NYCGirl9269

In California it covers RNY and VSG without issue as long as you do the 6 month monitored weight loss. It's difficult to get it to cover the DS, and Loop DS (but my Loop DS got approved). I haven't heard anything about MGB though so I don't know if it's covered here. Personally, I think it'd probably be like the DS and Loop DS and be a pain in the rear end to get them to approve it, but I'm sure some people have gotten lucky.

Thing is, there’s no surgery that will allow you to eat the way you used to and still maintain a weight loss. You don’t have to “diet” forever but you will need to eat mindfully. A lot of us are accustomed to eating with reckless abandon and that’s how we got big in the first place. Since I’m done losing weight, I allow myself occasional treats. Nothing is forbidden forever, but if mealtime was a TV show, some foods are part of the regular cast and some are “guest stars” I see once in a while. I don’t “diet” but I do try to make good choices about what to eat (with an indulgence thrown in here and there).

My starting BMI was 47. I had the gastric sleeve done almost two years ago. I lost 100% of my excess weight and I'm now down to 125. I'm in maintenance at this point but I still eat fairly low carb and I avoid sugar and junk food. It's not impossible to lose all your excess weight with the sleeve but on average, people who have the bypass lose a bit more. For that reason, I REALLY wanted the bypass but it was medically contraindicated for me and the sleeve was my only option. I was disappointed at the time but it all worked out well.

I have accepted tgat my future eating habits will never look anything like my old eating and tgats how I got to 313 in the first place. Tge surgery really is just 1 tool to help you reach your weightloss goals. I don't eat a lot of carbs at all, less than 60-65 grams a day 70-75 if I exercise that day. I don't really do Keto as we can't have all that high fat and its not healthy long term. I just find creative ways to satisfy my favorite food cravings and whatever I "think" I can eat I put half that on my plate. If you eat sugary starchy foods more & more gradually on the regular you will decrease the amt that tgey bother you or cause dumping thus making it easier to incorporate them daily and putting weight back on. I lose 2.7 lbs a week on avg on about 600-800 cal a day but my day is mostly Protien then veggies with healthy fats and a small amt of fruits and carbs. I have been speaking with a councelor ev 2 weeks and my Nutritionist every month to make sure I stay focused, satisfied and don't make the wrong choices destroying my chances of success. Snacking is my biggest issue, sugar free candies, Skinny pop corn, popsicles, beef Jerky, cheese sticks etc. I had to get all Snacks out of my room, car and severely limit the amt I buy myself. I can easily stall if I snack on the wrong foods.. I had an eating disorder in my 20s and I had to totally rebuild my relationship with food, its still hard but being disabled and in pain daily was harder.

- if both surgeries are just as easy to fail as they are to succeed, why do the research charts show this difference?
Research is based on averages. The numbers you are quoting do not apply to everyone in exactly the same way....it is an aggregate of those who reach goal AND those who don’t. 1 person loses 100 lbs. Another loses 40 lbs. Average weight loss of this “control group” is 70lbs...which is no where near what each person actually lost. @catwoman7 probably explained this better than me In her earlier post, lol
Second, if you need to rely on averages for your peace of mind, it may be worth your while then to look into the makeup of the studied. Age, gender, starting weight, lifestyle habits, medical conditions, genetics, etc. Daunting, yes, but more informative and contextual.
But really, wanna beat the average? Stick to plan more consistently than the “average” person (barring any medical conditions of course).

Also, I wanted to ask, did you get to choose the size boujie you wanted for your sleeve or know what size Dr used for you??
Doc just did his thing with no input from me. I have no idea how what size he used!

Also, did you cravings and hunger completely return after 6 months or it does but slightly?
My hunger levels and occurrences has not returned to pre-op levels. I can’t remember when I first felt hungry though (it was months in)...but I do remember it was a rare occurrence. Even now at 2+ years out, i still have days of just not wanting/forgetting to eat. When i do get hungry, it isn’t the ravenous kind of hunger though. And it doesn’t take much to satisfy it.

