Gastric Sleeve and VLCD

So I'm having a sleeve done in May. I'm one of those people who deeply believes that eating as much as you can while maintaining a deficit (and meeting your macros, for health reasons) is the best way to lose weight. I hate the whole "I must eat 1,200 a day, no matter who I am!" crap, and I get upset when I see people using a VLCD to try to lose weight (~1,000 calories especially.)

I've been looking at how many calories I can expect to eat per day after surgery, and while I understand the first few weeks with a liquid diet being very low, it seems that a lot of people are eating 600-800 afterwards. I can't see how that can be right, or healthy. I was expecting 1,200 to 1,400. I have an appointment with my nutritionist from my surgery team in a few weeks so we can chat about these kinds of things one on one, but I was wondering if anyone else had thoughts? Or experience with the issue?
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Replies

  • AJ_G
    AJ_G Posts: 4,158 Member
    Most people eat that few of calories on a gastric sleeve because their stomach is a quarter of it's original size and they can't fit anymore in. The gastric sleeve is an option that should be used for the obese who are at serious health risk if they do not lose a good amount of weight very quickly. If that is not the case, then in my opinion, a gastric sleeve is not the best choice, and a moderate calorie deficit is the best way to go.
  • Greenrun99
    Greenrun99 Posts: 2,065 Member
    You change the rules when you have surgery.. maybe you need to rethink the decision unless its your only choice.
  • Iknowsaur
    Iknowsaur Posts: 777 Member
    Most people eat that few of calories on a gastric sleeve because their stomach is a quarter of it's original size and they can't fit anymore in. The gastric sleeve is an option that should be used for the obese who are at serious health risk if they do not lose a good amount of weight very quickly. If that is not the case, then in my opinion, a gastric sleeve is not the best choice, and a moderate calorie deficit is the best way to go.

    I qualify. It is covered by insurance, and I've been in the program for it for the last 6 months.
    My concern is long-term calorie intake, especially with exercise /: If you eat 600 calories a day for the first year while working out, the math is just kinda scary.
  • WBB55
    WBB55 Posts: 4,131 Member
    :(

    Gastric sleeve at 18...

    I applaud you for wanting to take control of things. But surgery? You have so many more options and so much time to learn how to make good choices. Don't start a life where you take the "quick" way.

    I'm telling you with all the love I can spread over the internet: WAIT. Learn good habits. Make friends with people who can help and inspire you.
  • AJ_G
    AJ_G Posts: 4,158 Member
    Most people eat that few of calories on a gastric sleeve because their stomach is a quarter of it's original size and they can't fit anymore in. The gastric sleeve is an option that should be used for the obese who are at serious health risk if they do not lose a good amount of weight very quickly. If that is not the case, then in my opinion, a gastric sleeve is not the best choice, and a moderate calorie deficit is the best way to go.

    I qualify. It is covered by insurance, and I've been in the program for it for the last 6 months.
    My concern is long-term calorie intake, especially with exercise /: If you eat 600 calories a day for the first year while working out, the math is just kinda scary.

    If you eat 600-800 calories a day for an entire year you will absolutely damage your metabolism and cause it to slow down, then it's going to be a long hard road trying to increase your metabolic capacity again without gaining too much weight...
  • Iknowsaur
    Iknowsaur Posts: 777 Member
    :(

    Gastric sleeve at 18...

    I applaud you for wanting to take control of things. But surgery? You have so many more options and so much time to learn how to make good choices. Don't start a life where you take the "quick" way.

    I'm telling you with all the love I can spread over the internet: WAIT. Learn good habits. Make friends with people who can help and inspire you.

    I actually lost 100 pounds a few years ago and regained >< I said no to the surgery at 15, but I feel like I'm in a place where I can handle it. I have a few weight-related health issues, so I think it's the best thing for me right now.

    Thank you though, I totally understand where you're coming from.
  • Iknowsaur
    Iknowsaur Posts: 777 Member
    Most people eat that few of calories on a gastric sleeve because their stomach is a quarter of it's original size and they can't fit anymore in. The gastric sleeve is an option that should be used for the obese who are at serious health risk if they do not lose a good amount of weight very quickly. If that is not the case, then in my opinion, a gastric sleeve is not the best choice, and a moderate calorie deficit is the best way to go.

