I have a high BMI of 57 and almost 200 lbs to lose to be in "normal range" (but I would be thrilled to lose, say, 130). I asked on another message board about DS vs VSG. Many DSers flat out told me that I would NOT succeed with "just" a VSG based on my BMI. They made some compelling arguments and provided some studies which were also compelling, but I don't know if they can overcome my fears and worries about the DS. The Vitamin regimen is intimidating, and I don't want to be fighting to keep up Protein and vitamin levels against malabsorption for the rest of my life. But, on the other hand, I don't want to fail. This weight MUST come off me soon - I feel like a medical ticking time bomb.

For those of you with a lot to lose like me - what made you decide to go with the sleeve instead of the DS? (or RNY)

As my username implies, I didn't have either (not the best decision, but I went with what info was available at the time), anyway, if you do go for VSG it's a relatively straight forward procedure to revise to the DS. Note that 2 stage DSers tend to be slower losers as you'll already have had some weight loss.

You *might* not need to revise to the DS which is partly how the VSG came about (ie it being stage 1 of a 2 part DS). If you don't think you can keep up with the Protein and Vitamins that the DS requires then VSG is a good choice.

RNY I don't believe is such a good choice. It's very difficult to revise from (possible, but it has a lot more complications). With RNY you're no longer able to take Non Steroidal Anti Inflamatory Drugs (NSAIDs, eg ibuprofen and who knows if you'll need them in the future). Also you only malabsorb calories for 2 years whereas you malabsorb nutrients forever so you still have to be diligent with protein and vitamins. This is why so many RNYers get regain and then seek revision (think of what Carnie Wilson got down to and then regained back to over 200lbs).

Also 40% of RNYers suffer from dumping, search for it on youtube and you'll soon see it's something you seriously want to avoid (people look like they're dyeing of a heart attack). HTH.

I simply did not want my digestive tract rerouted, the malabsorbtion and dumping that TJP mentions above were the chief reasons besides just the fear of having my esophagus and small bowel completely severed and reattached elsewhere. It also bothered me that the stomach is no longer accessible via a scope down the esophagus and you would have to use a specialist and have the scope passed down into the bowels and back up into the stomach - you'd have to consult a chart to see the new routing of the tract to visualize this. I've had stomach problems in the past, an ulcer and have a family history of stomach cancer. My sister had a bypass and was just in the hospital last week for anemia and was finally scoped the long was around after they had a specialist come in to do it they found that she had a severe bleeding ulcer. This was not diagnosed for days because it could not be easily examined With a sleeve the stomach is still there and the digestive tract is all intact.

EDIT: Sorry, I didn't notice that you specified a DS bypass rather than the more common RNY. With the DS the stomach is left in line and reduced in size like the sleeve (although seemingly not as restricted). Please take the above mentions about stomach being not in line with the fact that this is an RNY procedure.

The sleeve is super simple, fast and effective and as TJP mentions above can be revised to a full bypass if it doesn't have the results you need.

I weighed 375 pounds last December, had the sleeve and now weigh 237 by the next June, in 6 months I've lost more than 60+ percent of my excess weight. I went from a TIGHT 52" waist to a comfortable 38" (close to fitting in a 36"), a 3X top that was bugging in the arm pits to a size LARGE top that fits nicely. It can and DOES work for most.

Go with what you want and feel safe with, no one can make the decision for you.

I admit that I am not diligent enough with the massive Vitamin regimen that is required with a malabsorptive procedure. I had to choose what I could live with vs. what I knew I would fail miserably at. Losing weight is one thing, believe me, I get that. Living with vitamin counts of 20-30 pills a day is absurd in my little world, and there is no way I would do it for the rest of my life.

Those same DS'ers told me I would fail miserably with a VSG only revision from my band. I had a BMI of right at 50 starting my VSG journey, and after 10 months, 138lbs lost, a BMI of 22, I'd like to say that I am by all means a success with VSG as a stand alone procedure.

Plus, I wanted to have another child. Dealing with deficiencies or too high vitamin levels (which occurs with DS'ers as well) was something that I refused to deal with in pregnancy.

I refused to have RNY also. The long term complications and regain stats with RNY were not in my best interest.

I'm 2 years out, maintained my loss for a year before pregnancy weight started creeping in, and today myself and the baby are thriving. I do not have to take in any additional Vitamins or supplements, and have zero issues eating enough calories to support my body and another developing human.

Best wishes in your research. It is very difficult to decide. I had to look at what I was willing to live with 10, 15, 20 years and beyond, not just what could get the weight off the quickest.

