Hi everybody,

I've been around for a few months, but normally post in the sleeve forums. However, I need to ask some questions of you all. Basic stats: HW: 331 CW: 312 GW: 150 or 145. I have decided to have bariatric surgery, but need to decide which one. I thought I had decided, but I am revisiting the the decision between bypass or sleeve and wanted to get some different opinions.

I've been working with my doctor and PA for about 3 1/2 months now, and have lost close to 20 pounds with a higher protein/lower carb goal, and moderate exercise. It has been very good so far, and not difficult for me to stick with at all. I would describe it as a healthy head space when it comes to food right now- I could live like this long-term. My PA (the one who I deal the most with) and I talked about which surgery I should go with at the appointment before last in June. She thought that although either surgery would be a good choice for me, but seemed to lean toward the sleeve. I was happy with that, and I decided on the sleeve.

However, yesterday I had my psych eval. That doctor urged me to reconsider getting the bypass and here's why: She said that with my history of being able to settle in and focus for months at a time and lose a good amount of weight on my own (70 pounds was the most I've lost at once over a period of 5 months), but then all of a sudden derail, she suggested that bypass might be better because of how it would make me feel sick if I eat too many carbs or sugars, whereas the sleeve doesn't necessarily have the same consequences. Basically, that while I'm in a great place right now and making good decisions, the bypass might make it harder for me if/when I do revert to bad habits. I wasn't thrilled to have to go back and revisit this decision between the two surgeries as I had thought it was one major decision down, but I promised myself not to take any of my care team's opinions/suggestions lightly, as I really really want this to last my whole life (which is a long time hopefully since I'm still pretty young at 28).

Before seeing the doctors I slightly leaned toward sleeve because it wasn't malabsorptive and it would be a less invasive procedure. However, I know that people tend to lose more with the bypass and it has a much longer track record. I went into this being open to either procedure.

I guess I'd like to know from you, what you think about the surgeries, maybe why you chose bypass, and if you have any advice for me and my particular situation.

Thank you very much

You'll get a ton of opinions, so here's mine!

I went with bypass for a couple of reasons. I wanted the best chance for maximum success -- bypass has better stats for losing and keeping off weight. I also had GERD which can be worsened by sleeve and I certainly didn't want to go there. Haven't even needed a TUMS since surgery -- no meds for reflux. I also liked the idea of dumping because being a sweets and carbs kind of girl, I knew I needed something to help me avoid them. I haven't really tried anything off plan but I did have a dumping experience yesterday with Peanut Butter which I have tolerated before. I can tell you, no mini cupcake (my ultimate temptation) is worth going through that again!

So, there's my 2 cents worth!

I originally thought I would go with the sleeve. It just seemed less scary, you know? Eventually switched to bypass because it's been around longer and helps with a greater % of weight loss. Also my doctor nudged me toward a bypass due to my diabetes. Really looking forward to not taking Metformin anymore!

Your surgeon knows you best and can help you decide. Good luck!

I too was set originally on the sleeve. After research and docs recommendation I am now going for RNY because of acid reflux. Initially I was disappointed. But after being real honest with myself I believe the sleeve would more easily allow me to cheat. Sweets are a big weakness for me. It is nothing for me to eat 6 very large donuts at one sitting. I need some consequences to help me long term and I think the dumping will be a good one.

My stats are similar to yours. Top weight 317, CW 307, goal 150. Like you, I've been able to lose 50 to 70 lbs on my own in the past, but haven't been able to keep at it. I decided on the RNY gastric bypass because, like Ginger Snaps said, I think it gives me the best chance for maximum success. Good luck to you whichever you decide!

Thanks for posting this, I had also been debating on which surgery to have for the past few days

I too was leaning towards the sleeve at first because it seemed less invasive and I didn't like the idea of rearranging my intestines. But, after talking with my surgeon and thinking it through, I went with bypass. The biggest reason was the success rate. While the sleeve is showing great success so far, it hasn't been around long enough to show long term results. Also, there seemed to be a lot more room to fail since it isn't quite as restrictive as bypass. For me, I only wanted to do something this drastic once so I better go all the way. I think the sleeve can be very effective for certain people. I just don't think I'm one of those people. The fear of making myself sick by eating something I shouldn't, will definitely help keep me on track long term. Seeing all the angles might help you choose, but you know yourself. Maybe try making a list of pros and cons for each option. That might help put it into perspective.

Edited August 2, 201411 yr by CrashNCamsMom

I'm about 90% decided on RNY. Promised my Dr not to decide until after my nutritionist appt on the 11 th. However unless she leads me into some deep epiphany....I'm choosing bypass.

I'm in the process of having to make the same decision. I've researched both about as much as I can on Google and am leaning strongly towards bypass for the same reasons everyone above has listed. I figure if I am going to have WLS, I want the best "bang for my buck" - and bypass seems to have a proven track record of doing that. My surgeon seemed to be trying to steer me towards the sleeve, but that was just in my initial 15 minute visit with him. He did say he thought I would do well with either one. There still isn't much long term data on the sleeve and that worries me a little. Also the fact that with the sleeve, they say "if needed, it can be converted to bypass later." Why not just do the bypass to begin with instead of possibly having to go through major surgery again?

My stats are similar to yours. I've also been able to lose a lot of weight in the past (92 lbs once!) but always gained it back quickly. And I believe part of that was due to gaining weight at a much lower daily calorie intake after long=term restrictive dieting. So I am hoping the malabsorption part of bypass will be another element that can prevent that same cycle from happening again.

I've been very disciplined with taking medications as directed every day, so taking the Vitamins needed to deal with the malabsorption doesn't seem daunting to me at all. I also am very good about following through with routine medical exams like blood work (I had to have blood drawn monthly for 5 years for something in the past), so that also won't be a problem for me. You might want to consider those things since they will be a lifelong requirement for bypass.

I have an endoscopy still and that might make the decision for me if it shows effects of GERD.

Whatever you decide, best of luck to you!

I have the Lapband and I have beat the band with no problem. I am actually working with my doctor to have a second surgery and have the band removed and to get the gastric bypass. With the sleeve, it's still too easy to eat the bad stuff. I'm going with the gastric bypass to help keep control of my eating habits. I have three cousins that had the bypass done over ten years ago and they all have kept off over 100 pounds each. And I have a fourth cousin that had the bypass a year ago. They all say it was the best decision of their life. I originally went with the band because I was scared of the bypass. My doctor also didn't educate as well as my new doctors. Now the bypass doesn't seem so bad after all.

Good luck with your decision!

_{When I first started this process, I was doing the sleeve. It was through post like these that helped me change mind. This "pal" is the best!!}