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).
6. Which studies contradict it?
I-BAR-01, A-BAR-05, A-BAR-24; A-BAR-20 (states that in sleeve gastrectomy the pylorus is preserved 'such that the stomach function and digestion remain unaltered', reports less anaemia after sleeve (17%) than after bypass/BPD (45-50%) and that purely restrictive procedures are usually not associated with B12 deficiency).
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
- 25 October 2026 provisional
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 only 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 (5)
-
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 only 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 checkedAfter 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 only 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 checkedDeficiencies 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
No study in this group is marked as key.
Studies with mixed or unclear results (0)
No studies in this group.
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
- Bariatric Surgery versus Intensive Medical Therapy for Diabetes - 5-Year Outcomes.. Schauer PR et al.. N Engl J Med 2017 · PMID 28199805 · DOI 10.1056/NEJMoa1600869
- 2022 American Society of Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) Indications for Metabolic and Bariatric Surgery.. Eisenberg D et al.. Obes Surg 2023 · PMID 36336720 · DOI 10.1007/s11695-022-06332-1
- Bariatric surgery and long-term nutritional issues.. Lupoli R et al.. World J Diabetes 2017 · PMID 29204255 · DOI 10.4239/wjd.v8.i11.464