I researched a lot for 7 yrs while waiting to get an insurance company to cover wls for me, or to come up with funds to self-pay. This gave me a lot of time to read all the forums, research drs, etc. I actually looked into the DS very seriously. I have seen a certain group of DSers behave like a cult in going to other surgery forums and try to sway new people to the "darkside" as they like to call it. While I totally believe in "paying it forward" and answering people that ask questions, telling people they will fail if they choose any other procedure is wrong. Some of these same people in the group were 5 yrs out from their DS and not at goal yet. Some had regained a little weight back. One had gained 75 lbs. They are requied to take 15-20 vitamins a day as well as sometimes 2 different meds to prevent smelly gas and stool. But they will tell you this isn't common and doesn't happen to most, or they blame it on the persons diet of carbs, which is what they brag about being able to eat with no problems. These vitamins are not the cheap ones, they have to use the more expensive "dry" vitamins. The cost for all these a month are $50-$200. The sad part to me is, some of the folks that spend all their time and $ to keep their labs normal, still sometimes have deficiencies. I am not asking anyone to believe me or go by my research. But you can find it all right on the DS forum at OH. Also check the complications board. Read read read.

I also wrote a well-known DS surgeon back when I was trying to make my decision, Dr Baltasar. I asked him which surgery offered the best quality of life, and which he would recommend to a family member of his own. He said hands down the Sleeve.

If you decide after researching that you still want the DS, I really do wish you the best. I just wanted to encourage you to research yourself and not let anyone sway you or tell you what is best for you, cause only you know that.

Thank you, everyone! Great responses!

I am really trying to visualize my life 20 years from now, or (god willing) when I am elderly. Do I want to have a massive Vitamin regimen? No... For me, another concern is having to stay more strictly away from carbs as a DSer. I'm a lacto-ovo vegetarian. While I can follow a reasonably low carb diet with ease, I can't do an extreme low carb diet because most of my veggie Protein sources also have some carbs (exception of eggs and cheese, but I wouldn't want eggs and cheese to be basis of my lifelong diet).

I have to try to not get caught up in the evangelical DS culture. They make some great points, but some seem to have blind faith in their cause. Some are quite militant about pushing their surgery of choice.

I'd rather end with a BMI of 30 and be able to take just, say, 4 Vitamins a day and eat my normal healthy vegetarian diet (just in much lower quantities) than have an end BMI of 22 and have to take 30 vitamins a day and subsist on eggs, cheese, and maybe even have to start eating meat to keep my protein levels up.

Also, it seems many that have the DS see it as a bonus that they don't absorb much fat calories. That means they can enjoy lots of butter, mayo, heavy cream, etc. But to me, that isn't a bonus. I've never ever had a taste for high fat foods. So what some people may see has the best part of a DS diet, I honestly just see as .... well, "ewww." LOL!

I have a high BMI of 57 and almost 200 lbs to lose to be in "normal range" (but I would be thrilled to lose, say, 130). I asked on another message board about DS vs VSG. Many DSers flat out told me that I would NOT succeed with "just" a VSG based on my BMI. They made some compelling arguments and provided some studies which were also compelling, but I don't know if they can overcome my fears and worries about the DS. The Vitamin regimen is intimidating, and I don't want to be fighting to keep up Protein and vitamin levels against malabsorption for the rest of my life. But, on the other hand, I don't want to fail. This weight MUST come off me soon - I feel like a medical ticking time bomb.

For those of you with a lot to lose like me - what made you decide to go with the sleeve instead of the DS? (or RNY)

My PCP recommended that I check into the VSG. He said that it was the least invasive surgery and that it was only five years old but of all of the patients that he has had that had WLS the sleeve was the one that he has had the least amount of patients with problems. I highly respect his opinion and decided to check into the sleeve through this site.

Thank you, everyone! Great responses!

I am really trying to visualize my life 20 years from now, or (god willing) when I am elderly. Do I want to have a massive Vitamin regimen? No... For me, another concern is having to stay more strictly away from carbs as a DSer. I'm a lacto-ovo vegetarian. While I can follow a reasonably low carb diet with ease, I can't do an extreme low carb diet because most of my veggie Protein sources also have some carbs (exception of eggs and cheese, but I wouldn't want eggs and cheese to be basis of my lifelong diet).

I have to try to not get caught up in the evangelical DS culture. They make some great points, but some seem to have blind faith in their cause. Some are quite militant about pushing their surgery of choice.

I'd rather end with a BMI of 30 and be able to take just, say, 4 Vitamins a day and eat my normal healthy vegetarian diet (just in much lower quantities) than have an end BMI of 22 and have to take 30 vitamins a day and subsist on eggs, cheese, and maybe even have to start eating meat to keep my protein levels up.

Also, it seems many that have the DS see it as a bonus that they don't absorb much fat calories. That means they can enjoy lots of butter, mayo, heavy cream, etc. But to me, that isn't a bonus. I've never ever had a taste for high fat foods. So what some people may see has the best part of a DS diet, I honestly just see as .... well, "ewww." LOL!