    I qualify. It is covered by insurance, and I've been in the program for it for the last 6 months.
    My concern is long-term calorie intake, especially with exercise /: If you eat 600 calories a day for the first year while working out, the math is just kinda scary.

    If you eat 600-800 calories a day for an entire year you will absolutely damage your metabolism and cause it to slow down, then it's going to be a long hard road trying to increase your metabolic capacity again without gaining too much weight...

    Yeah, that was mostly my concern.
    I guess I'll bring it up at my meeting >> Blah.
  • lemon629
    lemon629 Posts: 501 Member
    :(

    Gastric sleeve at 18...

    I applaud you for wanting to take control of things. But surgery? You have so many more options and so much time to learn how to make good choices. Don't start a life where you take the "quick" way.

    I'm telling you with all the love I can spread over the internet: WAIT. Learn good habits. Make friends with people who can help and inspire you.

    I actually lost 100 pounds a few years ago and regained >< I said no to the surgery at 15, but I feel like I'm in a place where I can handle it. I have a few weight-related health issues, so I think it's the best thing for me right now.

    Thank you though, I totally understand where you're coming from.


    You very well might re-gain it this time, too, only this time you will be left with a permanently altered stomach. It happens all the time. One of my close friends lost and gained weight several times over. She eventually had the gastric sleeve (she weighed approximately 280 at the time) in Dec. 2010 and lost maybe 60 pounds in the following year. Guess how much she weighs now? Over 300. She gained 20 pounds in just three months last year! I know several other people who have gained the weight back after the surgery, but she is the one whose situation I know the most about.

    Regardless of how you go about it, you have to learn how to manage your eating. The organ you need to be concerned with is your brain.
  • deksgrl
    deksgrl Posts: 7,237 Member
    My boyfriend's brother had the surgery, but it was a last resort for him, he had to due to health issues, but he is middle age. I am not sure how many calories he actually eats. He is a big man at 6'4 and he has to be careful both with what he eats and the amount he eats. He has very small servings. He had the surgery about 10 years ago, but now has gained some back, even though he eats small servings.
  • AJ_G
    AJ_G Posts: 4,158 Member
    :(

    Gastric sleeve at 18...

    I applaud you for wanting to take control of things. But surgery? You have so many more options and so much time to learn how to make good choices. Don't start a life where you take the "quick" way.

    I'm telling you with all the love I can spread over the internet: WAIT. Learn good habits. Make friends with people who can help and inspire you.

    I actually lost 100 pounds a few years ago and regained >< I said no to the surgery at 15, but I feel like I'm in a place where I can handle it. I have a few weight-related health issues, so I think it's the best thing for me right now.

    Thank you though, I totally understand where you're coming from.


    You very well might re-gain it this time, too, only this time you will be left with a permanently altered stomach. It happens all the time. One of my close friends lost and gained weight several times over. She eventually had the gastric sleeve (she weighed approximately 280 at the time) in Dec. 2010 and lost maybe 60 pounds in the following year. Guess how much she weighs now? Over 300. She gained 20 pounds in just three months last year! I know several other people who have gained the weight back after the surgery, but she is the one whose situation I know the most about.

    Regardless of how you go about it, you have to learn how to manage your eating. The organ you need to be concerned with is your brain.

    This is a really good point. If you are forced to lose weight because you can't fit anymore calories in your stomach, you're not learning how to eat properly on the way down. This is one of the reasons that the majority of people that have weight loss surgery or lose weight with meal replacement shakes almost always gain all the weight back and more because they used a gimmick to lose the weight, then once it was lost went back to their old ways.
  • a_stronger_me13
    a_stronger_me13 Posts: 812 Member
    :(

    Gastric sleeve at 18...

    I applaud you for wanting to take control of things. But surgery? You have so many more options and so much time to learn how to make good choices. Don't start a life where you take the "quick" way.

    I'm telling you with all the love I can spread over the internet: WAIT. Learn good habits. Make friends with people who can help and inspire you.

    I actually lost 100 pounds a few years ago and regained >< I said no to the surgery at 15, but I feel like I'm in a place where I can handle it. I have a few weight-related health issues, so I think it's the best thing for me right now.

    Thank you though, I totally understand where you're coming from.

