I went to my surgery consult today completely invested in bypass. Met with the surgeon and he was surprised. Then after discussing my role in my grandchildren's lives (Im raising them)he suggested I consider the sleeve because it's. Safer.

I'm 5'3" 350 lbs and in his words startling good health considering my weight.

In THE end he says the decision is mine.

What do I do?

I would go with your doctor's recommendation. My doc did both the Sleeve and Gastric Bypass, but stopped doing the GB because he was having such good results with the Sleeve. He was originally doing the Sleeve as stage 1 of a 2 stage surgery for the super obese - to get them down to a weight where it was safe to complete the Gastric Bypass. They were losing so much weight with the Sleeve, most of his patients never needed the GB.

I had the same experience kinda...Other then migraines caused by the weight pressing on my spine. I was going to the Lap band and ended up with the sleeve. Then I got totally invested in the sleeve. I love my sleeve....

Not saying anything about the other surgeries but the reason I went for it was because of the importance of nutrient absorption. Sure my experience turned out that I had a by pass as well. But I have the sleeve for quicker absorption of food.

I was just the opposite, I went in totally knowing that I was going to have the sleeve. After talking to my doc, I changed to the bypass. I had bad heartburn, and one of the complications of the sleeve is an increase in acid reflux. Also, sleevers tend to lose about 10% less than bypass patients. I may be vain, but losing an additional 12 pounds with bypass is another size down. I'm on protonix for the first 6 months post-op, but should be able to go off of it at my 6 month follow-up appt. Which means no prescription meds for me after 6 months! I'm totally pleased with my decision to go with bypass as opposed to the sleeve.

I think your surgeon is absolutely correct.You should opt for gastric sleeve because if you are able to lose weight with the sleeve then there would be no need for the bypass.I think you will love the end result and will be happy with your decision in the long run.

I look at it a little differently. In a lot of cases the sleeve is a first step towards the bypass anyway. You could get the sleeve and keep the bypass an option for down the road. I do NOT mean that you will be unsuccessful...just that if your grandkids are older, your health needs determine it or your situation changes, you could potentially have the bypass later...

I don't want two surgeries...I want one. I will have to deal with surgery for my legs (Dr. Said so) in a year or so....I really feel I will be best with RNY however I will keep researching and talk to the nutritionist as he suggested...move along with my tests and make a decision. Hoping for Oct surgery.

If you get any of these WLS's there should be no need to switch up unless something bad happens like slippage or me who had everything go wrong except death. They all get the job done if you do the work...

I ended up with a Roux en Y because of complications with the sleeve. Otherwise..It would have just been the sleeve and no other....

My doc said either one works. However I had gerd, pcos, sleep apnea, high bp, diabetes and he said RNY will solve all the issues. He has seen a lot of success with sleeve but it's a new thing so there isn't a lot of data available to compare. RNY has been around for a long time and has a ton of data out there that shows the success of WLS and it's known to be the golden WLS. and I really didn't want to go through a surgery again so I decided to go with RNY. Best decision I made in my life. Results are phenomenal and I am much happier in my life than I ever was. For RNY there is the restrictive and malabsorption part helps you lose a lot quicker. In sleeve it's restrictive but no malabsorption and you don't have to take vitamins much like you do when you get a RNY. I take the vitamins and happy tanking them. But it's really all up to you.

In sleeve it's restrictive but no malabsorption and you don't have to take Vitamins much like you do when you get a RNY.

That is not true. ALL bariatric patients should be taking vitamins on a regular basis due to the low amount of food that we eat. The RDA is based on a 2,000 calorie a day diet, bariatric patients usually do not eat anywhere near that amount. If one can't get the nutrients from the amount of food taken in, then one should take supplements.

I was pretty much set on sleeve and my surgeon thought bypass was better for me. You have I see what other health concerns you have if any and what you are comfortable with. I ended up having bypass and am happy with my results.

That is not true. ALL bariatric patients should be taking vitamins on a regular basis due to the low amount of food that we eat. The RDA is based on a 2,000 calorie a day diet, bariatric patients usually do not eat anywhere near that amount. If one can't get the nutrients from the amount of food taken in, then one should take supplements.

