable
- What was actually found?
Faster emptying; unknowns
- How large was the observed effect?
not applicable
- What do the results mean in everyday life?
The stomach changes but keeps working
- What are the study's limitations?
Not systematic
- What does it say about Elawady's specific claim?
Premise partly correct
- Do the results apply to Germany and Europe?
Applicable
- What can explicitly not be concluded from this study?
Harm or benefit
No study in this group is marked as key.
Regional context
Germany / EU
Most key data are European (Sweden SOS/SOReg, Finland SLEEVEPASS, Switzerland SM-BOSS). European and international society guidelines consider bariatric surgery for severe obesity with lifelong follow-up.
Egypt
No Egypt-specific outcome data were identified in this review. Elawady states in a transcript that sleeve gastrectomy is very widely performed in Egypt ('مصر كلها بتعملها'); the procedure-specific risks (reflux, deficiencies) apply wherever it is performed, and follow-up quality (supplements, endoscopy, mental-health screening) determines part of the risk.
What applies in my country?
General scientific assessment
Mostly false Physiology premise partly correct; conclusion that sleeve is wrong in principle is not supported by outcome data.
This statement concerns biological or medical relationships. The scientific assessment above applies regardless of the country; country-specific food data do not change it.
References
- Effect of Laparoscopic Sleeve Gastrectomy vs Roux-en-Y Gastric Bypass on Weight Loss, Comorbidities, and Reflux at 10 Years in Adult Patients With Obesity: The SLEEVEPASS Randomized Clinical Trial.. Salminen P et al.. JAMA Surg 2022 · PMID 35731535 · DOI 10.1001/jamasurg.2022.2229
- Association of metabolic-bariatric surgery with long-term survival in adults with and without diabetes: a one-stage meta-analysis of matched cohort and prospective controlled studies with 174 772 participants.. Syn NL et al.. Lancet 2021 · PMID 33965067 · DOI 10.1016/S0140-6736(21)00591-2
- Life Expectancy after Bariatric Surgery in the Swedish Obese Subjects Study.. Carlsson LMS et al.. N Engl J Med 2020 · PMID 33053284 · DOI 10.1056/NEJMoa2002449
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