I decided on the sleeve because I do not want the malabsorption that accompanies bypass nor do I want dumping syndrome. With bypass your pouch is approximately 1oz while the sleeve leaves you with about 3 oz. I do not think 1oz stomach allows for enough nutrients personally. As a nurse I do not like the thought of the lap band. It is a foreign body in your system. There is also incidence of erosion with the band and slippage. If you have more than 50lbs to lose lap band doesn't yield the best results. In addition, with lap band you have to visit your doctor for adjustments etc. Sleeve has become the first choice for bariatric surgery however, it hasn't been around as long as the others so evidence based research on the long term effects is still limited. This is what I based my decision on and I hope that helps. Good luck. Do your own research and be an educated consumer.