It’s not unusual to feel cold after gastric sleeve surgery. As patients say, welcome to the “always cold for the rest of your life club.” Sensitivity to cold temperatures is one of the most prominent side effects of undergoing weight loss surgery.

While most people feel colder post bariatric operation, some feel warmer than usual. The feeling of cold and hot usually is your body’s reaction to a significant change in fat storage and weight. The freezing sensation after VSG can be explained as follows:

  • As you lose weight, you lose a significant amount of the insulating layer of fat deposits under your skin.
  • With less caloric intake, there is a lack of heat production, as digestion creates a lot of warmth within the body.

This article will uncover why you feel chilly after gastric sleeve and how you can warm up!

6 reasons you feel cold after gastric sleeve surgery

Anybody always freezing cold after gastric sleeve surgery

“I used to be hot all time, and now I hide in the evening under an electric heating blanket.” – Lynn, Past Patient

1. Loss of Insulation

Obese individuals have more insulation in the form of fat tissue acting as a barrier against cold. When you are eating a high-fat diet and are gaining weight, you build up a layer of fat just underneath the skin. This layer of fat is called subcutaneous tissue, also known as blubber or adipose tissue, and acts as a form of insulation and wards off cold.

In fridged conditions, obesity acts as an advantage due to preventing the loss of heat. However, in hotter climates, heavier individuals are more susceptible to heat stress. After gastric sleeve surgery, this internal layer of fat begins to thin out, causing a frequent sensation of cold.

2. Lack of Caloric Intake

Digestion is a primary source of heat within the body. After vertical sleeve gastrectomy, you eat less, and your metabolism increases. Since you are eating less food, your body cannot utilize the required energy to process those calories and generate body heat.

3. Less Energy Needed to Move

When you are carrying all of that extra weight, more energy is required to keep you going. Once you are thinner, your body no longer needs to work hard and use as much energy to keep you moving. The energy created by your body will make you feel warm. Less energy production means less heat generation.

As you get lighter, there is less strain on the body, and your Basal Metabolic Rate (BMR) is lowered. BMR is the number of calories used for the body’s basic functions to keep you alive, such as breathing.

4. Thermoregulation

Thermoregulation is the body’s ability to maintain its core temperature regardless of the environmental temperature. The mechanism that regulates the temperature deep within your body is related to the internal fat surrounding the organs.

The cold receptors send signals to the hypothalamus (part of the brain) as our body temperature drops. The body reacts by muscle contraction (shivering) and blood flow restriction to the skin.

Gastric sleeve leads to rapid weight loss and internal fat reduction. Therefore, thermal control of the body gets affected. However, the patient’s thermo-regulation after vertical sleeve gastrectomy (VSG) will finally adapt to the changes.

5. Cold Intolerance

Some people are cold intolerant regardless of their weight. Cold intolerance is generally related to thyroid or blood vessel problems, etc. However, cold intolerance can be linked to quick excess body fat loss and the body’s thermal regulation.

6. Anemia (Low Iron Levels)

The feeling of chilliness is a common symptom of anemia – low hemoglobin. When your iron is low (anemic), you feel body ache because you’re so cold! It’s typical to have low iron after this bariatric surgery, especially gastric bypass. If this problem gets too bad, you may require iron infusions; better safe than sorry.

Is it normal to feel cold after bariatric surgery?

Yes, it is normal! This issue of feeling cold more usual is not anything to feel concerned about. It is a nominal price compared to the risks involved with obesity, such as type 2 diabetes, heart disease, and cancer. Just keep in mind that your body has just undergone a procedure that can send it into shock as it readjusts. That adjustment takes time, and you are going to notice the changes as this takes place.

Some say that this issue goes on for a while but then eventually goes away. And many who do not undergo surgery but eat low-fat diets may experience the same problem as it has to do with losing that layer of fat and not the surgery itself.

How long until I stop feeling cold?

For most VSG patients, it takes about 3 to 6 months until their body returns to a normal thermostat. However, it is not uncommon for a cold spell to last a few years.

“There has been one side effect of my surgery that I am not doing well with. I am freezing! I cannot seem to do anything to warm up short of wrapping up in an electric blanket set on high. My muscles constantly ache from being tensed up from the cold, miserable headaches, and shivering all the time. I even went as far as seeing my doctor, who to give him credit, really tried hard not to laugh at me…after blood work, he confirmed that I am healthy, just my internal thermometer is not calibrated yet to my new weight. Sigh..when is spring? lol” – Ashley, Past Patient

How do I get warm after gastric sleeve?

My hands and feet freezing all the time - Feeling Cold After Gastric Sleeve

The solutions to this problem of feeling freezy after gastric sleeve surgery are to simply layer up and wait it out. It is helpful that you take care to keep your body heat at a safe level by wearing more layers or turning up the heat as needed. You can also buy comfy hats and mittens to keep your hands and ears warm and cozy.  In time you may very well adjust to where you do not notice the sensation of being colder than usual.

This is a transition period. You gain so many benefits from bariatric procedures that outweigh this side effect which can be easily overcome.

This is a list recommended by past patients:

  • B12 shots – “As long as I do my B12 shots, I’m not freezing. If I miss one, I think it’s 30 below.”
  • DIY heating pads – “I’m constantly freezing and have my heating pad on all the time.”
  • Move to a warmer climate
  • Bundle up with thick clothing

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UPDATED August 2022 – Ron Elli, Ph.D.