SarcasticGastric

It's interesting how high folks are placing will to succeed. I like the idea because it gives me a sense of control, but if will to succeed were sufficient, I wouldn't be having this surgery. If your biology is fighting you, I'm skeptical that your will to succeed is going to prevail.

My understanding of the best research is that the surgery changes the weight that your body defends. If your body previously defended 400 lbs and now defends 280 lbs, getting to 200 lbs is going to be as difficult as losing and maintaining an 80 lb weight loss when you were 400 lbs. What weight will your body defend after surgery? No one knows. Research points to genetics playing a major influence on outcome. No one wants to hear that because it feels random and unfair, but that's pretty much life in a nutshell. Life isn't fair, all you can do is play the odds and hope for the best.

It's not unusual to see people regretting the sleeve and wishing they'd gone with the bypass because of GERD, but I don't see anyone wishing they'd gotten the sleeve after they went with the bypass.

If anyone out there went with RNY and wish they'd gone with VSG, I'd love to hear why you feel that way.

I have this fear as well. I even took my paranoia a step further after finding some research that there's a genetic factor to how well bariatric surgery works (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3644642/). I actually did a DNA test through AncestryDNA and uploaded the results to Promethease so that I could see if I have one of the "bad" genes and I do. In the study I linked to it correlated with losing about %5 percent less body weight. For me that would be me being an extra 20 lbs heavier and that's just one gene. So if I have 200 lbs to lose and I can expect to lose, on average, 70-75% of my excess body weight with RNY, that's 140-150 lbs. With that gene I have I might have to adjust that to 120-130. At 120 lbs lost I wouldn't really be where I want to be, but I'd be MUCH better off than I have been.

In all honesty, I sort of regret checking this gene. At the end of the day I don't think it makes sense to let 20 lbs influence my decision and it's just one more thing to discourage me. In case you're wondering, something like 95-96% of people have the "good" gene. I'm one of the "lucky" few with one of the bad variants (there's another variant that is even worse, but it is VERY rare). It's also possible I have other genes that will influence my success, for the good or the bad. I think the science will get better over time, but right now I don't think there's a great way to know how you're going to do without just taking the leap.

I haven't officially made a decision, but I'm leaning pretty heavily toward RNY. I may never be thin, but I think I can be much less fat and that has enormous health benefits, even if I never come close to my ideal weight. We shouldn't let perfect be the enemy of good.