Hey guys. I am having a dilemma recently. I don't know which type of surgery I should go for.

My endocrinologist and my nutritionist say bypass. My surgeon is not quite sure, and I am not also quite sure.

I am 23 years old, 114kg and 1,77 cm. My BMI is 36,6.

The negative about going for a bypass is that I am too young and this would give me too many restrictions. And a sleeve could maybe not make me reach my goal, because I am a "sweets addicted" and I know the bypass is more helpful in those cases.

Just can't decide. Can someone help me?

Tks and sorry for the bad English!

The decision is completely yours. I suggest you research both. Bypass still allows you to eat sweets, so does the sleeve and any other surgery. You have to be strong enough to know when enough is enough. I've seen people gain back almost all their weight with bypass, and eat like they never had surgery. As they say in the seminars, WLS is just a tool. The success you have all depends on you. I was sleeved 6 weeks ago, tomorrow, and I'm down 45 lbs. I chose the sleeve because I didn't want complete mal-absorption of vitamins, re-routing of intestines and I wanted to be able to eat just the right portion of foods. The sleeve gave me just that. I'm happy with my choice!

Btw, I was also a sweet addict, and I hardly crave sweets anymore since surgery. When I do crave it, I make myself a protein shake, and I'm good!!

With your age and your relatively low BMI, sleeve seems like the better option. But, it really does have to be your decision. I am sure you can have success with either surgery.

You need to go back and review the pros and cons. No one can make this decision for you. You are the one who has to live with this.

I agree with everyone that you have to make the final decision. Honestly, I think the sleeve is a better option. But don't take my word for it-- research, talk to people who have had the surgeries and then make the best decision for you. good Luck!

I was originally going for the bypass mainly because I am a sugar addict. But I found out from others who had the bypass that the dumping syndrome does not last forever and it is very possible to go back to eating sweets with the bypass. It is much more surgery and though there is a lot more data available on the bypass, the sleeve appears to be the wave of the future. In the Twin Cities where I live the sleeve has become the dominant wls performed. I asked my surgeon and he said that the only way he would recommend the bypass over the sleeve is if I were diabetic and I'm not.

I have to overcome my eating addiction. The surgery is not going to do that for me.

As I've not had either surgery (I am trying to revise to another procedure from lap-band due to a slip, though, so I'm doing a lot of research), the only advice I can give is to take predictions of how good the sleeve is going to be with a grain of salt. After all, researchers were saying the same thing about the lap-band back when I was first banded. It was supposed to be the wave of the future and it had a predicted long-term success rate that rivaled or exceeded that of the bypass. We all know how that turned out.

I can't tell you which procedure is best for you, that's up to you and your surgeon to determine. I can share a few things that I've found while researching:

• Malabsorbtion of calories with RNY lasts for 12-24 months, Vitamin malabsorbtion lasts forever.
• There are new transdermal vitamin Patches on the market that mean you don't have to worry about malabsorbtion of those nutrients since they aren't passing through your digestive tract.
• "Dumping" is not a guarantee with RNY.
• VSG can cause severe GERD, so if you already have GERD, it's not recommended that you have that surgery.
• You can succeed or fail with either procedure. Success with either one depends on your particular food issues, on how successful you are at resolving those issues, and how you've changed your lifestyle. There are a lot of people out there that are trying to revise from sleeve to bypass and from bypass to DS or band-over-bypass.

You didn't say why the endocrinologist and nutritionist recommended bypass. My surgeon left the decision to me but I had pretty severe reflux and we agreed that there was too much risk that the sleeve would create more problems with it.

I went with bypass and wouldn't change my decision at all. My starting BMI was 36, too. I was addicted to carbs and since surgery I really haven't craved them at all. I wasn't worried about "rerouting the intestines"... cutting off half your stomach with the sleeve is just as dramatic or invasive. I have had about 3 dumping episodes in the 8 months since surgery but that 'negative reinforcement' helps me stay on track. I have no problems eating anything really except carb-heavy foods like bread or crackers, tortillas, etc. I have had no nausea and only vomited twice when I ate too fast.

My sleep apnea disappeared after the first 25 pounds or so, I haven't chewed a Tums or Rolaids since surgery and I hit my goal weight at 5-1/2 months. I never imagined even hitting that goal and now I'm 9 pounds under it.

The decision is completely yours and based on your medical history and situation. My only advice is this: Don't make your decision based on fear. Both surgeries have pros and cons. Listen to the doctors and professionals who know your situation and make the decision of what you think is best for you. You can rock it either way.

Research, research, research and talk to people who have had both. Go to support groups in your area and talk to people. For me, 36 BMI on day of surgery, VSG was my best option. And, I had acid reflux for years before surgery. My reflux was really bad post op for the first 8 - 10 weeks. Now I'm doing great. My main reason for VSG was the nutritional data. All I'm required to take post op are daily OTC Vitamins and OTC B12. My digestive system is intact and works like anyone else, just with a smaller stomach.

Take in all the advice you can from your doctors & go with what you feel comfortable with. I was set on the sleeve but after talking to my doctor & a few cases of heartburn / acid reflux I have decided on the bypass but my BMI is 59 so I feel I will have a better chance at reaching my goal with the bypass.

Just a note on supplements and Vitamins since that seems to come up as a reason to go with sleeve instead of bypass. I had bypass and I take:

• 2 adult multi-vitamins a day (took 1 a day before surgery anyway)
• B12 every 2-3 days (labs were high at 3 months so he cut back)
• Calcium citrate
• Biotin

I also take D3 every 2-3 days but I had a deficiency before surgery, so I was taking that, too.

I have never been anemic and I can't tolerate Iron supplements, but I understand some people have to have those, too. It's not a requirement per se after surgery but depends on your body and lab results.

So, the Vitamin regimen is not difficult. Since I don't take iron, I can do them all at the same time in the morning. If you take iron, it has to be separate from the calcium citrate.