Lastly, can you just do complete Keto during the first year after surgery so you stay under 20 net carbs and in ketosis? Or our body doesn't need to be in fat burning mode because of the surgery?
I didnt do full-on Keto during weight-loss phase because there was no way I could get in the percentage of fat required...but I did do ultra-low carb (20 net carbs max) during that time.
But number of grams of carbs consumed is no where near as important as total calories consumed for weight loss. Though going low carb does tend to make me look lean. For my body this is good, cuz i can see more muscle definition, but for my face, not so good, as I look Skelator-ish. Since I have been consuming a higher number of net carbs (anywhere in the 100-175 range) my face looks much nicer, but the bod looks “soft”

P.S. sorry this was so long

Not a psychiatrist but Vyvanse is slow release Dexedrine or Dextroamphetamine. I was put on Dexedrine when diagnosed with bad ADHD at 14 and no other ADHD med, including Vyvanse, has worked for me since. I totally get that part. You'd have to talk to your doc about Dexedrine (the capsules are way better than the tablet for me personally) and everyone is different. Since its not extended release, I take it twice a day. Just thought I'd mention it as an alternative to Vyvanse that may work with the bypass. Good luck to you!

I did A LOT of research on this and I found my best option was R&Y & Im so glad I did it. I wanted the extra restrictive requirements, responsibilities and accountability for attention to my diet requirements. It's quite a commitment either way, a lifelong change to better your health. However R&Y route is a bit more intricate and to go that route does require some discipline and commitments like the taking of supplements for the rest of your life, I don't mind because they don't bother me and I've found affordable ones I like. I lose about 2.7 lbs a week and I have very little that I cannot eat, real sugar and snacking are my 2 nono's.. Dumping syndrome is no joke and makes you feel quite crappy, like the flu but worse and verry sudden, so the knowledge that if you eat too much, too fast, drink with food or the wrong foods you'll feel like absolute crap keeps me in line and accountable as well.
I seem to see a lot more ppl getting revisions these days too that had Sleeve vs R&Y (In my opinion) so its really about looking honestly at your personal relationship with food, discipline level and weighing out the pros and cons of each procedure for you Personally. Msg me anytime!

One other piece of advice I have is that you are focusing on the all or nothing approach that isn’t going to serve you well long term. Let’s pretend you only lose 90% of your excess weight. Isn’t that a heck of a lot better than where you are at now?

I started off at over 48 BMI and 339 lbs. I had 174 lbs to lose to get to goal. I knew this was a huge amount so one thing I did to help myself was I committed early to losing weight. I lost over 50 lbs before surgery by sticking to low carb, and I just hit 90 lbs overall right after my two month surgery-versary. I’m over halfway there, with 84 lbs remaining. If you’re worried about the honeymoon, you have control over that. Start today, because every pound you lose now is weight you don’t have to lose later. And stop worrying about averages or anecdotes. You aren’t an average, you’re one person being given a tool that you can do amazing things with, or you can waste entirely. The success is about the person.

I had hunger and cravings early on with my bypass, but the restriction and religiously following the Protein first mantra prevented me from indulging. The physical hunger is unpleasant now with a shaky, nauseous, generally yucky feeling. Head hunger is real and annoying. I mostly choose to not listen to the head hunger. 🤷‍♀️ If you follow the protein first rule, it is almost impossible not to be in ketosis at first. As soon as I had room I added in some carbs though (mostly fruit), as I did not want to stay in ketosis. I can’t stand the body odor when I am in ketosis 😂 I exercise a lot and lost 100% of my excess body weight in just over 6 months. I am in what I will label as the vanity phase, as I work towards my chosen goal of 150 pounds. Ultimately, I actually want to get to 135-ish so I have a little cushion for bounce back. I chose bypass due to a 15 year history of GERD. My surgeon generally pushes for sleeve, but agreed with my desire for bypass due to GERD. I think either surgery would have been effective, but I did not want to have a revision if my GERD got worse.

I hope some of that helps. 😊

most people lose their sense of hunger for several months. And when it comes back (it doesn't always, but it does for the vast majority), it's usually not as intense as it was pre-surgery. As for dealing with cravings, a lot of WLS patients work with therapists on that (I never have, but many people do...)

K, I'm going to echo what was said by several posters: its not the surgery that dictates success, it's the individual.
I was sleeved over 2 years ago. I chose sleeve because:
The idea of re-routing my intestines freaked me out (but for some reason removing most of my stomach didn't. LOL) I wanted to keep my pyloric valve intact, as I was taking NSAIDS and another time-release med (but surprise, surprise I ended up not needing them anymore after surgery) I was scared of dumping syndrome (again, suprise, surprise, I dump anyway) I was NOT prone to GERD My surgeon was completely comfortable doing either surgery on me. I started off at a BMI of 43 (235 lbs). I got to goal of BMI 23 by 7 months post-op. Lost a few more pounds figuring out what my caloric level should be but finally settled into BMI 21, and have been maintaining my weight of 115 (+/- 5 lbs) for over a year and a half. I am 2 years, 3 months post op. I have stayed below my goal weight (more than 100% excess weight lost) the entire time.
I have read accounts from other sleever's and rNy'ers similar to mine. I have also read accounts from both sleever's and rNy'ers who reached goal and regained, or never reached goal at all....I also don't see an obvious co-relation of results to the type of surgery underwent. (On another note, I have to date only read of ONE person who was more than 2 years out who was under BMI 18 AND had difficulties keeping weight on...but I digress).
Barring any medical issues, so long as you maintain a caloric deficit, you should expect to lose the same amount of weight with either surgery.
Good Luck!