    You've done it once with just changing your eating habits, why not try that again this time and not have to be concerned with metabolism issues or how much food you can fit in your new stomach?
  • Iknowsaur
    Iknowsaur Posts: 777 Member
    :(

    Gastric sleeve at 18...

    I applaud you for wanting to take control of things. But surgery? You have so many more options and so much time to learn how to make good choices. Don't start a life where you take the "quick" way.

    I'm telling you with all the love I can spread over the internet: WAIT. Learn good habits. Make friends with people who can help and inspire you.

    I actually lost 100 pounds a few years ago and regained >< I said no to the surgery at 15, but I feel like I'm in a place where I can handle it. I have a few weight-related health issues, so I think it's the best thing for me right now.

    Thank you though, I totally understand where you're coming from.


    You very well might re-gain it this time, too, only this time you will be left with a permanently altered stomach. It happens all the time. One of my close friends lost and gained weight several times over. She eventually had the gastric sleeve (she weighed approximately 280 at the time) in Dec. 2010 and lost maybe 60 pounds in the following year. Guess how much she weighs now? Over 300. She gained 20 pounds in just three months last year! I know several other people who have gained the weight back after the surgery, but she is the one whose situation I know the most about.

    Regardless of how you go about it, you have to learn how to manage your eating. The organ you need to be concerned with is your brain.

    This is a really good point. If you are forced to lose weight because you can't fit anymore calories in your stomach, you're not learning how to eat properly on the way down. This is one of the reasons that the majority of people that have weight loss surgery or lose weight with meal replacement shakes almost always gain all the weight back and more because they used a gimmick to lose the weight, then once it was lost went back to their old ways.

    I appreciate that you guys aren't supportive of the surgery, but I've made up my mind. I know how to eat well, I just sometimes have trouble doing it. I was able to maintain for two years on my own and then ended up making poor decisions that caused me to regain the weight. I decided that surgery will be a helpful tool in starting to lose again and then maintaining, especially given my medical problems, and I am having it done on May 30th with the full support of my family and friends who were also there during my "natural" weight loss.

    My question was really only about the metabolic issues/VLCD. It's fine if you want to urge me to rethink, I'm just letting you know /:
  • Luv2Smile55
    Luv2Smile55 Posts: 133 Member
    You will be eating extremely low calorie. My sister ate only 300 - 400 calories a day for months after her gastric sleeve surgery. Now after almost a year she is eating a 1000 calories but gains if she eats more. The Dr says this is common after eating such a low calorie diet after surgery. You definitely need to think this whole thing through very carefully. They remove 80% of your stomach. There's NO going back once you have it done. :noway:
  • ametolie
    ametolie Posts: 13 Member
    I had the sleeve done Oct 2010. I can tell you that you will start to eat a healthy amount of calories within 4 months. The first two months were completely liquid. Afterwards, you start adding in small amounts of solid food. Then before you know it you can eat everything you like. You just have to eat 6-8 times a day. You'll get all your calories in. But you will be constantly eating to do so. I've lost over 100 lbs after the sleeve. Then I got pregnant. I haven't gained back and am now back on the road of losing the rest of the weight. I have a little under 50 lbs to go. EXERCISE! Get on a schedule BEFORE you have the surgery. By schedule I mean 3-5 months of continual habit exercising 3-6 times a week. I wish I had. It would have made me drop all the weight before I got pregnant.
  • Collier78
    Collier78 Posts: 811 Member
    :(

    Gastric sleeve at 18...

    I applaud you for wanting to take control of things. But surgery? You have so many more options and so much time to learn how to make good choices. Don't start a life where you take the "quick" way.

    I'm telling you with all the love I can spread over the internet: WAIT. Learn good habits. Make friends with people who can help and inspire you.

    I actually lost 100 pounds a few years ago and regained >< I said no to the surgery at 15, but I feel like I'm in a place where I can handle it. I have a few weight-related health issues, so I think it's the best thing for me right now.

    Thank you though, I totally understand where you're coming from.


    You very well might re-gain it this time, too, only this time you will be left with a permanently altered stomach. It happens all the time. One of my close friends lost and gained weight several times over. She eventually had the gastric sleeve (she weighed approximately 280 at the time) in Dec. 2010 and lost maybe 60 pounds in the following year. Guess how much she weighs now? Over 300. She gained 20 pounds in just three months last year! I know several other people who have gained the weight back after the surgery, but she is the one whose situation I know the most about.

