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High BMI and sleeve



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Hi, I am from London, England and have been lurking around reading posts on this wonderful website for a few weeks now. I am really grateful to you all for posting it is so very helpful to us pre-opers.

I have noticed that many of you (if not all) have starting BMI's of under 40.

I was wondering if there is anyone here who had a BMI over 40 and has had satisfactory weight loss with the sleeve. My BMI is 41. The sleeve is my choice of surgery but my surgeon would prefer me to have a bypass. His reasoning is that the bypass is reversible and that he doesn't think I would achieve a satisfactory weight loss with the sleeve. I have a huge amount of respect for my Surgeon and so am trying to make sense of his advice and reconcile with my views.

I really don't want a band or bypass because I would like everything to function as it should but on a smaller scale. I am a volume eater and also binge sometimes.

Purdy

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Hi, I am from London, England and have been lurking around reading posts on this wonderful website for a few weeks now. I am really grateful to you all for posting it is so very helpful to us pre-opers.

I have noticed that many of you (if not all) have starting BMI's of under 40.

I was wondering if there is anyone here who had a BMI over 40 and has had satisfactory weight loss with the sleeve. My BMI is 41. The sleeve is my choice of surgery but my surgeon would prefer me to have a bypass. His reasoning is that the bypass is reversible and that he doesn't think I would achieve a satisfactory weight loss with the sleeve. I have a huge amount of respect for my Surgeon and so am trying to make sense of his advice and reconcile with my views.

I really don't want a band or bypass because I would like everything to function as it should but on a smaller scale. I am a volume eater and also binge sometimes.

Purdy

Hello Purdy... welcome to the forum!

Bypass is reversible theoretically but if you have bypass you have to assume it will be permanent. It is a very difficult procedure to reverse bypass and many times it cannot be done. I'd say most times it should not be done.

Your BMI is 41, it's really not all that high. When I think of a high BMIer I'm thinking 70+BMI. I was banded with a BMI of 41 (hardest surgery to lose weight) and I lost 100% of my excess weight.

Bypass is a harder surgery. Harder recovery, harder maintenance, harder on your body, and a lifetime of aftercare. It's great for some people but it's not my cup of tea.

There are many sleeved folks that are higher BMI folks and they are doing very well with a sleeve alone.

If you get bypass and fail (as one in five do) your options for a revision are poor. If you fail with a sleeve your options for a revision are wide open.

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I am a band to sleeve revision, so my situation is a little different, but I'll chime in with my opinion.

I started the sleeve surgery with a BMI of 47. My surgeon believes that the sleeve is successful for patients who are volume eaters, and those who had success with a restrictive procedure only. I lost weight with the band initially, then gained once I started having complications. I've never heard of the bypass being reversible. I'm 23 days post-op and have lost 25lbs.

The sleeve was my best option. Another surgeon that is a colleague to my surgeon talked to me right before surgery, and told me that he would of recommended a band to bypass revision. I told him, but you know nothing about me, my eating habits, my lifestyle, or my weight loss goals. He said well most people would want it that way, and I replied with there are plenty of people who do not want bypass, and I'm one of them. I didn't want to deal with malabsorption and the weight regain stats of the bypass are a cause for concern in my opinion.

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A BMI of 41 is not considered high and many patients here can't get weight loss surgery paid for if their BMI is less than 40. I was 295 pounds and lost 10 pounds on the pre-op diet putting me at 285 the day of surgery. The last time I weighed (weekly), I was down 27 pounds from the date of surgery and 37 pounds overall. You'll do great with the sleeve if that's what you choose to do.

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My BMI was 41 when I started looking in WLS. It was lower when I had the surgery but that's because it took 7 months and I lost 32 lb. during that time.

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There are a lot of people who have a bmi way over 41 and have lost all the excess weight.

The sleeve is going to take over the by pass in years to come in my opinion. So many people with bypass gain their weight back. There is no reason to have a procedure that causes malabsorption when the sleeve has just as good weight loss.

You will do great with a sleeve. You have come to the right place! We all love our sleeve and you will too!

Welcome to sleeve talk!

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Thank you all very much for your replies. You have reassured me that I have made the right decision. I am still a little puzzled about the advice from my surgeon but I think his doubts are based on his lack of experience of the sleeve as a stand alone procedure. Four years ago I almost had a band fitted and backed out at the last moment. My children were then very young and I probably just wasn't ready. I have also tried many, many years of analysis (v. unusual in uk) but don't seem to be getting anywhere and I feel that life is passing me by. I am so glad I didn't have the band. I would probably still be here asking about the sleeve!

This forum is great!

Thanks again.

Purdy

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Chances are if you would have gotten the band, you be getting a revision surgery to a sleeve like so many of us here.

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i know you might not ever read this but my bmi is 51 and my doctor is letting me get sleeve

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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    • KimBaxleyWilson

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
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