You need to look at the statistics from large research studies and not base it on what you see on the boards. Long time vets who are still hanging out here after several years post-op are likely to be patients who were very successful. And it could be that for many if us, staying active in the bariatric community might be one factor in our success.
The statistics show that the average RNY patient loses about 70% of their excess weight, and the average VSG patient loses about 65%. Most patients end up somewhere around that peecentage. Of course you will always find people who end up above or below the average, and some WAY above or below that. The percentages get smaller the further you get away from the average. A 100% loss is a couple standard deviations from the mean, so you're not going to find a ton of people who end up there.
My surgeon discouraged me from my goal of 100% loss, saying that only about 10% of his patients make it the far. But, i did it. And so did a few others from my clinic. But we're not the norm.

I've checked the research. Studies show that about 10-15% make it to a normal BMI. Most end up overweight or class I obese (both of which are infinitely better than weighing 300+ lbs). But some of us do make it. But it takes some serious commitment and hard work. You can do it.. but it'll take a lot of dedication and effort.

I echo that it is a mindset/attitude battle and what Ms. SSS said. I started with very similar stats to you, I am 5'7 as well. I discussed it with my surgeon and he echoed that the individual dictates the success and not the surgery. I chose the sleeve because:
Like Ms.SSS said, I didn't want to have my intestines messed with. It freaked me out. My surgeon said I would lose roughly the same amount of weight either way, if I followed their plan. I am not prone to GERD and did not want to spend extra time under anesthesia. I didn't want dumping syndrome. Thus far, I don't think I have experienced this yet. Things have set wrong in my pouch but that's about it. I specifically asked them in depth would I be able to lose the weight that I wanted and they confirmed, yes. The surgeries are much more advanced than even 4-5 years ago. There is no 18 month window where you start to regain. If there was for everyone, then why would anyone ever do this? The 18 months is a honeymoon period, as someone else said. In either surgery, you will have to have discipline. This isn't a miracle cure. Both can be stretched back out. Anecdotal experience isn't indicative of success or failure. If that were true, all the RNY friends that I have regained almost all their weight back (both were over 400lbs) while my one sleeved friend has kept it off. I don't think that means RNY doesn't work. They just fell back into poor eating choices and never truly changed their mindsets. They thought it was the easy way out and it's not. Gastric sleeve has been the right choice for many, myself included.

Whatever you choose in the end, know that it has to be mentally first and it is basically a reset to unlearn bad habits, train for good habits, and give you 6 months to a year head start on your weight loss. Just like with anything, like Mando said, the success is your choice.

most of the ghrelin is produced in the lower part of the stomach. The area where most of it is located is removed during sleeve surgery. None of the stomach is removed during RNY, but since the lower stomach isn't really used anymore (or at least not for processing food), the ghrelin isn't really accessible. However, I'm honestly not sure if it the ghrelin that lives in your lower stomach gets into your system regardless (and thus causes hunger) or not for those who've had RNY. Although some ghrelin is produced in the upper part of the stomach, too, so with either surgery, there will be SOME ghrelin in the stomach. I'm just not sure what continuing effects it has if it's still physically there, but mostly in the part of the stomach that's not being used to process the food anymore. Maybe one of the medical people on here will know the answer to that. BUT....RNY people do lose their sense of hunger for awhile, too. Most of us, anyway. It's typical to lose it for anywhere from a few months to a year out.

I lost my hunger for five months. Some people don't get it back until they're a year out.

those percentages are averages. And as with all averages, there are people who fall on either side of that range. You'll find people on here who've lost 90% or 100% (with either surgery) and you'll find people who've lost 20% or 30% (with either surgery). It all comes down to how closely you stick to your program. If you stick to it and don't let bad habits creep back in, you'll do fine and will likely lose more than average.

as for missing hunger control when revised to bypass - I definitely had hunger control with my bypass. I don't think you can compare a revision to a "virgin" surgery.

