Hi there. I am female, 5'9, with a BMI of 35 and hypertension being treated with medicine. I am trying to decide between the lap band, GB, and the sleeve. Does anyone with the "minimum" qualifying requirements give me some advice on how to decide? In my opinion, I have about 65 lbs to lose. I am worried about losing too much with any of the procedures (who would have thought that would be a concern...LOL!).

thanks so much.

Shan

I'm not quite as much of a lightweight as you at a 40ish BMI, but close; these have been my thoughts in going thru this as a relative lightweight.

With the band you have less to worry about in the losing too much department, and may not lose enough; and there is the higher risk of complications down the road with erosion and slippage problems. The bypass presents you with a lot of long term lifestyle limitations (malabsorbing minerals, inability to use NSAIDS for pain relief, dumping prospects, dietary restrictions for the pouch to name a few) that probably are not worth the trouble for the amount of weight you have to lose. Some people report losing beyond goal with the VSG, but not specifying what those goals were and if they actually wound up losing "too much". Most people find that there are enough "sliders" (foods that just slide on through) that they worry about eating too much despite the restriction, but I don't think that it is that much of a problem if you can adjust to having a sane diet (and some exercise with it) long term - a lot of fruits and veg are sliders as well as twinkies and chips, so it's largely up to you how you balance things out once in maintenance mode.

You can also discuss this with your surgeon (or prospective surgeons if you haven't settled on one yet) as there is still some controversy within the VSG world as to how big to make the sleeve - too small and it is thought that there is excessive reflux problems while too big and it is thought that weight loss and regain resistance may be inadequate (but they really don't know as they are all waiting on more longer term - 5+ years - data to confirm their assumptions). If possible, find a surgeon who has as much VSG experience as possible - 500+ procedures is best - as he will have a better feel for how different patients fare with the sleeve and how best to tailor the sleeve for the individual.

Good luck on the decisions,

I was around 36.5 BMI with co morbidities. My doc offered me RNY or Sleeve. The sleeve looked much better to me, with less problems in the long run. Studies I have read say the sleeve works the very best for those with less to lose... meaning people with less to lose, lose a higher percentage of their weight than those with more to lose. (This was just a comparison within sleeve patients, not with RNY or Band) The studies show most sleeve patients lose... I think it was 57-79 % of excess weight... many here lose all. I don't think losing too much is a problem for the majority of sleeve patients.

At 10 months out I have lost 83% of my excess body weight. I am losing VERY slowly the last 6 weeks.. around a pound lost over that time. I mostly eat what I want with protein first as the main rule. If I can lose 14 pounds over the next year, that would be fantastic, we will see.

depends on insurance. Kaiser does it as long as doctor recommends it and they think it is a medical necessity. I only needed to lose around 50 to 70 pounds after losing first 60 by diet/exercise, so doctor told me about sleeve. I would for only 50 pounds, assuming you dieted to get that low, go with sleeve. Lap Band puts foreign device in your body and it can erode into the tissue and cause problems and have to be removed.

Truthfully for 50 pounds, if you have not been dieting and exercising then diet and exercise first. Do surgery only if you need to have the extra tool to keep you from putting the weight back on.

I have a BMI of 35 and no comorbidities and I have been approved as a self pay for VSG. I only discussed the lap band and VSG with my surgeon. His opinion is that people like me should have the opportunity to pursue the surgery before health issues appear. He did mention that doctors have to document decisions outside the NIH guidelines. I didn't really understand all that, but it must be a liability issue.

If you have documented medical problems that would be resolved or helped I think they will wave the BMI requirement. I would suggest the sleeve to my Mother, if she brought it up, and she only has about 50lbs to lose but it's 50 that really gets her down and is hard on her body.