    Regardless of how you go about it, you have to learn how to manage your eating. The organ you need to be concerned with is your brain.

    This is a really good point. If you are forced to lose weight because you can't fit anymore calories in your stomach, you're not learning how to eat properly on the way down. This is one of the reasons that the majority of people that have weight loss surgery or lose weight with meal replacement shakes almost always gain all the weight back and more because they used a gimmick to lose the weight, then once it was lost went back to their old ways.

    I appreciate that you guys aren't supportive of the surgery, but I've made up my mind. I know how to eat well, I just sometimes have trouble doing it. I was able to maintain for two years on my own and then ended up making poor decisions that caused me to regain the weight. I decided that surgery will be a helpful tool in starting to lose again and then maintaining, especially given my medical problems, and I am having it done on May 30th with the full support of my family and friends who were also there during my "natural" weight loss.

    My question was really only about the metabolic issues/VLCD. It's fine if you want to urge me to rethink, I'm just letting you know /:

    I can understand, and won't try to talk you out of it, but I do have some advice. I've seen multiple people I know have the surgery, and then continue to overeat. Also, a friend of my husbands had it, didn't exercise, and tore ligaments in his ankle walking down the stairs because after losing muscle with the fat he didn't have anything to support the tendons and ligaments around his joints. Be careful, follow the nutrition plan, see the nutritionist often (even if you think you have it handled), make sure you get plenty of protein (it will keep your hair from thinning and your nails from getting brittle, and you can by a 3 oz liquid shot that has 42grams in it through health stores) You won't be able to eat more than a baby food jar of food in one sitting for a while. Some things you used to love will cause you to "dump" or have bowel issues. Remember why you had it done, and make good food choices. Moderation will be key for you. Good luck!
  • IronPlayground
    IronPlayground Posts: 1,594 Member
    I really don't think anyone can answer your question. It's a valid concern. My sister in law had the surgery and it's a concern I had for her. It hasn't been that long for her so I can't give you any information on how things are going. I know that she supplements a lot since there is a lot of things her body needs that can't be met with such limited amounts of food.
  • suejersey
    suejersey Posts: 36 Member
    There is a lot of assumptions being made here by people who have not had the surgery...but that is all I will say about that.

    I had the sleeve done 10/11/12. I have lost 143 pounds to date and I am now maintaining for about the last six months. I work out 4 days per week - bodycombat - weight training. I get between 1,200 and 1,500 calories per day.

    I do not feel deprived, I feel satisfied, I eat vegetables and protein, low carb (but some carbs) and I also enjoy a treat (chocolate, ice cream, et cetera)

    I have learned and every day is a new commitment to making good food choices and taking care of my body.
    Although I know and believe that people can either not lose a significant amount of weight or gain it back, it has to be something
    where they truly have not made any changes, are choosing to eat calorie dense, but not nutritious or filling foods.

    I can totally see myself committed to this new way of life and eating forever. It was a tool I needed. Not everyone needs it, but those that do, it is not a quick fix but a tool that helps us meet our goals to live a healthy and full life.

    Once I was back on solid food I ate about 600 calories per day for a good 6 months, then 700, then 800. I was probably at 800 till about a year and moved up to 1,000 and at 1 1/2 years 1,200.

    I sometimes eat my calories back from exercise (400 - 600 per workout) if I "need" them. If I don't, I don't. Some days I am hungrier than other days. I try to listen to my body and think of food as fuel. I want to fuel my vessel the very best I can, so I choose foods that will do that.

    HTH! Good luck.

    So basically, a synopsis yes 600 to 800 calories for the first year was my experience. After that 1,000 to 1,200 and now that maintaining I am shooting for 1,200 to 1,500.
  • Escloflowne
    Escloflowne Posts: 2,038 Member
    After reading some of the replies, I'm so happy I decided to go with a healthy diet and exercise, some of this stuff is just scary to me!
  • bump.
  • I do anywhere between 400-600, which my nutrition says is on target! I am two and a half months out!
  • fitkatb
    fitkatb Posts: 14 Member
    The gastric sleeve will reduce the volume capacity of the stomach. Not the calorie capacity. I had a friend that had the lap band surgery and GAINED weight because she was slurping down milkshakes all day. I have another that has totally stalled out on weight loss with the lap band because she refuses to stop drinking sweet tea all day long and eats cookies for breakfast because it's easy to get down.

