I apologize in advance for the long rambling nature of my first post. I'm struggling to figure out if having bariatric surgery is the best option in order to help me become healthy, and if it is, which surgery is the best fit. I fully understand that bariatric surgery is simply one tool and won't work without eating right and getting off the couch but I'm having a hard time wrapping my head around why it would happen after surgery, if, I haven't been able to do it before. I've done the starve myself and exercise which worked wonders for about six months but regained all the weight and more. Later, I was able to drop about 20 pounds with good eating and walking but I plateau and again put on more weight. I'm currently at another plateau but worry that again I'll soon see an increase in weight and even if I don't gain more, I'm certainly not happy with my health at this size. I wonder if I simply didn't try for long enough and question why spend the money on surgery, if I can just keep the money and try another round of eating better and moving more given I'd be doing it following the surgery anyway. I'm also worried that having bariatric surgery is going to result in having to pay for revision work every number of years which seems to defeat the purpose.

The second question is obviously if I do go ahead which option would be the best fit. I'm 27, 43 bmi, I don't suffer from any obesity related conditions, but I suffer from bipolar 2. Being bipolar brings medication which from my research basically means if I want to keep my current medication regiment, gastric bypass is not an option. I'm left considering either a DS or a VSG. My wife had the VSG performed a little more than a year ago so I've been able to watch her experiences but I'm also finding a number of individuals who had a VSG, are going back and having the DS performed. If I'm going to have surgery I would prefer to just have it done once and not have to worry that 5 years down the road I have to go back for another surgery which is part of the appeal of the DS. On the other hand, the DS seems to be a more drastic surgery with a higher risk for complications and given my relatively lower bmi, I'm not sure I'm the targeted audience.

Again, sorry for the longish rambling post but I'm hoping individuals who are or have been in my position can provide me with some advice/insight or places I might not have looked at.

Have you thought about a lap band?

It sounds like you've done a great job researching and considering your options. I think the time is right for you to meet with a couple of surgeons (make sure they perform the DS - not all do this advanced surgery) and talk them through. They are the ones who can help you make the right call there.

In terms of why will it work now when it didn't work before? Well, there are people who don't succeed with weight loss surgery, whether that means not getting to goal or regaining a lot of weight. But the truth is, there are FAR many more people who succeed with weight loss surgery than there are who succeed without it. Orders of magnitude of difference. The surgery gives people a tool that they need to be successful. Society has built up a construct that weight loss is purely a matter of will power, knowledge, and character - but that's a lie. The vast majority of us need a physical tool to succeed, and WLS gives us that.

Everyone who has WLS is like you in one way -- they tried and failed to lose the weight "on their own," usually many times, before submitting to surgery. And most of them can be considered successes after surgery. They are not different from you. You can do it too. I know it seems like a big leap of faith, but this may be the right time to find some faith in yourself and in the medical process -- good luck!

My band has helped reduce hunger, and increase satiety.

Those were MY major issues with weight-gain; Always hungry & a bottomless pit.

I was already eating pretty healthy most of the time, except for binging on McD's 1/4 pounders once in awhile.

Head-hunger. Had to learn to fill my emotional bottomless pit with other things. Still working on that.

Please do not consider yourself low BMI. A 40 BMI is what insurance requires for an outright approval (no other health issues required.) In other words, they think you will have so many health problems that paying for a $20,000.00 plus procedure is a costs saving measure. I say this because I was in denial for many years and because the weight comes on over time you are lolled into a sense of apathy. Very much like the lobster who gets placed in a pot of cold Water on the stove top. The amount of damage the excess weight places on our bodies is astonishing. I can fast forward a couple decades and tell you whole story because I am it.

Good luck on your decision. Only you and your doctor can make this decision but if you ask us specific questions we will gladly answer. Whatever you decide, I urge you do do something about your weight NOW.