I didn't say you don't take them at all but I did say you don't take them as much as you do when you have RNY. Like you said everyone has to take them but with RNY it's more due to malabsorption while with sleeve and band you are restrictive but can still absorb. Please reread what I wrote! Thnks!

Remove part of the stomach does create malabsorbtion. ..I agree with Lisa it is false that sleevers don't need supplements.

That is not true. ALL bariatric patients should be taking Vitamins on a regular basis due to the low amount of food that we eat. The RDA is based on a 2,000 calorie a day diet, bariatric patients usually do not eat anywhere near that amount. If one can't get the nutrients from the amount of food taken in, then one should take supplements.

My support group has members with all the 3 commom types of surgeries. The lap banders have the most complaints. The RYN'ers seem to be happy with the results. Sure everybody only wants one surgery, but the sleeve offers less complications than the bypass or the lap band. But all three surgeries have one thing in common, they all work if one keeps to the rules. You will find the surgery is only a tool. It is not magic. The mind game of weight loss is the hard part.

Remove part of the stomach does create malabsorbtion. ..I agree with Lisa it is false that sleevers don't need supplements.

Removing the stomach does not create malabsorption, rewiring things does. This is what a digestive system does currently with out WLS:

Small Intestine/Bowel

The mixture of food, liquid, and digestive juice (chyme) that passes out of the stomach, in a regulated controlled manner, enters into the small intestine/bowel. The average total length of the normal small bowel in adults is about 7 meters/22 feet. The small intestine has 3 segments:

• the duodenum,
• the jejunum, and
• the ileum.

Each part or section performs an important role in nutrient absorption.

Duodenum – The chyme first enters into the duodenum where it is exposed to secretions that aid digestion. The secretions include bile salts, enzymes, and bicarbonate. The bile salts from the liver help digest fats and fat soluble Vitamins (Vitamin A, D, E, and K). Pancreatic enzymes help digest carbohydrates and fats. Bicarbonate from the pancreas neutralizes the acid from the stomach.

Jejunum – The chyme is then further transited down into the second or middle part of the small intestine, the jejunum. Mainly in the first half of the jejunum, the majority (about 90%) of nutrient absorption occurs involving Proteins, carbohydrates, vitamins, and minerals.

Ileum – The ileum is the last section of the small intestine and leads to the large intestine or colon. The ileum mainly absorbs Water, bile salts, and vitamin B12.

When you get RNY this is what happens:

The malabsorptive element in gastric bypass is achieved by surgically dividing the small intestine in a certain area. Once divided, the lower part of the intestine (jejunum)is pulled up to directly connect to the small pouch or "new" stomach. The other end of this divided intestine is surgically sewn back at a specific point further down the small intestine. The shape of the intestine now somewhat resembles a "Y." As a result, when food is eaten, it enters the "new" stomach, then travels into the jejunum, first "bypassing" the upper part of the intestine. The effect of bypassing the upper portion of the intestine decreases the amount of calories and nutrients that are absorbed into the body.

Now for the sleeve this is what happens:

In a sleeve gastrectomy, approximately 50 to 85% of the stomach is cut away, leaving a tube-like stomach about the size and shape of a banana. The procedure leaves the complicated sphincters at the top and bottom of the stomach intact. The procedure does not require any implantable devices or re-routing of the intestines.While removal of most of the stomach is the only change to the digestive system, it has far-reaching impact. For one thing, the stomach obviously holds less food and liquid.

Please definitely look at the anatomy and physiology of each WLS before jumping to conclusions. Its important to understand what each surgery does and what complications people can have. I do believe each proceedure requires vitamins in the long run because we are not eating as much but with RNY its more due to malabsorption because things have been change a lot internally.

Hope this helps! Thanks!

My support group has members with all the 3 commom types of surgeries. The lap banders have the most complaints. The RYN'ers seem to be happy with the results. Sure everybody only wants one surgery, but the sleeve offers less complications than the bypass or the lap band. But all three surgeries have one thing in common, they all work if one keeps to the rules. You will find the surgery is only a tool. It is not magic. The mind game of weight loss is the hard part.

And I agree with you 100%. They all work but we have to make it work. Thank you for the info!