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Gastric Bypass or Sleeve? Need feedback, please!



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I'm scheduled to have surgery the first week in May and was set on having the Roux en Y, but after attending a support group meeting and hearing that almost 1/2 had the sleeve and are losing just as much weight, I'm wondering if I am making the right choice? I haven't been able to go back to the support group since, due to scheduling conflicts, so I thought I'd ask my question here:

If you are post-op, which procedure did you choose, and why? I've been reading up on the sleeve and it seems like there is no risk of dumping or bad gas/flatulence issues, as there is with the RNY. As a teacher, I've been worried about these 2 issues, but I also want to choose what will be more effective in the long run. I'm so torn! Please help!

Thank you!

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Following- I'm in the same position! The more I read, the more I think sleeve is right for me!

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Only you can answer what you feel is best for you. I want the sleeve but everyone keeps telling me band. I am going with my gut and going with the sleeve.

I know that does not answer your question. Just keep researching and praying.

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I got the sleeve because I didn't want to change the way my digestive system functions, but just make my stomach smaller so I can eat less. There is no malabsorption with the sleeve, and less risk of dumping. I also know an entire family of people who are at risk for an aggressive form of hereditary stomach cancer, so they all opted to have their stomachs removed quite a few years ago and they are doing just fine without it. That gave me hope that I would be able to live a normal life after the sleeve, and four months post-op I can say that I am living a normal life. Sometimes I even forget my sleeve is there! I feel like my old self, just not able to eat as much.

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Weight loss similar for both. If you have diabetes then there is an advantage to bypass because bypassing part of small intestine biochemically alters things and people can be in non diabetic range in only few days after surgery even before losing much weight. If you have addiction to sweets then dumping may be helpful to get you to change your behavior. There is a bit more risk with bypass. But it is still gold standard in WLS with the most research on it for effectiveness long term.

Sleeve has been done for a long time for other reasons besides WLS and is somewhat safer. Only past 5 years or so for sole WLS (without the DS part)

Sleeve may reduce hunger considerably because of reduced grehlin. However hunger does come back usually. But not as strong.

Sleeve is not reversible though could be changes to a bypass. The rest of stomach is discarded and can't be put back though. Sleeve may not be good choice if you have history of GERD.

Bypass can be revised by very experienced surgeon since rest of stomach still inside you. Not that you'd provably want to!

I had no co morbidites nor diabetes so chose sleeve and have lost 100 lbs in a year. Even though supposedly no dumping I can't eat real sweet stuff like ice cream or I do get a bit if a dumping response. It's not fun. Which is good. I won't eat ice cream anymore at least or more than 1 bite.

Maybe you already knew all the differences above. Just choose what's right for you.

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I was going to go with the sleeve but got RNY ....first longer history with the rny, sleeve is still considered a newer procedure as far as long term results... revisions, in my year of classes and research I have talked to a lot of people who got the band or sleeve and still ended up getting RNY including the friend that told me about the sleeve. I only wanted to have it done once... I am a food addict and wanted the most restrictions and limitations on my eating as possible, I have sleeved friends on my fitness pal that eat junk, yes it's their choice not to change their food habits but I didn't want that option of being able to eat a lot of greasy, sugary foods and although many of them have lost great they are very strict on themselves as not to backslide...I am 5 months out and I haven't dumped, I have had no issues with any foods, my blood work is good. I am down 78 lbs and feel great... if you have no medical issues that require one over the other the choice is up to you. Recommended reading The Big Book of Gastric Bypass and there is also one for the Sleeve and Band very detailed pre op, the surgery itself and first few months post... good luck!!

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-200+ pounds in 10 months on the SLEEVE!!! Very happy.

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Hi, I understand the confusion but you need to make this decision for yourself. Maybe you should have this discussion with your doctor and then it will be more clear what is medically best for you.

I chose the sleeve for myself for all of the same reasons that were given by LumpySpacePrincess. I just needed something to help me eat less so I could lose the weight. I didn't want to have to take Vitamins for the rest of my life and worry about malabsorption issues, and I didn't want to deal with "gassiness". I have had no dumping as does happen with the rny. I know the Sleeve is permanent but I wasn't looking for a diet... I was looking for a change in life style so I could have a permanent healthy life. I suppose everyone has their own reasons for choosing which surgery they have but if you do your research and make the comparisons you will find the one that works best for your life style and for your issues. I wish you much luck.

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I think that the opinion you should seek is that of your surgeon. just because they know your ENTIRE medical history, comorbidities, physique, etc. Some pre-existing diagnoses make one or the other surgery more desirable too. example- if you are insulin resistant, diabetic or metabolic syndrome, generally insurance will only reimburse for RNY.

if you have any form of GERD or have had hiatal hernia or a positive EGD in the past, insurance will generally only reimburse for RNY.

even if neither of these are an issue, your insurance still may dictate which procedure you have. I have some background in billing/coding and you wouldn't believe some of the hoops that are placed for bariatrics. good luck!

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Update: I did some more research and spoke to my surgeon and he thinks the sleeve is a fine option for me. I'm so happy and relieved! I've been agonizing over this for weeks!

Tomorrow I get to call the surgery scheduler, get my EKG set up, and schedule my surgery!!! I'm so excited and READY to begin my journey!

Thank you all for your input!

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I did the sleeve and have never been happier. I am looking at my 1 year anniversary and I am 135 lbs down. I think if you are really addicted to sugar the bypass is more for you. I didn't have this problem and was scared of the complications that you can get with bypass. My surgeon does both. I was type 2 also has gone! I was maxed out on all the oral meds I am on none now since January. I can eat anything I want but just a really small amount. I think you really have to look at your relationship with food and what kinds of foods get you in trouble. Good luck either way we are behind you and hope you love the new life you will be entering! Change is hard but it's soooooo worth it.

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I did the sleeve and have never been happier. I am looking at my 1 year anniversary and I am 135 lbs down. I think if you are really addicted to sugar the bypass is more for you. I didn't have this problem and was scared of the complications that you can get with bypass. My surgeon does both. I was type 2 also has gone! I was maxed out on all the oral meds I am on none now since January. I can eat anything I want but just a really small amount. I think you really have to look at your relationship with food and what kinds of foods get you in trouble. Good luck either way we are behind you and hope you love the new life you will be entering! Change is hard but it's soooooo worth it.

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Like some have said, go based on what your past history is with weight loss, and research the success rate not only at the beginning but three, four, five years out. At the time of my surgery I did not hear of many sleeve failures. I have now started to hear more people have low success rate.

Of course if I was a fast loser the failure rate would not have mattered to me but it's still something to be considered. I had saw so many people losing, watching YT videos, thinking positively, thinking I would be a great loser going based on the fact that I was the active fat girl in the past, and because the initial weight loss rate was the same as with the Gastric bypass, however when it came my turn I was in the lower percent. Sucks, but that's life. Keep in mind too that all sleeves aren't done the same and I did not know that until know, however that still might not have made a difference because I was comfortable with the surgeon and he did my friend's RNY surgery over ten years ago, and she initially kept off most of the weight for the longest, and has now gained about seventy pounds back in the last two/three years.

In short I would mostly go based on success rates years out, combined with personal history, and diet habits. GL

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I went with the gastric bypass due to my diabetes. And it so far has worked to that affect. I am 3 weeks post op and have not had a single shot of insulin since 2 days post op. I had originally asked about band to sleeve revision but if you're diabetic, bypass is the way to go. If not it's probably a personal choice but any of these are just tools and we have to stick with them or they're all able to be defeated if the wrong habits return.

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      Soooo I am coming to a realization
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      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.
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      1. summerseeker

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

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