P-Diddy

Further proof that I'm barking up the right tree. That the statistical model we're presented doesn't really give any information about my demographic in a meaningful way. This only leads me to believe my instincts are right.
I fail to see how suggesting that women who aren't my age aren't good models of my outcome is some how equal to needing a "PRECISE" demographic. It doesn't need to be "PRECISE" i.e. males in their mid-thirties with X amount of body fat etc...more so I was just interested in the very least that the models be male and I'd like to see them at my starting BMI. But strawman away!

Further proof that I'm barking up the right tree. That the statistical model we're presented doesn't really give any information about my demographic in a meaningful way. This only leads me to believe my instincts are right.
I fail to see how suggesting that women who aren't my age aren't good models of my outcome is some how equal to needing a "PRECISE" demographic. It doesn't need to be "PRECISE" i.e. males in their mid-thirties with X amount of body fat etc...more so I was just interested in the very least that the models be male and I'd like to see them at my starting BMI. But strawman away!

I began my journey (2015) where you are now - 5'9" and 400+ lbs. I had the sleeve because I wanted to keep all of my plumbing in place and functioning. I have lost 1 full-grown man so far, and I do not regret my choice AT ALL. While a full bypass would have gotten me to my ultimate goal (for me, about 185) faster, I am SO MUCH healthier even now that the pace of the last 75 pounds is a bit easier to take on.
It seems that I am near the point that I need to exercise to accelerate my weight loss further - not a bad thing at all. If you are comfortable with the idea of the Sleeve, don't let ANYONE change your mind!! The doctors are the "experts", but this is YOUR BODY, not theirs. This is YOUR LIFE, not theirs. As a result, this is Their Advice, but it is YOUR Decision!!!
Take control of your future and be comfortable with the decision that You make.
God Bless,
Bryan

Well, I agree, and thats why I wish medicine had demographics for us to look at. I think clearly its the case that a person with a higher BMI would be MORE likely to lose more weight than a person with a lower BMI. Mostly because of Basal Metabolic Rate. A person who weighs more has a higher metabolic rate than a person with a lower weight (all other things equal). Thats why I was dubious when she said "People with high bmi's don't lose as much weight as people with low bmi's" that contradicts what I know about BMR. Given that I lose a lot of weight anytime I diet, which has been too numerous times to count, I think its safe to assume I'll also lose weight rapidly with any surgery.
Thats what I think too! I think that if I can get through say 80 lbs or so by next summer (surgery wouldn't be til fall). Not only would I have a significant gain in energy but also the introduction of summer and wanting to be more active and simply having more opportunities to be active socially it will only continue to spurn on quality weight loss.


I've given it some thought and I've settled on two factors.

A. If there is some genetic ailment or physical condition that limits my weight loss like one of the responders was discussing then it seems logical to have the Sleeve. If I don't lose weight I don't lose weight but I don't have a lifetime of malabsorption problems and thousands more in medical costs for potential problems.

B. If I lose in the upper percentages like many of you have (go you!) than I'll just be that more happy that I chose sleeve than bypass.

Thanks for everyones input. I'm leaning more towards the Sleeve again.

Thats alarming as I do have Hypothyroidism. But when I diet I lose weight rapidly. For instance I tried to do meal prep and lost nearly 20 lbs in a month. Wouldn't Hypothyroidism restrict my weight loss now TOO if it was going to be an indicator for gastric bypass?
I found the article interesting. While its interesting it has no practical use. I can't test for these chormosomal markers @ Walgreens.

I'm only 2 months out, but I have a few things to contribute that I feel are appropriate. I stressed a lot over which surgery to have. BMI 40 at the highest. I wanted something reversible. I was scared. My mother had early bypass in the 90's and she suffers terribly now from mal-absorption, cant swallow important meds, can't eat.

I got lucky with a rep for a travel surgery company over the phone who spent time with me discussing sleeve. Thank goodness she was insistent.
I'm having an experience that seems not typical, but I am believing one thing from research and limited experience.

Gastric sleeve makes the most logical sense as a concept when you break it down. Individuals vary but logically . . .
It does not actually change the flow of the human body, or digestive system, it just keeps the natural flow, but reduces the pouch of your stomach size. It does not leave foreign objects like the band, port, etc in the body. Scarring is minimal, invasion is lower, recovery is faster. For me the recovery has been so fast it's almost unbelievable. It simply restricts you from overeating and presents you with a nauseous reminder to STOP, or SLOW DOWN constantly. Recovery seems to be the fastest for a general observation, Side effects for me have been nearly non-existent. I had a home made seltzer yesterday as an experiment (I do NOT call that "soda") and surprise, I did not die, explode, tear out my staples. Like all things in life, be smart, listen to your body. Seltzer provides an oral stimulation I enjoy within reason, and a squirt of some taste also can happen. Vitamin effectiveness is too early to gauge at 8 weeks, but at least taking those larger pill presents no problem like the eternal suffering my mother's radical bypass endures for 25 years, causing non adherence to Vitamins, which then causes more problems. My anecdotal research tells me men have a vastly different easier experience when compared to women overall. ANECDOTAL. I'm just 2 months out, and of course years of a journey lie ahead. Oh by the way, I'm also HIV positive, 35 years healthy, never needed meds until proactive treatments started recently, and even those I have no problems with post surgery.