    None of the weight loss surgeries are any more effective than diet and exercise in the long run and have pretty substantial failure rates. The reason: people don't change their behavior.

    But that being said, as for your concern about VLCD post op, there are lots of options for getting your calorie count up. I'm not really familiar with the sleeve, but I'm guessing it gives you the restrictive aid of the lap band without decreasing the size of the esophagus, which is what makes it so hard for people to eat some of the foods they really need to be healthy with the lap band. Food that are more calorie dense, like natural peanut butter, avacados, whole milk instead of low fat and the like will be your best option. You'll get (more) sufficient amounts of proteins and good fats and get your calorie count up.
  • WBB55
    WBB55 Posts: 4,131 Member
    My question was really only about the metabolic issues/VLCD. It's fine if you want to urge me to rethink, I'm just letting you know /:

    My suggestions, every day, no matter what, to minimize the damage you're going to fight every day for the rest of your life:

    -Take a multi vitamin (one with iron, calcium, D, B12, iodine (unless you get it in salt))
    -Eat 75 calories of vegies
    -Eat 120 calories of fruit
    -Eat 2 servings of whole grains (whole wheat, brown rice, quinoa, barley, lentil, etc.)
    -lift weights 2x per week
    -walk at least 20 min. every day to maintain bones
    -eat at least 100 g of protein (more is fine)
    -eat at least 30 g of fat (more is fine)
    -eat at least 25 g of fiber (more is fine)
    -drink as much water as you can
    -sleep at least 7 hours
  • Ashley_Panda
    Ashley_Panda Posts: 1,404 Member
    I had it done at 17 and have regretted it every single day. Guess what? Nearly nine years later and I'm still trying to lose the weight.
  • dj59lane
    dj59lane Posts: 52 Member
    I had the bypass about 20 months ago for me it was a health issue. I have lost 95 lbs and have had months when I didn't lose anything.
    if I may give you a few pointers.
    1. This is your journey, the clinic knows what works, if you follow the program, go on the boards etc it will work.
    2. People will tell you this is the easy way out it's not. You have to unlearn bad habits, refuse food from others and you may throw up alot.
    3. You will only eat about 500 calories the first few months. Even now I only eat 1000-1200 per day generally lower than that.
    4. Food will taste different, one day something will be fine for you the next not so much it's alot of trial and error.
    5. Don't worry about calories worry about getting the protien you are required to-- find the foods that work best for you.
    6. Start eating a modified diet now, lots of chciken, protein drinks, taking your vitamins I did this for 2 months before and it made the trasisition easier.
    Finally be cautious about who you tell people judge.
    If you ever want to chat privately please message me.
    Best of luck
    Deb
  • parkscs
    parkscs Posts: 1,639 Member
    I dunno, eating 6-8 times per day and being physically unable to eat medium/larger portions for the rest of your life sounds pretty bad. There are plenty of procedures that I would still opt not to do, even if my insurance offered to cover it. Insurance paying for something is not a good reason to make a life-altering decision.

    Just my $0.02, but you can't sit here and say that people who eat 1200 calories or follow VLCDs are upsetting and then turn around and pursue a gastric sleeve. You will be on a VLCD after having the procedure done and it's no more or less healthy for you then than if you simply followed a VLCD with doctor supervision today without the operation. You'll still have to deal with the potential lack of energy and the possibility of malnutrition unless you stick closely to your planned diet. Going this route is basically forcing yourself to follow a VLCD because you're having the majority of your stomach surgically removed... seems a lot more extreme than the people who eat 1200 calories on MFP.

    Not saying it's the wrong decision, but ... well, maybe I am. :tongue: You've lost the weight before, so you know you can do it again. This just seems like an easy out (but one that also alters your life and not necessarily for the better).
  • Iknowsaur
    Iknowsaur Posts: 777 Member
    There is a lot of assumptions being made here by people who have not had the surgery...but that is all I will say about that.

    I had the sleeve done 10/11/12. I have lost 143 pounds to date and I am now maintaining for about the last six months. I work out 4 days per week - bodycombat - weight training. I get between 1,200 and 1,500 calories per day.

