I originally set out to have the sleeve. When I had my first appointment with my surgeon, he said I might want to consider gastric bypass because I had severe acid reflux and sometimes the sleeve makes it worse. He also said the gastric bypass usually has better weightloss results, and they are more likely to be long term. So, thats why I chose the gastric bypass, among other things. But, there is a lot more research and longterm studies out for the gastric bypass than the sleeve, although many people seem to do just fine with the sleeve. Ultimately it comes down to you and your specific comorbidities as well. I don't know about the sleeve, but I know many who had diabetes gets better almost instantly with gastric bypass. So, do some research on both surgeries and discuss them with your surgeon. Hope this helps!