I am 19 months post-op on RNY. My body had reached the point that I could no longer lose weight. I dieted and exercised without any positive results, period. I choose RNY specifically because I wanted to avoid revisions. Because of your medical condition DS may be the way to go. I am not experienced enough to make that determination. What I found interesting about my surgery was that I completely lost my hunger. It is not difficult to lose weight when you do not have hunger constantly gnawing at your bones. I lost 110 pounds somewhat effortlessly and at least so far I have maintained that weight loss.

I 2nd James reply. You are young now, the older you get, the harder it is to continue the weight loss yo yo until it just simply starts adding up. Also, you may not have other comorbidities now but trust me, it will catch up with you. Yo yo dieting damages your metabolism and over time your body responds by gaining back more than you lost. When you age it gets harder to fight back. It sounds like you are doing a fabulous job of research, I think it is time that you talk with a surgeon who understands your medical condition and your goal to not have to deal with revisions. It sounds like the lap band or sleeve may not be the best option for you based on what you already learned, and bypass may be out because of your medication requirements. I would look to a surgeon who specializes in bypass and DS. They are going to be able to advise you best. Good luck and I wish you all the best!

I am almost 3 months out and down over 60 lbs. I am a 35yo male with around same height and weight to where you started. I am super happy with my results thus far. I have no regrets. does your insurance plan help cover the surgery costs? that is a huge factor for me. I couldn't afford it if I didn't have insurance. bipolar and meds would be my biggest concern. talk to a surgeon about that. I had a VSG and have read a lot and don't know of many instances of people getting revised to a DS down the road. Welcome to the site, please read a ton like I did, you will find so many helpful people...

@@AbruptlyBlue Thank you for taking the time to post your questions and concerns.There are so many who don't reach out and just read hoping to find an answer to their specific question or need when they would do better to just ask I say this because this is exactly what you need to do.

As you explore the idea of surgery before you jump in with both feet for any surgery a good first place to start is with the Dr.

Compile a list of medications, medical diagnosis and questions that you would like to present to the Dr. this way when you have your initial meeting, you can ask them what you need to know and they will be advised of where you are at from a medical and medicinal standpoint.

An important part of bariatric surgery is often psycho therapy, there is usually a consult prior to surgery with the Dr.'s bariatric psychologist and they might also be in a good position help to answer any questions you have with regard to your bipolar condition and medication for such.

Having a good support system is paramount to success, so I would also loop in your current Dr.'s and psychiatrist and let them know that you are thinking of WLS, though you have not yet determined which one will be the best for you, and perhaps once you have narrowed down the Bariatric practice you could have all your doctors consult to help you determine which surgery might be the best fit for you.

I honestly think that more people should take this approach to WLS before undergoing the actual surgery. I am banded, and so far this surgery is working for me. I am not losing weight rapidly it's a process and often wrought with learning curves. However I have not gained back any weight, and continue down the path to good health. I still like the fact that the band is adjustable to my lifestyle and that when needed I am able to open it up or tighten it up as needed, as well as knowing I have not re-routed any of my inner organs.

That said however, there is also a foreign object in my body that has the potential to cause problems and there are those that are not comfortable with this idea.

So give it some long hard thought do your due diligence and ready and learn all you can about the different surgeries. Talk to your Dr. and others...and see what works best for you and perhaps others who also have similar conditions.

Best of luck to you, and please let us know what you decide and how your doing!

Have you thought about a lap band?

I've certainly considered the option but I'm fairly certain it simply isn't the right fit for myself.

My band has helped reduce hunger, and increase satiety.

Those were MY major issues with weight-gain; Always hungry & a bottomless pit.

I was already eating pretty healthy most of the time, except for binging on McD's 1/4 pounders once in awhile.

And that sounds very familiar. I seem to be mainly a grazer but also a binger the odd time which I feel lucky in that I don't necessairly have the same issues my wife had with food going into her surgery. Which is why with my eating pattern I wonder if I just shouldn't save the cash and try some more willpower.