Negatives I'm becoming aware of . . .
you can find unhealthy high calorie foods that can slow or stop weight loss and slip by the restriction process. My personal example is Low Sugar Fudgesicles. I'm craving chocolate, I did not used to. I used to binge eat popsicles in general, now regular popsicles taste weird, but the Sugar Free Chocolate products like Peppermint Patties, dark chocolate, in general also help because they have a laxative effect. I ate too many "Outshine' fruit low sugar popsicles last night watching Netflix (with no chill unfortunately) - and I vomited in my sleep, which strikes me as a bit potentially dangerous. I hope the negative reinforcement works. Tastes seem to change a bit. Cravings change. Whiskey/Scotch/Vodka tastes gross now unless it's an expensive super high quality bourbon. That may seem minor to you, but taste and craving changes can seem bizarre. I can sense a long term danger that mentally, I will "figure out" how to outsmart the surgery when I'm stressed and resorting to old eating behaviors and patterns. Last week I went to support a friend who is a cabaret theater singer, and there was pressure to order food and drink to keep the prime seating location we were in. I felt guilty for the waiter with me milking an appetizer and one drink for an hour and I pushed it ordering more food, and more alcohol, ill advised. I gained 2 pounds just from that stupid exercise. Thankfully avoided vomiting, but perhaps that would have been better mentally. My weight loss was so slow at first I was genuinely scared then angry. Then I resumed cardio exercises and teaching Zumba, which is twice as much exercise as just taking Zumba. Then the weight started falling off. Muscle tone is weird. I need to lift weights as I did when very overweight. It feels different.
Hope this contributes and helps.

I weighed 470 pounds and had a BMI over 63. At the time of the surgery, I weighed 389 with a BMI of 52. Currently weigh 198 with a BMI of 26. (I don't like this website rounds up in my profile )

I have a theory that I want to share.
When I was in college, I ate at the all-you-can-eat buffet style cafeteria. I lost weight. Being confronted with so many choices, I naturally gravitated to eating pretty much the exact same meal for Breakfast every day, and dinner was essentially the same each night as well. I found comfort in a consistent meal routine.
Getting married, having children, fixing dinner that kids would eat, having leftovers, not wanting to waste food.. all these things really played a part in my gaining 150lbs after leaving college.
During the preop and post op diets, I had to completely separate my eating from that of the family. I actually found it extremely easy with our set-up, and so it is now 2nd nature. I eat the same things every day, and it is comforting to me (not boring). I always know what I'm going to have, so that stress of "what's for dinner" doesn't apply to me anymore. Granted, I'm only 3.5 months out of surgery, so we'll see how I feel in a couple more years.
My theory is that people that don't mind a limited palette of foods do exceptionally well (mentally) after surgery. Those people that always want something different all the time.. they are going to have a harder time. There are a ton of ways to make salads, but ultimately, it's still salad.
How does all this play in for you? Are you someone that would say "But we had chili last night!" or "Do we ALWAYS have to have spaghetti Mondays?!".. you would probably do better with a bypass. But if you're more like me (and have no history of GERD), then the sleeve would probably work well for you.
Men lose about twice as fast as women in general. I think the ultimate success is up to your individual body and mind, and less about the procedure you choose.
Another thing to think about is your willingness to undergo a second, revisional surgery. Sleeves leave this as a possibility, whereas a bypass is "one and done". A revision doesn't have the dramatic success of an initial surgery, but sometimes is needed if the weight loss stops too soon, or you develop severe GERD.

Oh, and wanted to add.. with your height, a "normal" weight would be 165lbs. (unless you work out and have tons of muscles). The bypass could be expected to get you to about 225lbs, the sleeve 235lbs. The duodenal switch should get you lower still.
But, your comment about not wanting to take vitamins....
You'll HAVE to take Vitamins with any of the procedures. But, with the sleeve, it'll be swallowing maybe 2-3 pills. The bypass is around 5-6 pills I think. The duodenal switch is a handful of pills, several times a day.
Not knowing your situation.. I think you'd be happiest with a sleeve, and keeping the potential for a revision open down the line. (Unless you have GERD). If you only get heartburn after a heavy meal or specific foods.. that's different. GERD happens regardless of what you ate, and is HORRIBLE. You'd know it if you had it.
Many times insurance won't cover a revision unless it's from medical necessity. So keep that in mind too..