I didn’t start at as high a bmi as you but I still thought I’d share my experience so far.
I chose sleeve with my surgeon’s support, even though I suffered from stress related gerd. Yes, I have some issues but manage it with medication. I chose sleeve surgery because it doesn’t change the digestive tract as much as other surgeries. Yes my stomach is smaller but it is the same length as it was as are my intestines. I think this is why absorption is not as great an issue with sleeve. My nutrient absorption is good. I haven’t taken Multi Vitamins since I reached my goal a year ago & my blood work come back fine.
Yes, bypass patients do tend to lose weight more quickly to begin but the 5 year average of weight lost & maintained across both surgeries is about the same - 60-65% of the weight initially to be lost. Dr Vuong has a great video that explains this very well. Think it’s called how to maximise your weight loss.
The amount of weight you successfully lose & maintain really comes down to the individual. Even though I’ve exceeded my original goal (lost about 135%), I’ve had the view that I would find a place of balance between maintaining my weight & maintaining my lifestyle. I believe that if you restrict your food choices & intake to a point you can not enjoy your life & the things you like to do your diet will fail because you will consciously or subconsciously revolt against the restrictions you employed. Honestly, my diet is still pretty restrictive but I’m not quite 2 years out so I have a long way to go to find the balance of what works for me.
Currently, I eat low sugar & artificial sweeteners, low fat, moderate carbs (whole or multi grains but no breads, rice, pasta), fruits, vegetables & of course I’m Protein & Portion Control focussed. I have the odd glass of alcohol but I often don’t finish the glass. It’s easy to manage & doesn’t affect how I socialise so far.
The Keto debate is an interesting one. My 3 week pre surgery diet was keto but I know I could not maintain the high fat requirement long term but that is me - I don’t like overly fatty foods. But it certainly gave me a kick start. There is research that says the high fat content causes cholesterol problems. There’s research that shows that while it may help people with diabetes to begin, long term it can cause erratic insulin levels due to the low carb intake. And of course there’s research that it’s great. I think you have to find the diet that works for you.
Good luck whichever surgery you choose.

Yup, I got an ulcer in the first year. I don't smoke, don't drink alcohol at all, no caffeine at that time, so soda - absolutely no risk factors, but there it was. Doc thinks maybe one of the stitches didn't heal well and caused a spot for irritation, Anyway, a couple of months on omeprazole and that was done. Never had a problem since. I drink small bits of Decaf coffee now, but not much. No alcohol, no soda.
I also developed blood clots in my legs about 10 days out. Again, no risk factors except obesity, major surgery and varicose veins. I was out of bed walking the halls within a few hours after surgery and doing 10,000 steps a day by day 7. 3 months on a blood thinner that that was done. However, I developed phlebitis in those darn veins again just a couple of weeks ago. So I think I just need to have the veins taken care of with an ablation.

no. I've never had any issues with mine.

I personally can't eat a ton of fat at one sitting, but I do know RNY "vets" who eat Keto, so evidently it's do-able!
There's no general requirement to keep fats low with either surgery, that I'm aware of. Programs vary a lot, but they all seem to be fairly high Protein. Some programs are also low carb, but not all (mine was pretty balanced - and I eat a pretty well-balanced diet now, at almost six years out). I don't think most programs have much to say about fats. It seems like everyone talks about protein - and many (but not all) about carbs.

P.S. if you are talking stomach volume, I can definitely eat a lot more than I could the first few months post-surgery, but not nearly as much as I could pre-surgery. For example, pre-surgery I used to be able to eat half a large pizza at one sitting. No way could I do that not - it'd be physically impossible. I can manage 1-2 pieces, though.

also, AZHiker mentioned GERD/heartburn - yes, if you have that, you should seriously consider getting RNY as VSG could make that worse (not guaranteed, but it happens to enough people that they'll usually warn you against that). Otherwise, it pretty much comes down to personal preference. You'll find success stories with both - and unfortunately, failures with both (as long as you're committed to the rules, though, you'll do fine with either surgery)

also, yes - you may have to change a few of your meds....but it depends. Most meds are fine. Extended release versions usually have to be replaced with something non-extended-release, though. They should be able to find a substitute for you if the one(s) you take aren't going to "work" after RNY.

And you may well find that you will not need a lot of your meds after surgery, including antidepressants. Did you know that most of your body's serotonin and dopamine are actually made in the gut? The gut biome is extremely important in regulation of so many functions, and all that is going to change. You are going to lose all that stored estrogen that is hiding in fatty tissue, and your gut biome is going to get an overhaul as you eat healthier foods.