    I do not feel deprived, I feel satisfied, I eat vegetables and protein, low carb (but some carbs) and I also enjoy a treat (chocolate, ice cream, et cetera)

    I have learned and every day is a new commitment to making good food choices and taking care of my body.
    Although I know and believe that people can either not lose a significant amount of weight or gain it back, it has to be something
    where they truly have not made any changes, are choosing to eat calorie dense, but not nutritious or filling foods.

    I can totally see myself committed to this new way of life and eating forever. It was a tool I needed. Not everyone needs it, but those that do, it is not a quick fix but a tool that helps us meet our goals to live a healthy and full life.

    Once I was back on solid food I ate about 600 calories per day for a good 6 months, then 700, then 800. I was probably at 800 till about a year and moved up to 1,000 and at 1 1/2 years 1,200.

    I sometimes eat my calories back from exercise (400 - 600 per workout) if I "need" them. If I don't, I don't. Some days I am hungrier than other days. I try to listen to my body and think of food as fuel. I want to fuel my vessel the very best I can, so I choose foods that will do that.

    HTH! Good luck.

    So basically, a synopsis yes 600 to 800 calories for the first year was my experience. After that 1,000 to 1,200 and now that maintaining I am shooting for 1,200 to 1,500.

    Eeeep!
    Thank you, this was exactly what I was wondering.
    Maybe I was only seeing answers from people within the first year.
    Although I'm sure even that one year will take a hit on my metabolism >>
    Thank you thank you again :D
  • Escloflowne
    Escloflowne Posts: 2,038 Member
    I had the bypass about 20 months ago for me it was a health issue. I have lost 95 lbs and have had months when I didn't lose anything.
    if I may give you a few pointers.
    1. This is your journey, the clinic knows what works, if you follow the program, go on the boards etc it will work.
    2. People will tell you this is the easy way out it's not. You have to unlearn bad habits, refuse food from others and you may throw up alot.
    3. You will only eat about 500 calories the first few months. Even now I only eat 1000-1200 per day generally lower than that.
    4. Food will taste different, one day something will be fine for you the next not so much it's alot of trial and error.
    5. Don't worry about calories worry about getting the protien you are required to-- find the foods that work best for you.
    6. Start eating a modified diet now, lots of chciken, protein drinks, taking your vitamins I did this for 2 months before and it made the trasisition easier.
    Finally be cautious about who you tell people judge.
    If you ever want to chat privately please message me.
    Best of luck
    Deb

    To me, this sounds like the exact opposite of the easy way out...
  • I had the sleeve in October of 2012. I lost 90 and then got pregnant. I was eating 500 calories a day and during pregnancy ate 1500 (religiously, plus I had hyperemesis and threw up 20+ times a day) and gained 60 pounds. The surgery totally screwed my metabolism and now I'm doing Keto because regular calorie deficit doesn't work unless I'm netting only 500 a day. I wouldn't say I regret it, but your entire body changes and I don't respond to nutrition or medication the same way anymore. I'm working hard to restore my metabolism but my insulin resistance is worse. Some people can diet like a normal person after the surgery but I was not one of them. Good luck with what ever you decide, no one can tell you if it's right for you or not.
  • lrmall01
    lrmall01 Posts: 377 Member
    I appreciate that you guys aren't supportive of the surgery, but I've made up my mind.

    You should at least wait until your prefrontal cortex is fully developed before making a decision regarding an irreversable procedure that you will have to live with the consequences of for the rest of your life. Of course I've not been in your shoes, but I think it is a bad idea.
    My question was really only about the metabolic issues/VLCD.

    I haven't had the surgery or anything but I just see no way it could be healthy. I think you are very astute in making the connection that the procedure will force you to eat VLCD and the nutritional challenges that will be a result of that restriction. Since you already stated there is no way you are going to change your mind about all I can say is you better make sure what few calories you get are VERY nutrient dense. I'm also not sure how you are going to eat in a manner to support muscle mass, which will be needed to help keep your metabolism up. From what I have seen, those with this procedure end up still having high body fat percentage most the time. I'm not sure if it is because they can't eat enough protein to support the LBM or if they choose not to, but I think it is something to consider.

    Good luck (don't do it)! :-)
  • dj59lane
    dj59lane Posts: 52 Member
    Glad to hear someone else weighting in on the bypass/sleeve