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Sleeve Gastrectomy and Anemia

Clinical knowledge base written and curated by GastroAGI Team from primary medical literatureLast updated August 1, 2025

Sleeve gastrectomy (SG) has been shown to have a positive impact on anemia recovery in patients with obesity who undergo bariatric surgery. According to the findings from a retrospective cohort study conducted in Ontario, Canada, SG was associated with greater odds of anemia recovery compared to Roux-en-Y gastric bypass (RYGB). Specifically, the adjusted odds ratio (aOR) for recovery with SG was 1.41, indicating that patients who underwent SG were more likely to experience hematologic improvement than those who underwent RYGB.

Key Details About SG and Anemia Recovery:

  1. Recovery Rates:
  • Among 1664 adults with obesity and preexisting anemia who underwent bariatric surgery, nearly 60% recovered from anemia within 6 months post-surgery.
  • Recovery rates continued to improve over time, reaching 59.8% at 1 year and 69.7% at 5 years post-surgery.
  1. Impact of Procedure Type:
  • Sleeve gastrectomy demonstrated better odds of anemia recovery compared to Roux-en-Y gastric bypass.
  • This suggests that the type of bariatric surgery plays a significant role in hematologic recovery, with SG being the preferred option for patients with preexisting anemia.
  1. Patient Characteristics:
  • Neither preoperative body mass index (BMI) nor weight loss at 6 months was found to influence anemia outcomes.
  • Instead, patient characteristics and the type of surgery were identified as more critical determinants of anemia recovery.
  1. Why SG May Be Preferred:
  • SG may be less likely to cause malabsorption of nutrients, particularly iron, which is essential for hemoglobin production and anemia recovery.
  • In contrast, RYGB is associated with a higher risk of nutrient deficiencies due to its bypass of portions of the gastrointestinal tract, which could exacerbate anemia.
  1. Clinical Implications:
  • Bariatric surgery provides a net benefit for patients with obesity and anemia.
  • Sleeve gastrectomy may be the preferred surgical option for candidates with preexisting anemia, as it offers a greater likelihood of hematologic recovery.

Conclusion:

Sleeve gastrectomy is an effective bariatric surgery option for improving anemia outcomes in patients with obesity. Its association with higher recovery rates compared to Roux-en-Y gastric bypass highlights its potential as the preferred choice for individuals with preexisting anemia. This information can help guide surgical decisions and optimize patient outcomes in this population.

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