Even though I am one of the most carnivorous women I know in my circle of friends, I can completely relate to you in regards to the high fat content of their diet.

I do full fat foods like Peanut Butter, nuts, salad dressings, and avocados/guacamole, but I've read the posts of what they eat daily and I swear I could feel the "fat film" glazing over my mouth just by reading their posts.

DS definitely has it's place, and for the right patient, I'm sure it works fabulously.

Do you eat seitan, tempeh, and/or tofu??? I went through a stage where meat just wouldn't work all that great. I ate seitan for a few weeks, loved it, tempeh was "alright", and tofu is still something I enjoy.

I also made the comments on a post about DS vs. VSG about how if I had to choose, I would definitely choose lugging an extra 40 pounds around and being in the "overweight" BMI range vs. living the DS lifestyle. I can accept a higher BMI vs. the complications and long term rigorous vitamin/supplement regimen that comes with DS. For me quality of life at 160lbs is way better than battling deficiencies.

Keep researching, lean on your surgeon, and a nutritionist. I wish you all the best, and know all your diligence now will serve you well post-op.

The sleeve was the only choice for me. And as you see I am 4 months out and down 80 lbs. I am aiming to lose over 100 lbs for the 6 month surgiversary (and I know I will make it).

It all boils down to what do YOU feel most comfortable with. Just know that you can revise from the sleeve to the DS, but you can not change from the DS to the the sleeve.

I have a high BMI of 57 and almost 200 lbs to lose to be in "normal range" (but I would be thrilled to lose, say, 130). I asked on another message board about DS vs VSG. Many DSers flat out told me that I would NOT succeed with "just" a VSG based on my BMI. They made some compelling arguments and provided some studies which were also compelling, but I don't know if they can overcome my fears and worries about the DS. The Vitamin regimen is intimidating, and I don't want to be fighting to keep up Protein and vitamin levels against malabsorption for the rest of my life. But, on the other hand, I don't want to fail. This weight MUST come off me soon - I feel like a medical ticking time bomb.

For those of you with a lot to lose like me - what made you decide to go with the sleeve instead of the DS? (or RNY)

Well just check out my weight loss. . . I have about 30 more to lose and have done it all without the DS. So based on that statistic I don't believe you NEED to have the DS, RNY. Sleeve worked just fine for me. But the decision is yours. Good luck!

Wow, great topic. I wish I had something substantial to add. I am 21 years old, and I can't see myself living with the DS. The surgery itself seems to work, but the side effects of the surgery like smelly, smelly loose stools, high fat diets, and malabsorption just do not appeal to me for the rest of my life. But I wish you the best luck in making a decision!

SomethingClever - in case you miss it in my signature, let me say up front that I don't have VSG. I am considering (very seriously) VSG as a revision to my current AGB, which has slipped.

Pre-op I weighed in the neighborhood of 385. I'd guess a little more, because that was when I was weighed at my initial consultation. The hoops took several weeks, so it's entirely possible my actual day of surgery weight was higher.

For me having had a restrictive procedure and now considering another restrictive procedure is all about the restrictive. I do not want a malabsorptive procedure right now, nor did I back then. Maybe if I were older, or had comorbidities, or were in a "lose weight or die soon" situation (not that that's separate from comorbidities, but it has much more urgency), I would consider a malabsorptive procedure -- but not until then.

Between RNY or DS I would pick DS, even though I wouldn't want it. I know a few DSers and it has actually worsened their eating habits. Don't get me wrong, they've lost a lot of weight, but they are not eating healthy. "If I want a Krispy Kreme, I have it, and just have really stinky poo afterward." DSers are also a population a bit "known" in the online WLS communities for being excited about carbon packs for their underwear. That's not a joke. A dear friend of mine had RNY around 2004. As she put it a few years ago, "I'm just now starting to see the consequences of living with this thing long term."

With any procedure, you're going to (I won't say NEED but I will say do best with) supplements... Vitamins, Protein, Calcium, B12 complex, etc. I used to add in a few more but those are the staples.

As for being able to lose without DS... like I said, I was about 385 when I had my AGB surgery. That was March 2006. I found out February 2008 I was pregnant. Early 2008 was my lowest post-op at around 210. That's a loss of about 175 lbs... still about 30 from my goal, but enough that I was tickled pink. Point being - my stats and yours sound comparable. I think my pre-op BMI was around 56, and I was in the super morbidly obese" category, nearing the point where I wasn't going to be able to buy clothes in stores. While I didn't hit goal, I'm pretty sure I would have if I hadn't gained during pregnancy/slipped. I have maintained this weight for about 2 years now, which I could NEVER do before surgery. I believe it's entirely possible to lose significant weight with a restrictive procedure, because I did it. And I suspect weightloss with VSG is a bit "easier" than with AGB. ("Easy" isn't the word I want, but I can't come up with the right one.)

