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If I were to oversimplify the choice, I think it comes down to what your biggest behavioral obstacles are. I ruled out the lap band and sleeve because, as my surgeon said, I could still sip milkshakes and nibble on cheeseburgers until I'd gained another 100 pounds. If you want more freedom to still eat certain things (which is a completely valid reason to opt for one of these - it just depends on self-control) then the sleeve or the band might be for you. However, the percentage of excess weight loss is less for these two than for the RNY. The sleeve is actually pretty darn close in terms of weight loss to the bypass. And the part of the stomach that distributes a hormone that causes hunger is removed, so that's a great perk. You will have to remind yourself to eat. I might have chosen the sleeve if my insurance carrier covered it, but they don't. I chose the RNY because I wanted the dumping syndrome, which causes you to get sick if you eat anything too high in fat or sugar. Some people don't want that, but I felt like I needed it to help me change my relationship and behavior with those kinds of foods. My surgeon has videos that go over each surgery and it's pros and cons on his website: http://poplawskibariatric.com/for-prospective-patients/ If you can, watch those videos because I couldn't have made my decision without them. Good luck to you!

Thanks everyone for such honest and thoughtful and helpful answers. I think I'll need to see a counselor too. I've already got it in my head that I'm going to fail, even after getting the surgery, which would be the most extreme thing I've ever done. I wish it was easier to believe in myself.

I'm in my first month of 6 months supervised weight loss, and I'm wondering how you guys' relationships with food have changed. If you were an emotional eater, what do you do now instead of eat? Do you really get so that you don't want food in the same way you did before surgery (e.g less hungry or food makes you nauseous instead of sparking a craving)? Or any other thoughts would be great. Thanks everybody!!

And DANG 117 pounds?!?! You are a rock star!

Thanks, Sheryl!

Hey All, I am a professional web developer and am putting together a website, http://myrouxeny.com, for anyone affected by morbid obesity and weight loss surgery. I want this site to be a haven for those who are afraid to speak up themselves (like in this forum), but need support and encouragement. If any of you would be interested in writing regularly or just once, to tell your story to the site's audience, I would love to answer any questions you might have, and get your story out there. It can be an entirely anonymous contribution or entirely... un-anonymous(?) if you do choose. This is solely to benefit the community of our peers. Email me at cj@myrouxeny.com with any questions or if you're interested. I'm also putting together a gallery of before and after photos, so email me if you'd like to be a part of that gallery. Thanks, everyone

Thanks so much. I'm going to use the " Diet and Excercise" short answer. It's TRUE! And yeah, I hope I'm strong enough to be one of the successful ones when the time comes I'm really scared of failing.

I feel shy about telling people I'm getting a RNY. I'm scared of judgment I guess. What are your guys' experiences with coworkers and acquaintances, etc?

Good luck! I'm cheering for you!

Wow, that is so awful. I'm so sorry. Definitely file a complaint. It will help others avoid having to go through what you went through. A center of excellence is important to have, but as we can see, it doesn't seem to guarantee bedside manner and attentive care, which it should. I read through what it takes to be a center of excellence, and it involves the following (the disease-state in our cases would be bariatric surgery, essentially, I think): Board certified specialist and subspecialties in the disease-state Current diagnostic and treatment technology Standardized (where applicable) care plans If surgical services are involved standardized surgical and medical device packs Unique or innovative service not found in the service area Long-term sustainable business plan Dedicated full-time CoE director or manager Center defined capital budget for acquisition of new technology, devices etc Outcomes better than the national average Active satisfaction measurement of physicians, payers and patients Patient referrals from what would be considered outside of the normal hospital or health system service area Fully developed patient disease-state educational materials (and that doesn't mean a pamphlet from an association or pharma) Outcome case studies Transparency dashboard which reports surgical and treatment outcomes, case mix index, mortality and morbidity data, financial indicators, satisfaction rates for physician, payer and patient, quality measures, market share, etc Joint Commission CoE certification*(Leon) Other third party external accreditation's if available for the disease-state The disease-state is a core competency of the organization Centers brand name and brand architecture is consistent with and fully integrated into the hospital or other providers brand plan.

That is a lot of unclear information. If I were you, I would call the office of your surgeon and see of they have anyone on staff to help patients comply with their insurance requirements, let alone help uncover what they are exactly. Insurance providers are terrible at clearly and consistently explaining how to qualify for benefits. Don't rely on answers in this forum or online- find an insurance advocate or professional to help you. You shouldn't have to do this on your own.

That's so great! Have you lost any weight? How is it going in general?

Oh my gosh Cooksie you're halfway done!!

Thanks so much, everybody. Jeez this forum is amazing. Everyone is so supportive I called my insurance company today and they said that the 6 months supervised weight loss needs to result in the primary care physician concluding that normal diet and exercise isn't working and that I need to try something else. So I guess my fate is in my physician's hands. It's hard to really know what constitutes failure after six months of dieting (haha I know what failure after a decade of dieting looks like... I just need a mirror LOL).

Does anyone know what they look for, like a certain amount of weight loss or weight gain or nothing? Does it depend on the insurance provider?