Reversibility
Each Weight Loss Surgery (WLS) type is designed to be permanent. However, the Adjustable Gastric Band (AGB) is fully reversible if necessary since the surgeon can remove the band from around your stomach. The Gastric Bypass (RNY) can be reversed, although the procedure is more complicated. The Gastric Sleeve (VSG) is absolutely irreversible since it involves removing most of your stomach from your body. Because of its reversibility, the AGB may be the choice for some younger patients or for those who do not want to take a dramatic step that affects their actual body parts.
Invasiveness and Recovery
The AGB is least invasive and has the shortest recovery time. It can even be an outpatient procedure, and you could get back to work in a week. This might be the only realistic option if you have very little sick leave available or you do not want to tell work colleagues about your surgery. The RNY and VSG are inpatient and require longer recovery times
Safety: Complications and Side Effects
Some risks of the AGB are band slippage or leakage, or erosion of the band. You could have vomiting or reflux if your band is displaced or filled too tight. Since the band can be removed, most of the complications can be stopped by emptying or removing the band.
The VSG has a higher rate of complications than the band. They can include leakage at the suture site. Nearly a quarter of RNY patients have complications of some sort, with more serious ones including staple line separation or leaks. You might opt for the AGB if you have a lower BMI without many health issues, or you might be more willing to take on RNY risks if your BMI is higher and you are more concerned about obesity-related issues such as diabetes.
The risk for nutritional deficiencies is higher with RNY and VSG. You can greatly lower your risk by taking the appropriate nutritional supplements, but you need to be prepared to take your bariatric vitamins for life. The effects of vitamin and mineral deficiencies can include osteoporosis, anemia, and nerve damage.
A Sweet Tooth and Dumping Syndrome
What are you looking to get out of your WLS? If all you need is help with portion control, AGB may be for you. It only helps with portion control, and it is up to you to make healthy food choices. On the other hand, the gastric bypass is best if you are looking for a tool to help you avoid sweets. That is because of the malabsorptive nature of RNY.
With RNY, your food passes through the lower part of your small intestine with less digestion than it would before surgery. Sugars that get to your small intestine can give you symptoms of dumping syndrome, including weakness, extreme fullness, diarrhea, nausea, and vomiting. Foods that cause dumping syndrome tend to be sugary and high-carb foods, such as candy, soft drinks, cakes, and pastries. Dairy and alcohol can also cause problems.
Most patients who get RNY have dumping syndrome at some point. Dumping syndrome can be beneficial because it gives you extra motivation to eat right – you know that if you grab that brownie, you may be headed for hours of misery! That can be a good reason to choose RNY. However, if the thought of dumping syndrome scares you, RNY is not for you!
There are many factors to consider as you choose your WLS type, but keep in mind that the decision is individual. You need to choose the WLS type that will work for you, even if it is not the one that worked for someone else. The decision is something to make after one or more serious conversations with your surgeon.