I have a high BMI of 57 and almost 200 lbs to lose to be in "normal range" [...] For those of you with a lot to lose like me - what made you decide to go with the sleeve instead of the DS? (or RNY)

As my username implies' date=' I didn't have either (not the best decision, but I went with what info was available at the time), anyway, if you do go for VSG it's a relatively straight forward procedure to revise to the DS. Note that 2 stage DSers tend to be slower losers as you'll already have had some weight loss.

You *might* not need to revise to the DS which is partly how the VSG came about (ie it being stage 1 of a 2 part DS). If you don't think you can keep up with the Protein and Vitamins that the DS requires then VSG is a good choice.

RNY I don't believe is such a good choice. It's very difficult to revise from (possible, but it has a lot more complications). With RNY you're no longer able to take Non Steroidal Anti Inflamatory Drugs (NSAIDs, eg ibuprofen and who knows if you'll need them in the future). Also you only malabsorb calories for 2 years whereas you malabsorb nutrients forever so you still have to be diligent with protein and vitamins. This is why so many RNYers get regain and then seek revision (think of what Carnie Wilson got down to and then regained back to over 200lbs).

Also 40% of RNYers suffer from dumping, search for it on youtube and you'll soon see it's something you seriously want to avoid (people look like they're dyeing of a heart attack). HTH.[/quote']

This is a very informative post. I used to wonder who the DS was best for

I realize this is a really old post - but my surgeon mentioned DS as one of the four primary surgeries for weight loss, but he said he doesn't like to do it because people lose TOO MUCH weight with it and are sickly as a result. According to him, the nutritional deficiency is much more severe in a DS surgery, to the point that patients require IV infusions for minerals and Vitamins because no matter how many supplements they take, it's not enough - the body won't absorb it. He mentioned that while RNY is still the most common surgery, VSG is the up and comer because of the similar results of RNY without the dumping and nutritional deficits that many people get with RNY.

Personally, I never wanted a band because I don't like the idea of a foreign object in my body. I only knew about RNY and decided against it years ago (been overweight my whole life). When I finally got a point this summer that I felt that I HAD to do something to lose this weight, I started researching and learned about VSG. I had never heard of it, and the more I've educated myself about it, the more it seems like the right surgery for me. With VSG, you can have a somewhat normal life, you don't have to fear food will make you violently ill. Dumping syndrome isn't anything I would ever want to experience!!

Any of the available surgeries have a potential to give you complications, just as they all have the potential for great success. While you can't really control complications post-op, you do have all the choice in your eating habits and exercising post op to lose the weight and keep it off. Ultimately, only you can decide what you want to live with for the rest of your life. I'd never tell anyone they should get one surgery over another - but I would definitely make sure they knew all about the sleeve before they made their decision!

Oh, wow!! What a blast from the past. I got an e-mail saying there was a response to this thread, and I had completely forgotten that I even had an account here. Cool!!

OK, well, this gives me a chance to post an update. I ended up choosing the sleeve surgery, and went under the knife in December 2011. I have since lost 150 pounds, and I am very happy with my decision.

Now, I am still technically obese, but my health is vastly improved and I am very happy to be where I am. I started at just over 360 pounds and I now weigh about 210 pounds. I am actually going to have a tummy tuck in a few weeks to remove a lot of hanging skin on my stomach that is giving me rashes and all kinds of grief. The surgeon said I'll be losing a lot of pounds in skin with the tuck, but I am not doing it with the goal of weight loss.

I'm so glad that I choose the sleeve. Yes, if I had chosen the DS I may have gotten down into a normal BMI range - but ... you know what? I'll keep these extra 40 -50 pounds and enjoy a varied diet without any worry about malabsorption. I take daily Vitamins, but not mega doses. I know some may not see my story as a success because my BMI is still ... 32, I think? But I'm very happy and very healthy. Blood pressure, cholesterol, blood sugars... they are all perfect now.

Life is good.

Good luck to all of you who are contemplating your choices. There is no "perfect" weight loss surgery for everyone, but I think the sleeve is pretty close.

I have a high BMI of 57 and almost 200 lbs to lose to be in "normal range" (but I would be thrilled to lose' date=' say, 130). I asked on another message board about DS vs VSG. Many DSers flat out told me that I would NOT succeed with "just" a VSG based on my BMI. They made some compelling arguments and provided some studies which were also compelling, but I don't know if they can overcome my fears and worries about the DS. The Vitamin regimen is intimidating, and I don't want to be fighting to keep up Protein and vitamin levels against malabsorption for the rest of my life. But, on the other hand, I don't want to fail. This weight MUST come off me soon - I feel like a medical ticking time bomb.

For those of you with a lot to lose like me - what made you decide to go with the sleeve instead of the DS? (or RNY)[/quote']

For me the reason why I did not go with RYN was plain fear and I am happy with my sleeve ..