Originally I wanted the DS, it is covered by my insurance but there is no surgeon in network that does it. I have exhausted all of my appeals including IMR which I will have the decision at the end of this month. I am approved for RNY Or Vsg. If Ds Is completely off the table for me VSG will be my choice. My question is: At 330lbs, what are my chances of getting to my goal of 170? and more important what is the % of regain?

I am sorry but I won't be of much help but I am in the exact opposite situation. Insurance will most likely deny my pre-auth for VSG but will cover DS. I plan on fighting for an appeal if I am denied but I hope I can be considered a candidate for DS if I am unable to get the VSG.

I think the insurance bean counters have screwed the pooch on this one

Your chances of getting 160 pounds off are totally, completely, 100% excellent as long as you follow through! We've see people lose well over 200 lbs with the sleeve alone. The trick is, when you get a few months out from surgery, keeping those old bad habits from creeping back in (trust me on this one!) until you're at goal.

Once in a great while you'll see someone come back to the boards at 3-4 years out, who has gained back 20 or so pounds, but they generally hold themselves fully accountable and know what they need to do to get it back off, and that's just getting back to the basic plan that let them shed all the weight in the first place.

As far as regain goes, I don't have links handy but research shows a LOWER rate of regain with VSG vs. RNY. There appear to be two big reasons for that: First, the stretchy portion of our stomachs is gone, which is where the majority of ghrelin is produced, whereas the RNY pouch is made from the stretchy part, and they don't have any of the remnant stomach removed, so they still have that hormone there making them hungry and possibly compelling them to eat when they don't need to. And, their pouch is stretchy, and can (and does) get bigger over time, to where they can pretty much eat normal-sized meals.

Plus, they have the advantage of caloric malabsorption for a year or two, so for awhile they can eat what they want and still lose weight... sounds great, but when that malabsorption comes to and end, many of them have never changed their bad habits. Unfortunately, the nutritional malabsorption is forever.

So basically, with your tight little un-stretchy sleeve, you physically will never be able to overeat again (although as with ANY wls, you'll still need to be careful about WHAT you eat)... your chances for long-term success are excellent with the sleeve. I don't know if you're a member at obesityhelp.com, but on the VSG board there, you'll find lots of sleevers who have lost 150-200 lbs or more and are doing great.

I am sorry but I won't be of much help but I am in the exact opposite situation. Insurance will most likely deny my pre-auth for VSG but will cover DS. I plan on fighting for an appeal if I am denied but I hope I can be considered a candidate for DS if I am unable to get the VSG.

I think the insurance bean counters have screwed the pooch on this one

Now stop me if Im wrong, but isnt DS a two part surgery? Months apart? What if you get approved then get the first part, then just never get the second part?

I think feedyoueye has a great idea. Put off the 2nd surgery until you know that you do not need the second part of the surgery. I am sure if you show great progress with just the sleeve your doctor will not continue with the second part.

Lily

Now stop me if Im wrong, but isnt DS a two part surgery? Months apart? What if you get approved then get the first part, then just never get the second part?

Feedyoureye,

Yes, it can be done as a two part surgery but my insurance excludes the DS as a two part surgery. The only way they cover it is if it is done as one complete surgery. I am not terribly high on the BMI scale but I do have a comorbidity that qualifies me for WLS. I would love to just get the VSG since I think it will be a very successful tool for my weight loss. If I am unable to win my appeals for the VSG then all that I have left is the DS since the band and rny are out of the question.

Feedyoureye,

Yes, it can be done as a two part surgery but my insurance excludes the DS as a two part surgery. The only way they cover it is if it is done as one complete surgery. I am not terribly high on the BMI scale but I do have a comorbidity that qualifies me for WLS. I would love to just get the VSG since I think it will be a very successful tool for my weight loss. If I am unable to win my appeals for the VSG then all that I have left is the DS since the band and rny are out of the question.

You do know that the DS is basically the VSG + RNY? I'm just asking because you wrote that RNY is out of the question.

You do know that the DS is basically the VSG + RNY? I'm just asking because you wrote that RNY is out of the question.

Actually the bypass portion of the DS is very different than the bypass of an RNY.

I stand corrected, the bypass portion of the DS is a distal bypass which can be done with an RNY. I guess what I meant to say is that what I find out of the question is how the stomach is dealt with in an RNY procedure.

