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Can NOT decide between the VSG and RNY! How did you choose



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1. VSG can be converted to duodenal switch (DS) if the initial weight loss is insufficient. In both cases, the pylorus remains intact, so food is let out of the stomach gradually. Both have a much lower risk of dumping syndrome than RNY, and the weight loss outcomes of DS are even better than RNY.

2. More foods tend to be tolerated after VSG/DS than after RNY, mainly due to the intact pylorus and size of the stomach. VSG also allows regular nutrient absorption and doesn't cause as many embarrassing bowel/gas disorders.

3. Weight loss can be more gradual after VSG than RNY, which can result in somewhat less loose skin. No guarantees!

4. RNY is a better option for people who graze or eat junk food/fast food, though, because the sleeve only controls portion size and sometimes hunger, not eating frequency or food quality.

5. RNY may also be better for people with reflux, as VSG can worsen it over time.

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I just received the approval from my insurance and I will be receiving a date soon, and up until this point i have said I wanted the RNY! However now I'm second guessing my decision and want to know how you all concluded on which surgery was best. I'm just concerned that their are not enough long term stats on the VSG which is what led me to picking the RNY. Are any of you 5+ years post op from the VSG and can tell me how you have done thus far. My only concern with the RNY is losing weight too quickly, I want a more gradual weight loss believe it or not!! Please help

I have numerous reason for choosing the sleeve.

1. The risk for malabsorption was unacceptable. I have cvid which already causes a Protein deficiency.

2. Because of my cvid (common variable immune deficiency) I have a very high chance of stomach cancer. Having a left over stomach that isn't easily accessible to scope (think every couple months) would be asking for trouble.

3. because the RNY leaves the stomach in the body, it doesn't decrease the ghrelin hormone like the sleeve does. Decreasing my hunger is a big thing for me. Another side effect of cvid is stomach issues. I'm used to having diarrhea. I'm afraid that if I have the RNY I will still be constantly hungry, but because the pouch is so small I'll eat the WRONG things (like chocolate) and because I'm used to dumping syndrome it won't deter me.

4. Rerouting my whole system just freaks me out

5. The sleeve has nearly comparable weight loss stats (and if u look at the 2+ year studies it actually has more)

6. the sleeve also changes how the guts bile acids bind to a receptor called fxr. In the absence of fxr weight loss occurs. So aside from restrictive and hormonal changes the sleeve causes a change in your metabolism. That's huge for me!

7. I don't like the idea that I might not be able to absorb needed medications

8. If I find the sleeve doesn't help, I can revise it to add the malabsorption part.

I suggest writing out a pro/cons list and going with what feels right to you. Good luck!!

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I too originally chose the RNY procedure but had the decision made for me to change to the VSG based on my endoscopy which showed that I had polyps in my stomach and there would be no way to monitor them if I chose RNY. Even before that I was struggling with the complexities of the RNY procedure with the rerouting of the intestines, complications such as ulcers were much higher, and the issues with possible malnutrition and side effects like dumping syndrome. The VSG does seem like a much simpler procedure with results that seem to be as good as the RNY. In the end both procedures have very good results and I don't think you can go wrong with either. It's a hard decision to make and I wish that surgeons would be a little more proactive in helping us with the decision. Good luck with your decision. In the end these are just tools. You can be equally successful with either procedure if you commit to sticking with the diet and exercising.

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    • LeighaTR

      I am new here today... and only two weeks out from my sleeve surgery on the 23rd. I am amazed I have kept my calories down to 467 today so far... that leaves me almost 750 left for dinner and maybe a snack. This is going to be tough for two weeks... but I have to believe I can do it!
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
      · 2 replies
      1. Selina333

        I'm so happy for you! You are about to change your life. I was so glad to get the sleeve done in Dec. I didn't have feelings of regret overall. And I'm down almost 60 lbs. I do feel a little sad at restaurants. I can barely eat half a kid's meal. I get adults meals often because kid ones don't have the same offerings at times. Then I feel obligated to eat on that until it's gone and that can be days. So the restaurant thing isn't great for me. All the rest is fine by me! I love feeling full with very little. I do wish I could drink when eating. And will sip at the end. Just a strong habit to stop. But I'm working on it! You will do fine! Just keep focused on your desire to be different. Not better or worse. But different. I am happy both ways but my low back doesn't like me that heavy. So I listened (also my feet!). LOL! Update us on your journey! I'm not far from you. I'm in Houston. Good luck and I hope it all goes smoothly! Would love to see pics of the town you go to for this. I've never been there. Neat you will be traveling for this! Enjoy the journey. Take it one day at a time. Sometimes a few hours at a time. Follow all recommendations as best you can. 💗

      2. Doughgurl

        Thank you so much for your well wishes. I am hoping that everything goes easy for me as well. We don't eat out much as it is, so it wont be too bad in that department. Thankfully. Also, I hear you regarding your back and feet!! I'd like to add knees to the list. Killing me as we speak! I'm only 5' so the weight has to go. Too short to carry all this weight. Menopause really did a doosey on me. (😶lol) My daughter also lives in Houston. with her Husband and my 5 grand-littles. I grew up in Beaumont, so I know Houston well, I will be sure to keep in touch and update you on my journey. I may need some advice in the future, or just motivation. Thank You so much for reaching out, I was hoping to connect with someone in the community. I really appreciate it. 💜

    • Alisa_S

      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.
      · 1 reply
      1. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • Alisa_S

      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.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

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

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
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