I just made an account to answer this. I am two and a half weeks post op from gastric sleeve. I too have PCOS. I am 37 years old and my highest weight was 330. At surgery and after the pre-op diet I was down to 305. I'm currently 289 today. My comorbidities were hypertension, high cholesterol, newly onset GERD, and insulin resistance. (never made it into the diabetic range).
I watched a ton of videos on youtube after I decided to have surgery. I watched the testimony of patients ranging from a few weeks out to twenty years. I also listened to bariatric surgeons discuss the process, pitfalls, and successes.
My PCP had been talking to me about this surgery for three years and at first I declined because of all the people I knew of that experienced full weight regain. I only decided to have the surgery when I had determined that not being able to eat as much and what I want all the time was a small price to pay for my health and quality of life.
Some things to consider between sleeve and bypass. Myth: Bypass patients are much more successful at keeping weight off. The sleeve is a newer surgery and was discovered as the first part of the duodenal switch. The 5 and 10 year outcomes for weight loss and regain tend to be around the same with the bypass slightly better.
The sleeve is less punishing and is easier to 'stretch' out with poor eating habits but it can be done with the bypass as well. Overall, a change in relationship with food is a higher predictor of sustained weight loss than either surgery. The Switch is the surgery with the most rapid weight loss and sustained loss without regain but it is a heavily malabsorption procedure, carries the most risk of post operative complications, including dehydration and vitamin deficiency and requires a very strict regiment to sustain a healthy lifestyle. It can also result in some interesting bowel changes. Too rapid weightloss can also result in gallstones. Quite a few bariatric patients have had gallbladder removal after surgery. It should be noted that actual operative complications are low for all surgeries but not zero.
Another controversial topic of sleeve vs gastric bypass is that the bypass is better for GERD. There are contradicting experiences for both surgeries. One thing is for sure you can certainly still have GERD with the bypass, although it seems revision from sleeve to bypass has worked to cure GERD for a lot of people. My GERD was very mild before surgery and so far I have not experienced any after. I am on a daily dosage of omerprazole but that's nothing new to what I was taking before. My triggers for GERD were fried foods and canned tomatoes. I know to stay away from that now.
Keep in mind that the bypass is reversible in most cases while the sleeve is not. Also, the sleeve can be converted into a bypass or switch if complications arise or you fail to lose or sustain a meaningful amount of weight. There are very few options for bypass and switch if regain occurs outside of dietary changes, exercise and will power.
Bypass patients can no longer consume NSAIDS, steriods, and possibly other medications after surgery for life.
Switch and Bypass patients are more likely to experience dumping syndrome but Sleeve patients can also suffer from it.
Constipation, diarrhea, and blockages and strictures can occur with all surgeries. Very minimal risk for long term serious complications.
I have read quite a few posts that spoke about pain after surgery with the sleeve. Speaking for myself the only pain I experienced was gas after surgery from the surgeon introducing it into my abdomen during the procedure. I was given liquid pain meds but never took any, and no otc pains meds either. I felt discomfort from the surgery port sites for maybe a week. After that I was good.
My surgery team has stayed on top of any side effects that could occur after surgery and I was very lucky. They gave me medicine for nausea before surgery, put an anti-nausea patch behind my ear also before surgery and discharged me with anti-nausea dissolveable meds. I took the meds for about a week though I never experience sickness and still luckily have not. I was a water drinker before surgery and can still easily drink water without any pain or nausea. Cold or hot temps don't seem to upset my stomach though some have reported either can cause pain. I am on the puree stage and things are going well.
Really, experiences vary. I'd choose a doctor carefully and if possible speak to prior patients to get their experience pre and post op. I was lucky my Aunt had the procedure done the year before and could report on her experience. We chose the same surgeon. He had a 98% success rate.
So after this long-winded wall of text I choose a sleeve because:
I wanted a slower and steady weight loss.
I did not want to re-route my insides. Had a co-worker suffer a bad bowel blockage with a bypass and had to have part of his intestine cut out.
I did not want restrictions on not being able to take certain pain or treatment options should they become necessary in the future.
I did not feel I have a dependent relationship with food. I ate too much of it. And sometimes the wrong things because they were easy and accessible. But I also enjoyed a lot of healthy foods. My kryptonite has always been lack of exercise and even skipping meals so that I overate when I did eat. I'm from the finish your plate generation, but I did not and do not rely on food for comfort, bordem or pleasure. Therefore, I felt and still feel that the more punishing procedures were not right for me.