Edited November 14, 201015 yr by Nillawaferz

mousygirl73

i don't mean to come off offensivley or anything like that but i implore you to really look into the DS because i have a friend that had it done and yes she has lost a ton of weight. she was like you 328lbs she had DS surgery 12/16/09 and she is down to 163lbs as of a month ago it may be a little more than that. the problem is not that she can't loose weight she does not look healthy and she knows it. the wieght came off too fast, it made her look older, she tired all the time, she always always always in the bathroom because the way that surgery is ten minutes after you eat you have to be very close to a bathroom if you know what i mean. she can't stop losing weight mind you she eats whatever she wants i do mean what she wants. she has not done once ounce of exercise and has lost half her body weight in less than a year. now this may sound good but it's not because the weight came off so rapidly it aged her a lot and she is afraid she will waste away to nothing because she eating but she is still losing wieght and she doesn't even want t lose anymore but it is simple out of her control. i know each person is different but i urge you to seriously think about the DS.

thickinphilly.

mousygirl73

i don't mean to come off offensivley or anything like that but i implore you to really look into the DS because i have a friend that had it done and yes she has lost a ton of weight. she was like you 328lbs she had DS surgery 12/16/09 and she is down to 163lbs as of a month ago it may be a little more than that. the problem is not that she can't loose weight she does not look healthy and she knows it. the wieght came off too fast, it made her look older, she tired all the time, she always always always in the bathroom because the way that surgery is ten minutes after you eat you have to be very close to a bathroom if you know what i mean. she can't stop losing weight mind you she eats whatever she wants i do mean what she wants. she has not done once ounce of exercise and has lost half her body weight in less than a year. now this may sound good but it's not because the weight came off so rapidly it aged her a lot and she is afraid she will waste away to nothing because she eating but she is still losing wieght and she doesn't even want t lose anymore but it is simple out of her control. i know each person is different but i urge you to seriously think about the DS.

thickinphilly.

I am so tired of fighting the insurance company. The VSG was my second choice and I am already approved for it. My only worry is not getting to goal. I just wanted the biggest baddest tool I could get..LOL I know I can rock the VSG, be vigilant about food choices ect.. I just want it done, my journey to WLS has been going on for 2-3 years. I wasted so much time being overweight and unable to participate in life..I just want to be healthy. I did lots of research into the DS, I know the pros and cons.

Thank you to those who replied. I appreciate all the advise an encouragement I can get:)

Good luck with whatever you decide to do. I briefly considered the DS, but my surgeon doesn't do it and I've seen some people say that they've lost too much weight. It's great that we have so many options and everyone can pick the surgery they think is right for them.

Good luck on your journey. The VSG has worked great for me.

Your chances of getting 160 pounds off are totally, completely, 100% excellent as long as you follow through! We've see people lose well over 200 lbs with the sleeve alone. The trick is, when you get a few months out from surgery, keeping those old bad habits from creeping back in (trust me on this one!) until you're at goal.

Once in a great while you'll see someone come back to the boards at 3-4 years out, who has gained back 20 or so pounds, but they generally hold themselves fully accountable and know what they need to do to get it back off, and that's just getting back to the basic plan that let them shed all the weight in the first place.

As far as regain goes, I don't have links handy but research shows a LOWER rate of regain with VSG vs. RNY. There appear to be two big reasons for that: First, the stretchy portion of our stomachs is gone, which is where the majority of ghrelin is produced, whereas the RNY pouch is made from the stretchy part, and they don't have any of the remnant stomach removed, so they still have that hormone there making them hungry and possibly compelling them to eat when they don't need to. And, their pouch is stretchy, and can (and does) get bigger over time, to where they can pretty much eat normal-sized meals.

Plus, they have the advantage of caloric malabsorption for a year or two, so for awhile they can eat what they want and still lose weight... sounds great, but when that malabsorption comes to and end, many of them have never changed their bad habits. Unfortunately, the nutritional malabsorption is forever.

So basically, with your tight little un-stretchy sleeve, you physically will never be able to overeat again (although as with ANY wls, you'll still need to be careful about WHAT you eat)... your chances for long-term success are excellent with the sleeve. I don't know if you're a member at obesityhelp.com, but on the VSG board there, you'll find lots of sleevers who have lost 150-200 lbs or more and are doing great.

Wow! I am glad I read this post. I have been ALL OVER the place with what surgery to get until about 2 weeks ago. Started on the Lap Band, RNY, DS and now the sleeve. I feel the most comfortable with it and finally feel at peace with my decision. I had wondered which was a better surgery.....RNY or the sleeve. I didn't even realize that the RNY patients still have the "hunger hormone". I didn't realize either that the caloric malabsorption stops but the nutritional malabsorption is forever. I am not a big fan of the malabsorption thing. I don't think they know enough to know what it does to your body over a long period of time. I believe the sleeve is the healthiest way to do a WLS....as long as you have a good surgeon and follow the rules.

Cool! As far as the ghrelin goes, it is produced in other organs too, but not like it is in the stomach... most of us don't lose our hunger completely, and those who do seem to be the ones who stay on a PPI long-term. But I will say that "hunger" post-sleeve is totally different than it was before. Once in awhile (for me at least) there may be an actual hunger pang, but at maybe 10% of the intensity that it used to be. Most of the time, I just kind of sense that it's time to eat something, kinda feeling more empty than hungry, like the gas tank's running low or something. A lot of people go into VSG thinking they'll never be hungry again, but that's just not the case (although it may seem like it for the first few weeks!), but it just has a whole new definition afterward--and it doesn't rule you, you control it. It's super-cool to be able to do that.

No matter what Big Bad tool you get, they will all require work form you. A tool is a tool nothing more, used improperly will quit working.