Hi Friends. I am new to the site, and have been approved by Kaiser for weight loss surgery. I have a meeting this week to decide which path I want to pursue. I live in the Denver area, and the only options shown are Lapband or RNY. Of those two, of course I will choose RNY. However, I have researched DS (Duodenal Switch) and I see the benefits of it and now am not sure which way to go. The only problem is, Kaiser does not offer DS here in Colorado. I have heard if you pressure them you have a chance to get that approved under certain circumstances. I have 120 pounds to lose (I am 5'7" tall and 280 pounds). Currently, Kaiser approves DS only if you are above 50 BMI. (I have a BMI of 42-44). But I have heard of exceptions to that, if someone is willing to pay to fly to another Kaiser region to have an in-network surgeon perform DS.

In short, DS seems like a better long-term solution, but I know it is more extreme than the RNY. RNY is great, but requires a person to use the tool well, and change one's lifestyle drastically to ensure its success. I get that and am motivated to do that. I just get scared when I hear of people who went through the RNY only to get back right where they started after the first year. I have a sluggish metabolism and a tendency to regain after diet success anyway, so this is of concern. I want to take responsibility for my life and choices, of course. But if I am going under the knife, I want the best solution available, and I have heard that DS offers a better long-term success percentage (not sure if this is true for everyone, but just saying what I have read).

So here's my question - any thoughts out there as to why you chose one or the other? I am truly not sure which path to go. Any advice or simply sharing your experience with me would be so helpful! Thank you

Edited December 9, 201312 yr by patrice1

There is theoretically some malabsorption with the sleeve because food transits through your system faster since the stomach capacity is so much smaller. The primary mechanism of the sleeve is reduced capacity, and yes it is adequate. You physically can't hold more than a cup at a meal (most women can only hold 2/3 to 3/4 of a cup).

There is also theoretically some malabsorption of B12 because your stomach produces an enzyme that helps you absorb it, and you have less stomach to produce the enzyme. It just means you need to supplement B12. Sleevers should take a Multivitamin every day as well as Calcium, but malabsorption is not at the same level as with RNY.

Since the digestive system is exactly the same, you can take any medications you would have been able to take pre-surgery.

As I said, if the sleeve is not "enough", you can always continue with the second part of the DS, which is the intestinal rerouting. If you have any questions about the sleeve, you can ask in the Sleeve section of this website, or ask here and we will get you the info you need. There is also the Big Book of the Gastric Sleeve, which is published by the owner of BariatricPal. He has also written the Big Book of the Gastric Bypass and maybe others. Maybe you should read all of those books to get the info to decide which surgery is right for you, along with your surgeon's advice.

my hospital is a "center of excellence" and does not offer DS. i dont know if that is significant or not, but something to consider.

This is extremely helpful. I am a sugar eater. I had never considered the VSG, but started reading about it today after reading this post. I get scared that I will fail but I know I have to get that out of my mind. Your results are great and I am reading about others. Did the portion control mechanism of the VSG end up being enough? Tell me more. And I will be open with my doctor about it, too. Is there some malabsorption with the sleeve? Can you have NSAIDs? Thank you for your help!

you should not take NSAIDs with the sleeve, but losing weight seems to go a long way in taking away a lot of reasons for taking them in the first place. portion control is doing it for me, and sugar still makes me feel icky. i have lost almost 70 pounds in almost 6 months. i am very happy with the sleeve.