Please do not consider yourself low BMI. A 40 BMI is what insurance requires for an outright approval (no other health issues required.) In other words, they think you will have so many health problems that paying for a $20,000.00 plus procedure is a costs saving measure. I say this because I was in denial for many years and because the weight comes on over time you are lolled into a sense of apathy. Very much like the lobster who gets placed in a pot of cold Water on the stove top. The amount of damage the excess weight places on our bodies is astonishing. I can fast forward a couple decades and tell you whole story because I am it.

Good luck on your decision. Only you and your doctor can make this decision but if you ask us specific questions we will gladly answer. Whatever you decide, I urge you do do something about your weight NOW.

You're certainly right that I don't have a low BMI but I just meant initially it seemed the DS was mainly for individuals with a higher BMI compared to myself, though, I've found that the DS certainly is being performed on those with lower & higher BMI to myself.

I am 19 months post-op on RNY. My body had reached the point that I could no longer lose weight. I dieted and exercised without any positive results, period. I choose RNY specifically because I wanted to avoid revisions. Because of your medical condition DS may be the way to go. I am not experienced enough to make that determination. What I found interesting about my surgery was that I completely lost my hunger. It is not difficult to lose weight when you do not have hunger constantly gnawing at your bones. I lost 110 pounds somewhat effortlessly and at least so far I have maintained that weight loss.

That is one thing my wife talks about and I still have a hard time wrapping my head around the idea she doesn't feel hungry all that much.

I am almost 3 months out and down over 60 lbs. I am a 35yo male with around same height and weight to where you started. I am super happy with my results thus far. I have no regrets. does your insurance plan help cover the surgery costs? that is a huge factor for me. I couldn't afford it if I didn't have insurance. bipolar and meds would be my biggest concern. talk to a surgeon about that. I had a VSG and have read a lot and don't know of many instances of people getting revised to a DS down the road. Welcome to the site, please read a ton like I did, you will find so many helpful people...

I'm potentially covered under my wifes insurance which she is checking to see if surgery would be covered under her plan but we might be able to cover the cost if it's not with the help of my parents.

I also am bipolar and could have the bypass. I would have chosen the sleeve if it had been offered back then. I lost 70 lbs with the lap band but am gaining some back due mainly to emotional issues.

Good luck with whatever you choose and let me know how it is going.

I`ve been reading the information package one of the consultant companies sent me about doing my research on any surgeon I would think about using and they have a basic saying that if somebody is going to lie about the small things, why would you trust them with the big things. Which is great advice but the surgeon they happen to use advertises that they were in a number of mainstream newsmagazines and even appeared with Oprah even though the closest they came was a blurry picture of Oprah on a stage. Would this be a red flag of they likely have little issue with pushing lies or is this simply how it works in Mexico?

@@AbruptlyBlue I think the surgeon you use is very important, I really am confident with my choice of surgeon I went to 3 different seminars and chose the surgeon that had WLS surgery himself. He gives you his personal cell number, and believes a lot of weight problems lie in the psyche, he does lean more towards lapband but will preform the surgery that your comfortable with. I love that he knows what it's like to be obese he has had his own struggles with rude medical Drs just like I have.

I hope this helps. My bmi was at 43. I am 54. I am also bipolar type 2. I have problems with my feet, lower back pain, arthritis, high cholesterol, yoyo dieting, hypothyroid, etc. The fact that I was on lithium long term has caused stage 3 kidney disease. Since the gastric bypass my diabetes has resolved, back and foot pain gone, kidneys stabilized. Arthritis also not bad anymore.. Feet compleatly better. Cholesterol normal. Some bipolar meds lessened. Trust me, the less meds you take the better for your organs. These things could be in your future if you don't get some help soon. As you age, everything goes to h---. I wish I had done this long ago. I had my surgery a year ago this month. Now I can go on walks, go up stairs without running out of breath, even my bipolar is better because I have a better frame of mind. Maybe you can go to a group meeting about the surgeries. That is what I did, the hospital near me had a comprehensive weight loss program. They will check your health from all sides. Please get some help before your health declines. I wish I had. I would have been having better health so much sooner. At least check with your doctors, it's worth it. Please don't wait much longer.